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Long-term non-invasive ventilation in children

Alessandro Amaddeo1, Annick Frapin2, Brigitte Fauroux1

  • 1Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker Enfants-Malades, Paris, France; Paris Descartes Faculty, Paris, France; Research Unit INSERM U955, Créteil, France.

The Lancet. Respiratory Medicine
|July 18, 2016
PubMed

Insights

Long-term non-invasive ventilation (NIV) is increasingly used in children for respiratory issues. Management requires specialized multidisciplinary centers due to diverse patient needs and conditions.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Biomedical Engineering

Background:

  • Long-term non-invasive ventilation (NIV) use in pediatric populations is rising globally.
  • NIV delivers ventilatory support via a non-invasive interface for various respiratory conditions.
  • Indications span central drive dysfunction, respiratory muscle weakness, and increased respiratory load disorders.

Purpose of the Study:

  • To review the expanding use and indications of long-term non-invasive ventilation in children.
  • To discuss the selection criteria for NIV based on pathophysiological features and technical aspects.
  • To emphasize the necessity of specialized multidisciplinary care for pediatric NIV patients.

Main Methods:

  • Literature review on the current trends and applications of pediatric non-invasive ventilation.
  • Analysis of indications, including central drive issues, muscle weakness, and increased respiratory load.
  • Discussion of technical considerations (interface, device) and management strategies.

Main Results:

  • Non-invasive ventilation (NIV) is indicated for diverse pediatric respiratory failures, requiring tailored approaches.
  • The choice of NIV modality depends on the specific pathophysiology, such as replacing central drive or supporting respiratory muscles.
  • Effective NIV management necessitates careful selection of interfaces and devices.

Conclusions:

  • The heterogeneity of pediatric respiratory conditions necessitates individualized NIV strategies.
  • Management of children requiring long-term NIV demands expertise in specialized multidisciplinary centers.
  • Expertise in sleep studies and patient therapeutic education is crucial for optimal outcomes in pediatric NIV.

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