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Non-invasive positive-pressure ventilation in children in otolaryngology

N Leboulanger1, B Fauroux

  • 1Service d'ORL et de chirurgie cervico-faciale, hôpital d'enfants Armand-Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France. nicolas.leboulanger@trs.aphp.fr

European Annals of Otorhinolaryngology, Head and Neck Diseases
|January 1, 2013
PubMed

Insights

Non-invasive positive-pressure ventilation (NPPV) effectively treats severe obstructive sleep apnea in children, often avoiding tracheotomy. Careful interface selection and specialized pediatric care are crucial for successful NPPV implementation.

Area of Science:

  • Pediatric Otolaryngology
  • Respiratory Medicine
  • Sleep Medicine

Background:

  • Obstructive upper airway diseases are prevalent in children and challenging to manage.
  • Non-invasive positive-pressure ventilation (NPPV) delivers continuous positive pressure via a non-invasive interface.
  • NPPV is a primary treatment for severe obstructive sleep apnea in children, considered before tracheotomy.

Purpose of the Study:

  • To highlight the efficacy of NPPV in pediatric obstructive airway diseases.
  • To discuss the indications for NPPV, including post-surgical persistent sleep-disordered breathing.
  • To outline the essential components for successful NPPV management in children.

Main Methods:

  • Review of NPPV application in pediatric otolaryngology and sleep-disordered breathing.
  • Discussion of interface challenges, particularly in infants.
  • Emphasis on the necessity of sleep studies and regular follow-up.

Main Results:

  • NPPV is the treatment of choice for severe pediatric obstructive sleep apnea.
  • It is indicated for persistent sleep-disordered breathing after surgery, especially in children with craniofacial malformations.
  • Simple ventilators delivering continuous positive airway pressure are often sufficient.

Conclusions:

  • The interface is a significant technical limitation for NPPV, especially in infants.
  • Sleep studies pre- and post-NPPV initiation are essential for assessing efficacy.
  • NPPV should be administered in specialized pediatric centers with expertise.
Abstract

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