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Long-term non-invasive ventilation in children with central nervous system disorders: A systematic review and

Dalal A Alzaid1, Florence Birru2, Mohammed M AlBalawi3

  • 1Division of Respiratory Medicine, Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada; Respiratory Care Program, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.

Paediatric Respiratory Reviews
|February 18, 2026
PubMed

Insights

Long-term non-invasive ventilation (LT-NIV) may improve sleep-related breathing disorders in children with central nervous system (CNS) disorders. However, limited data exist on its impact on mortality and hospitalization rates in this population.

Area of Science:

  • Pediatric Pulmonology
  • Neurology
  • Sleep Medicine

Background:

  • Long-term non-invasive ventilation (LT-NIV) is a common treatment for pediatric sleep-related breathing disorders (SRBD).
  • Children with central nervous system (CNS) disorders have a high prevalence of SRBDs.
  • The efficacy and outcomes of LT-NIV in pediatric CNS populations are not well-established.

Purpose of the Study:

  • To systematically review the existing literature on the use of LT-NIV in children with CNS disorders.
  • To assess the impact of LT-NIV on mortality, hospitalization, and respiratory parameters in this specific pediatric group.

Main Methods:

  • A systematic review and meta-analysis was conducted as a sub-study of a larger scoping review on LT-NIV in children.
  • Studies published between January 1990 and March 2024 were included, focusing on children with CNS disorders.
  • Risk of bias was assessed using the Non-Randomized Studies of Interventions tool.

Main Results:

  • Fifty-five studies involving 2,015 children with CNS disorders using LT-NIV were analyzed.
  • Meta-analysis showed no significant difference in mortality between children with and without CNS disorders.
  • Hospitalization rates appeared higher in children with CNS disorders, and LT-NIV use demonstrated reductions in the apnea-hypopnea index, though with variable individual responses.

Conclusions:

  • LT-NIV may offer benefits for pediatric patients with CNS disorders, particularly in managing SRBDs.
  • Current evidence is limited, with ongoing uncertainty regarding LT-NIV's effects on mortality and hospitalization.
  • Further research is needed to clarify the long-term outcomes of LT-NIV in children with CNS disorders.
Abstract

Keywords:
Congenital central hypoventilation syndromeMechanical ventilationMortalityPaediatricsQuality of life

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