Related Experiment Video
Updated: Dec 13, 2025
A Novel Inhalation Mask System to Deliver High Concentrations of Nitric Oxide Gas in Spontaneously Breathing Subjects
Published on: May 4, 2021
Home Overnight Gas Exchange for Long-Term Noninvasive Ventilation in Children
Lucie Griffon1,2, Samira Touil1, Annick Frapin1
1Pediatric Noninvasive Ventilation and Sleep Unit, Hôpital Necker-Enfants malades, Paris, France.
Insights
Systematic home monitoring of oxygen and carbon dioxide in children on CPAP/NIV revealed gas exchange abnormalities in about 12% of cases. These issues were often corrected with appropriate interventions, improving patient care.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Respiratory Physiology
Background:
- Continuous Positive Airway Pressure (CPAP) and Noninvasive Ventilation (NIV) aim to treat sleep-disordered breathing and nocturnal hypoxemia.
- Assessing gas exchange during home use of these therapies is crucial for stable pediatric patients.
- This study evaluated home monitoring data in children undergoing or being weaned from ventilatory support.
Purpose of the Study:
- To analyze results from systematic home pulse oximetry (SpO2) and transcutaneous carbon dioxide (PtcCO2) monitoring.
- To identify gas exchange abnormalities in pediatric subjects on long-term CPAP/NIV or during weaning trials.
- To document interventions made in response to abnormal gas exchange findings.
Main Methods:
- Home overnight SpO2 and PtcCO2 recordings were analyzed for stable pediatric subjects.
- Subjects were treated with or weaned from CPAP, NIV, or high-flow nasal cannula.
- Data collected between January 2017 and March 2018 from 79 subjects (110 recordings) were reviewed.
Main Results:
- Gas exchange abnormalities were detected in 11 subjects based on SpO2 and PtcCO2 criteria.
- Interventions included adjusting device settings (6 subjects), changing interfaces (2 subjects), or switching to high-flow nasal cannula (1 subject).
- Recording quality was generally good, with excellent results in 81% of cases.
Conclusions:
- Approximately 12% of systematic home SpO2 and PtcCO2 recordings in pediatric CPAP/NIV patients showed abnormalities.
- These abnormalities were amenable to therapeutic interventions, highlighting the value of home monitoring.
- Systematic monitoring can guide adjustments to optimize respiratory support in children.
Background:
The aim of CPAP and noninvasive ventilation (NIV) is to correct sleep-disordered breathing and nocturnal gas exchange. The aim of the study was to analyze the results of a systematic home pulse oximetry ([Formula: see text]) and transcutaneous carbon dioxide ([Formula: see text]) monitoring in stable pediatric subjects on long-term CPAP/NIV or screened for CPAP/NIV weaning, and the consequent interventions in the subjects with abnormal gas exchange.
Methods:
The home overnight [Formula: see text] and [Formula: see text] recordings of stable pediatric subjects treated with or weaned from CPAP, NIV, or high-flow nasal cannula between January 2017 and March 2018 were analyzed.
Results:
A total of 110 recordings, performed in 79 subjects, median age 6 (interquartile range [IQR] 1.5-14) y, were analyzed. Fifty-two recordings (47%) were performed during NIV, 43 (39%) during CPAP, 2 (2%) during high-flow nasal cannula, and 13 (12%) during a spontaneous ventilation weaning trial from ventilatory support. The quality of recording was excellent in 81% of recordings, 5 recordings (5%) had <4 h of recording time, 5 (5%) had artifacts on the [Formula: see text] signal, and 16 (15%) had artifacts on the [Formula: see text] signal. Gas exchange abnormalities were observed in 11 subjects with [Formula: see text] > 50 mm Hg during ≥ 2% of recording time (n = 8), mean [Formula: see text] ≥ 50 mm Hg (n = 6), mean [Formula: see text] < 35 mm Hg (n = 3), and [Formula: see text] < 90% during ≥ 2% of recording time (n = 2). Consequent interventions were (multiple interventions possible): change of device settings (n = 6), change of interface (n = 2), switched to high-flow nasal cannula (n = 1), and a control recording (n = 2).
Conclusions:
A significant number (∼12%) of systematic home [Formula: see text] and [Formula: see text] recordings in stable pediatric subjects treated with CPAP/NIV were abnormal and may be corrected by adequate therapeutic interventions.
More Related Videos
Related Concept Videos
01:23Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation...
01:16Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
01:23Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
01:14Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
01:26Oxygen Delivering System I: Nasal Cannula and Face Mask
Nasal Cannula
A nasal cannula is a lightweight tube split at one end into two prongs and placed in the nostrils. It is typically used to deliver low to medium levels of oxygen.
Suggested flow rate: The suggested flow rate for a nasal cannula typically ranges between 1 and 6 L/min.
Oxygen percentage setting:...
01:29Mechanical Ventilation I: Indication and Settings