Pediatric long‐term noninvasive respiratory support in children with central nervous system disorders

Author:

Carrara Marion1,Aubertin Guillaume123,Khirani Sonia456ORCID,Massenavette Bruno7,Bierme Priscille8,Griffon Lucie45,Ioan Iulia9ORCID,Schweitzer Cyril9,Binoche Alexandra10,Lampin Marie‐Emilie10,Mordacq Clémence11,Rubinsztajn Robert12,Debeilleix Stéphane13,Galode François13ORCID,Bui Stéphanie13,Hullo Eglantine14,Becourt Arnaud15,Lubrano Marc16,Moreau Johan1718,Renoux Marie‐Catherine17ORCID,Matecki Stefan1719,Stremler Nathalie20,Baravalle‐Einaudi Melisande20,Mazenq Julie20,Sigur Elodie21,Labouret Géraldine21,Genevois Anne‐Laure21,Heyman Rachel22,Pomedio Michael23,Masson Alexandra24,Hangard Pauline24,Menetrey Céline24,Le Clainche Laurence25ORCID,Bokov Plamen2526,Dudoignon Benjamin25ORCID,Fleurence Emmanuelle27,Bergounioux Jean28,Mbieleu Blaise28,Breining Audrey29,Giovannin‐Chami Lisa30ORCID,Fina Agnes30,Ollivier Morgane31,Gachelin Elsa32,Perisson Caroline33,Pervillé Anne34,Barzic Audrey35,Cros Pierrick35,Jokic Mickaël36,Labbé Guillaume37,Diaz Véronique38,Coutier Laurianne8ORCID,Fauroux Brigitte45ORCID,Taytard Jessica139ORCID

Affiliation:

1. Department of Pediatric Pulmonology AP‐HP, Hôpital Armand Trousseau Paris France

2. Sorbonne Université, INSERM UMR‐S 938, Centre de Recherche Saint‐Antoine (CRSA) Paris France

3. Centre de pneumologie de l'enfant Ramsay Générale de Santé Paris France

4. Pediatric Noninvasive Ventilation and Sleep Unit, AP‐HP Hôpital Necker‐Enfants malades Paris France

5. Université Paris Cité, VIFASOM Paris France

6. ASV Santé Gennevilliers France

7. Pediatric Intensive Care Unit, Hospices Civils de Lyon Hôpital Femme‐Mère‐Enfant Bron France

8. Pediatric Pulmonology and Allergology Unit Hospices Civils de Lyon Bron France

9. Department of Pediatric University Children's Hospital, CHRU Nancy; Université de Lorraine, DevAH Nancy France

10. Pediatric Intensive Care Unit Hôpital Jeanne de Flandre, CHU Lille Lille France

11. Pediatic Pulmonology and Allergology Unit Hôpital Jeanne de Flandre, CHU Lille Lille France

12. Department of Pediatric orthopedic surgery Hôpital Necker‐Enfants malades Paris France

13. Pediatric Pulmonology Unit Hôpital Pellegrin‐Enfants Bordeaux France

14. Pediatric Pulmonology Unit Hôpital Couple‐Enfant, CHU Grenoble Grenoble France

15. Pediatric Pulmonology Department CHU Amiens Picardie Amiens France

16. Respiratory Diseases, Allergy and CF Unit, Department of Pediatric University Hospital Charles Nicolle Rouen France

17. Department of Pediatric Cardiology and Pulmonology Montpellier University Hospital Montpellier France

18. Physiology and Experimental Biology of Heart and Muscles Laboratory‐PHYMEDEXP, UMR CNRS 9214, INSERM U1046 University of Montpellier Montpellier France

19. Functional Exploration Laboratory University Hospital Montpellier France

20. Pediatric Ventilation Unit, Department of Pediatric AP‐HM, Hôpital La Timone Marseille France

21. Pediatric Pulmonology and Allergology Unit Hôpital des Enfants Toulouse France

22. Pediatric Unit, Department of Physical Medicine and Rehabilitation Hôpital Pontchaillou Rennes France

23. Pediatric Intensive Care Unit American Memorial Hospital, CHU Reims Reims France

24. Pediatric Unit Hôpital de la Mère et de l'Enfant Limoges France

25. Pediatric Noninvasive Ventilation Unit, AP‐HP Hôpital Robert Debré Paris France

26. Université Paris Cité, INSERM NeuroDiderot Paris France

27. ESEAN‐APF Health Center for Children and Adolescents Nantes France

28. Pediatric Intensive Care Unit, AP‐HP Hôpital Raymond Poincaré Garches France

29. Department of Pediatric CHU Strasbourg Strasbourg France

30. Department of Pediatric Pulmonology and Allergology Hôpitaux pédiatriques de Nice CHU‐Lenval Nice France

31. Pediatric Intensive Care Unit, CHU Angers Angers France

32. Department of Pediatric CHU Félix Guyon Saint Denis La Réunion France

33. Department of Pediatric CHU Sud Réunion Saint Pierre La Réunion France

34. Department of Pédiatrics Hôpital d'Enfants—ASFA Saint Denis La Réunion France

35. Department of Pediatric CHU Brest Brest France

36. Pediatric Intensive Care Unit CHU de Caen Normandie Caen France

37. Pediatric Pulmonology and Allergology Unit CHU d'Estaing Clermont‐Ferrand France

38. Department of Respiratory Physiology CHU Poitiers Poitiers France

39. INSERM UMR‐S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique" Sorbonne Université, Paris, France Paris France

Abstract

AbstractRationaleThe use of long‐term noninvasive respiratory support is increasing in children along with an extension of indications, in particular in children with central nervous system (CNS) disorders.ObjectiveThe aim of this study was to describe the characteristics of children with CNS disorders treated with long‐term noninvasive respiratory support in France.MethodsData were collected from 27 French pediatric university centers through an anonymous questionnaire filled for every child treated with noninvasive ventilatory support ≥3 months on 1st June 2019.Main ResultsThe data of 182 patients (55% boys, median age: 10.2 [5.4;14.8] years old [range: 0.3–25]) were collected: 35 (19%) patients had nontumoral spinal cord injury, 22 (12%) CNS tumors, 63 (35%) multiple disabilities, 26 (14%) central alveolar hypoventilation and 36 (20%) other CNS disorders. Seventy five percent of the patients were treated with noninvasive ventilation (NIV) and 25% with continuous positive airway pressure (CPAP). The main investigations performed before CPAP/NIV initiation were nocturnal gas exchange recordings, alone or coupled with poly(somno)graphy (in 29% and 34% of the patients, respectively). CPAP/NIV was started in an acute setting in 10% of the patients. Median adherence was 8 [6;10] hours/night, with 12% of patients using treatment <4 h/day. Nasal mask was the most common interface (70%). Airway clearance techniques were used by 31% of patients.ConclusionCPAP/NIV may be a therapeutic option in children with CNS disorders. Future studies should assess treatment efficacy and patient reported outcome measures.

Publisher

Wiley

Subject

Pulmonary and Respiratory Medicine,Pediatrics, Perinatology and Child Health

Reference36 articles.

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