Focus area: Physicians
Long term non-invasive ventilation: how do we wean chidren?
A significant number of children are able to discontinue long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) but we need to study the underlying disorders, weaning criteria, and outcome of these children.
This study is a retrospective cohort follow up of children who are able to discontinue long term CPAP and NIV.
Authors analysed data about 213 patients on long term CPAP/NIV: Fifty eight (27%) could be weaned from CPAP/NIV. Most patients were young children with upper airway anomalies, Prader Willi syndrome or bronchopulmonary dysplasia.
CPAP/NIV was discontinued following spontaneous improvement of sleep‐disordered breathing in 33 (57%) patients, upper airway surgery (n = 14, 24%), maxillofacial surgery (n = 6, 11%), neurosurgery (n = 1, 2%), upper airway and neurosurgery (n = 2, 3%), or switch to oxygen therapy (n = 2, 3%).
CPAP/NIV was discontinued due to normal nocturnal gas exchange during spontaneous breathing in all patients.
Authors concluded that weaning from long term CPAP/NIV is possible in children but is highly dependent on the underlying disorder and long term follow‐up is necessary in children with underlying disorders.
Ref.: Weaning from long term continuous positive airway pressure or noninvasive ventilation in children. Meriem Mastouri MD et al.
Pediatr Pulmonol. 2017 Oct;52(10):1349-1354. doi: 10.1002/ppul.23767. Epub 2017 Jul 17.