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Continuous positive airway pressure for children: a discussion on how to maximize compliance
Valerie G Kirk1, Anne R O'Donnell
1Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada T2T 5C7. val.kirk@calgaryhealthregion.ca
Insights
Initiating continuous positive airway pressure (CPAP) for pediatric sleep-disordered breathing requires specialized approaches. This review offers strategies to improve CPAP cooperation and adherence in children needing this vital respiratory support.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Respiratory Therapy
Background:
- Increasing identification of pediatric sleep-disordered breathing (SDB) necessitates effective treatments like continuous positive airway pressure (CPAP).
- Pediatric CPAP implementation faces challenges due to limited center experience compared to adult treatment.
- A significant proportion of children exhibit non-compliance upon initial CPAP exposure.
Purpose of the Study:
- To outline a specialized approach for initiating CPAP therapy in pediatric patients.
- To provide troubleshooting strategies for maximizing initial and ongoing CPAP compliance in children.
Main Methods:
- This is a review article, synthesizing existing knowledge and clinical experience.
- Focuses on practical strategies for patient and family education and support.
- Highlights techniques for managing behavioral and technical challenges in pediatric CPAP use.
Main Results:
- Successful CPAP initiation in children demands tailored strategies distinct from adult protocols.
- Addressing non-compliance requires proactive management, including desensitization and positive reinforcement.
- Family involvement is crucial for sustained adherence and treatment efficacy.
Conclusions:
- A specialized, family-centered approach is essential for successful pediatric CPAP therapy.
- Effective troubleshooting can overcome common barriers to CPAP adherence in children.
- Optimizing CPAP use in pediatric SDB improves patient outcomes and quality of life.
Abstract:
As pediatric sleep facilities and resources expand, increasing numbers of children with sleep-disordered breathing requiring continuous positive airway pressure (CPAP) treatment are being identified. Despite extensive expertise in treating adults with CPAP, many centres have little experience using CPAP in the pediatric population. The successful initiation and continued effective treatment with CPAP requires a unique and specialized approach to the pediatric patient and their family. Nearly, half of children needing CPAP will be uncooperative upon initial exposure to this unusual treatment. This review aims to outline an approach to the successful initiation of CPAP treatment in children including some trouble-shooting strategies to maximize initial and ongoing compliance with prescribed therapy.
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