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Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
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Early use of Nasal-BiPAP in two infants with Congenital Central Hypoventilation syndrome

C Migliori1, A Cavazza, M Motta

  • 1Division of Neonatology and Neonatal Intensive Care, Spedali Civili, Brescia, Italy. claudio.migliori@tin.it

Acta Paediatrica (Oslo, Norway : 1992)
|August 2, 2003
PubMed

Insights

Nasal Bilevel Positive Airway Pressure (N-BiPAP) effectively ventilated two infants with Congenital Central Hypoventilation syndrome (CCHS). This non-invasive approach improved oxygenation and reduced the need for prolonged intubation or tracheotomy.

Area of Science:

  • Pediatric Pulmonology
  • Neonatal Intensive Care
  • Respiratory Physiology

Background:

  • Congenital Central Hypoventilation syndrome (CCHS) often necessitates prolonged mechanical ventilation.
  • Artificial ventilation in infants carries risks such as intubation-related complications and tracheotomy dependence.

Observation:

  • Two term infants diagnosed with CCHS were treated with Nasal Bilevel Positive Airway Pressure (N-BiPAP).
  • The infants received N-BiPAP at ages 53 and 31 days, with initial weights of 4030g and 3100g.

Findings:

  • N-BiPAP significantly improved transcutaneous oxygen (tcPO2) and carbon dioxide (tcPCO2) levels during sleep in both infants.
  • While minor complications like skin abrasion and reflux occurred, they did not require cessation of N-BiPAP therapy.
  • The use of N-BiPAP successfully avoided prolonged intubation and tracheotomy in these CCHS patients.

Implications:

  • Early implementation of N-BiPAP in CCHS infants can mitigate the adverse effects of invasive ventilation.
  • Non-invasive ventilation strategies like N-BiPAP offer a promising alternative for managing CCHS.
  • Careful monitoring is crucial for optimizing N-BiPAP therapy and managing potential side effects in infants with CCHS.
Abstract

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