Upper airway obstructive events on noninvasive ventilation in NMD adolescents

Simona Basilicata; Lucie Griffon; Clément Poirault; Brigitte Fauroux; Nevena Jovicic; Alessandro Amaddeo; Sonia Khirani

doi:10.1016/j.sleep.2024.12.015

Upper airway obstructive events on noninvasive ventilation in NMD adolescents

Sleep Med. 2024 Dec 17:126:235-238. doi: 10.1016/j.sleep.2024.12.015. Online ahead of print.

Authors

Simona Basilicata¹, Lucie Griffon², Clément Poirault³, Brigitte Fauroux², Nevena Jovicic⁴, Alessandro Amaddeo⁵, Sonia Khirani⁶

Affiliations

¹ Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy; Department of Translational Medical Sciences, Pediatric Pulmonology, Federico II University, Naples, Italy.
² Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP Necker Hospital, Paris, France; Université de Paris Cité, EA 7330 VIFASOM, Paris, France.
³ Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP Necker Hospital, Paris, France.
⁴ Department of Pulmonology, University Children's Hospital, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
⁵ Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy.
⁶ Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP Necker Hospital, Paris, France; Université de Paris Cité, EA 7330 VIFASOM, Paris, France; ASV Santé, Gennevilliers, France. Electronic address: [email protected].

PMID: 39721359
DOI: 10.1016/j.sleep.2024.12.015

Abstract

Home noninvasive ventilation (NIV) is expanding worldwide for pediatrics and is mainly indicated to treat nocturnal alveolar hypoventilation. Nasal mask is the most common interface used in children, but oronasal mask may be indicated in case of excessive mouth leaks or facial weakness. Obstructive events caused by the oronasal mask have been reported in a few studies on adult patients, but never in pediatrics. Some strategies to prevent their occurrence have been proposed, such as the increase of expiratory positive airway pressure (EPAP), the use of automatic adjusted EPAP or the switch to a nasal mask. We report here the cases of 2 adolescents with neuromuscular diseases, who experienced upper airway obstructive events by an oronasal mask. The management of these patients to improve NIV efficacy is described and discussed in line with the adult literature.