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Outcome of paediatric domiciliary mask ventilation in neuromuscular and skeletal disease

A K Simonds1, S Ward, S Heather

  • 1Sleep & Ventilation Unit, Royal Brompton and Harefield NHS Trust, London, UK.

The European Respiratory Journal
|October 12, 2000
PubMed

Insights

Noninvasive mask ventilation is effective for children with chronic respiratory failure from neuromuscular or skeletal conditions. This approach successfully improved blood oxygen and carbon dioxide levels in pediatric patients.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Biomedical Engineering

Background:

  • Noninvasive positive pressure ventilation (NIPPV) via mask is established for adults with chronic ventilatory failure.
  • Paediatric tolerance and efficacy of mask ventilation for respiratory insufficiency were previously uncertain.
  • Limited data existed on mask ventilation's impact on nocturnal and arterial blood gas control in children.

Purpose of the Study:

  • To assess the feasibility and efficacy of domiciliary mask ventilation in paediatric patients with ventilatory insufficiency.
  • To evaluate the effects of mask ventilation on nocturnal and diurnal arterial blood gas parameters in children.
  • To determine long-term tolerance of mask ventilatory support in a paediatric cohort.

Main Methods:

  • Domiciliary mask ventilation was implemented in 40 children (9 months-16 years) with ventilatory insufficiency from congenital neuromuscular and skeletal diseases.
  • Patients presented with conditions including symptomatic nocturnal hypoventilation, diurnal ventilatory failure, weaning needs, and chest infections.
  • Arterial blood gases (PaO2, PaCO2) and transcutaneous carbon dioxide (PtcCO2) were monitored before and after ventilation initiation.

Main Results:

  • Thirty-eight of 40 children tolerated mask ventilatory support long-term.
  • Diurnal PaO2 significantly increased (8.5 to 10.9 kPa) and PaCO2 significantly decreased (7.0 to 5.9 kPa).
  • Nocturnal PaO2 and PtcCO2 levels showed significant improvements in the monitored subgroup.

Conclusions:

  • Domiciliary mask ventilation is a successful treatment for paediatric ventilatory insufficiency.
  • This method effectively reverses respiratory insufficiency in children with congenital neuromuscular and skeletal diseases.
  • Mask ventilation offers a viable and well-tolerated therapeutic option for pediatric respiratory support.

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