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Use of Noninvasive Ventilation with Volume-Assured Pressure Support to Avoid Tracheostomy in Severe Obstructive Sleep

Montserrat Diaz-Abad1, Amal Isaiah2, Valerie E Rogers3

  • 1Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Case Reports in Pediatrics
|November 8, 2018
PubMed

Insights

Severe obstructive sleep apnea (OSA) in an obese child was successfully treated with a novel noninvasive ventilation (NIV) mode, avoiding tracheostomy. This volume-assured pressure support (VAPS) offers a new option for refractory pediatric OSA cases.

Area of Science:

  • Pediatric Pulmonology
  • Sleep Medicine
  • Critical Care

Background:

  • Obstructive sleep apnea (OSA) is prevalent in children, with obesity increasing treatment risks.
  • Standard treatments like adenotonsillectomy and CPAP may fail in severe pediatric OSA.
  • Tracheostomy is reserved for critically ill children or those unresponsive to other therapies.

Observation:

  • An 8-year-old patient with morbid obesity and severe OSA showed resistance to CPAP therapy.
  • The patient faced potential significant morbidity with conventional treatment options.

Findings:

  • A novel noninvasive ventilation (NIV) mode utilizing volume-assured pressure support (VAPS) was implemented.
  • This VAPS therapy successfully managed the patient's severe OSA and hypoxemia.
  • The patient successfully avoided a tracheostomy.

Implications:

  • Volume-assured pressure support (VAPS) presents a promising alternative for pediatric OSA refractory to CPAP.
  • This NIV approach may reduce the need for tracheostomy in complex pediatric cases.
  • Further research into VAPS for pediatric OSA is warranted to establish its efficacy and safety profile.

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