Mask interfaces and devices for home noninvasive ventilation in children

Area of Science:

• Pediatric Respiratory Medicine
• Biomedical Engineering

Background:

• Home noninvasive ventilation (NIV), encompassing CPAP and BiPAP, is increasingly utilized in pediatric care globally.
• Current NIV equipment is largely designed for adults, posing challenges for pediatric application, particularly in younger children.

Purpose of the Study:

• To provide a comprehensive review of home NIV equipment for pediatric patients (excluding neonates).
• To identify challenges and limitations in current pediatric NIV use, including interface fit and device adaptation.
• To highlight areas requiring future research for optimizing long-term home NIV in children.

Main Methods:

• This study is a narrative review of existing literature on home NIV in pediatrics.
• It synthesizes information on available interfaces and devices, their characteristics, and limitations.
• It also reviews management strategies for side effects and discusses optimal mask fit.

Main Results:

• Few masks are specifically designed for young children, though older children have more options.
• Skin injuries remain a concern, necessitating rapid management.
• There is a lack of recent studies on orofacial anomalies and optimal mask fitting strategies for pediatric NIV.
• Existing NIV devices may not adequately detect pediatric breathing patterns, impacting ventilatory efficiency and monitoring.
• Studies are lacking to guide device selection and optimal management strategies for home NIV in children.

Conclusions:

• Optimizing home NIV in children requires specialized equipment, including interfaces and devices adapted for pediatric use.
• Close follow-up and regular monitoring are crucial for managing side effects and ensuring therapy efficacy.
• Further research is needed to guide the selection of appropriate devices and management protocols for long-term pediatric NIV.