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Factors Associated with Changes in Invasive and Noninvasive Positive Airway Pressure Therapy Settings during

Suhail Al-Saleh1,2, Priya Sayal2, Derek Stephens3

  • 1Division of Respiratory Medicine, Hospital for Sick Children, Toronto, Canada.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|October 7, 2016
PubMed

Insights

Pediatric patients on positive airway pressure therapy are more likely to have their settings adjusted during polysomnography (PSG) if initiated recently, using bilevel positive airway pressure (BPAP), or having central nervous system/musculoskeletal diagnoses.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Respiratory Care

Background:

  • Positive airway pressure (PAP) therapy is crucial for managing pediatric respiratory conditions.
  • Polysomnography (PSG) with technology titration is essential for optimizing PAP settings.
  • Efficient allocation of PSG resources is vital due to limited availability.

Purpose of the Study:

  • To identify clinical predictors of setting changes during positive airway pressure (PAP) therapy titration.
  • To inform resource allocation for pediatric polysomnography (PSG).

Main Methods:

  • Retrospective review of 274 children undergoing PSG for technology titration.
  • Included patients used continuous positive airway pressure (CPAP), bilevel positive airway pressure (BPAP), or invasive positive pressure ventilation (IPPV).
  • Primary outcome: predictors of setting changes during IPPV, CPAP, and BPAP titration.

Main Results:

  • 623 titration PSGs were analyzed.
  • Significant predictors of setting changes included: reason for respiratory technology, type of respiratory technology, and time since ventilation initiation.
  • Most patients underwent BPAP titration (n=166).

Conclusions:

  • Shorter time from technology initiation predicted setting changes.
  • BPAP use was associated with higher likelihood of setting changes compared to CPAP or IPPV.
  • Central nervous system or musculoskeletal diagnoses were linked to increased likelihood of setting adjustments.
Abstract

Keywords:
pediatricpolysomnogrampositive airway pressure therapyrespiratory

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