Non-invasive respiratory support in children and young adults with complex medical conditions in pediatric palliative care

Title

Non-invasive respiratory support in children and young adults with complex medical conditions in pediatric palliative care

Creator

Fauroux B; Taytard J; Ioan I; Lubrano M; Le Clainche L; Bokov P; Dudoignon B; Debelleix S; Galode F; Coutier L; Sigur E; Labouret G; Ollivier M; Binoche A; Bergougnioux J; Mbieleu B; Essid A; Hullo E; Barzic A; Moreau J; Jokic M; Denamur S; Aubertin G; Schweitzer C

Publisher

Archives of Disease in Childhood

Date

2024

Subject

palliative therapy; dyspnea; randomized controlled trial; chromosome aberration; human; article; child; female; male; controlled study; diagnosis; clinical article; young adult; apnea hypopnea index; therapy; acute respiratory failure; noninvasive ventilation; sleep quality; continuous positive airway pressure; sleep time; sleep apnea syndromes; gas exchange

Description

Objective: Dyspnoea and sleep-disordered breathing (SDB) are common in children with life-limiting conditions but studies on treatment with non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) are scarce. The aim of the study was to describe children treated with long-term NIV/CPAP within a paediatric palliative care programme in France. Methods: Cross-sectional survey on children and young adults with complex medical conditions treated within the French paediatric NIV network with long-term NIV/CPAP. Characteristics of the patients were analysed and patient-related outcome measures of NIV/CPAP benefit were reported. Results: The data of 50 patients (68% boys), median age 12 (0.4-21) years were analysed. Twenty-three (46%) patients had a disorder of the central nervous system and 5 (10%) a chromosomal anomaly. Thirty-two (64%) patients were treated with NIV and 18 (36%) with CPAP. NIV/CPAP was initiated on an abnormal Apnoea-Hypopnoea Index in 18 (36%) of the patients, an abnormal nocturnal gas exchange alone in 28 (56%), and after an acute respiratory failure in 11 (22%) of the patients. Mean objective NIV/CPAP adherence was 9.3±3.7 hours/night. NIV/CPAP was associated with a decrease in dyspnoea in 60% of patients, an increase in sleep duration in 60% and in sleep quality in 74%, and an improvement in parents' sleep in 40%. Conclusions: In children with life-limiting conditions, long-term NIV/CPAP may be associated with relief of dyspnoea, an improvement of SDB and an improvement in parents' sleep.

Rights

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Citation List Month

September List 2024

Collection

Citation

Fauroux B; Taytard J; Ioan I; Lubrano M; Le Clainche L; Bokov P; Dudoignon B; Debelleix S; Galode F; Coutier L; Sigur E; Labouret G; Ollivier M; Binoche A; Bergougnioux J; Mbieleu B; Essid A; Hullo E; Barzic A; Moreau J; Jokic M; Denamur S; Aubertin G; Schweitzer C, “Non-invasive respiratory support in children and young adults with complex medical conditions in pediatric palliative care,” Pediatric Palliative Care Library, accessed February 10, 2025, https://pedpalascnetlibrary.omeka.net/items/show/19725.