Non-invasive Ventilation for Children With Chronic Lung Disease
Advances in medical care and supportive care options have contributed to the survival of children with complex disorders, including children with chronic lung disease. By delivering a positive pressure or a volume during the patient's inspiration, NIV is able to reverse nocturnal alveolar hypov...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2020.561639/full |
| _version_ | 1818870811389329408 |
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| author | Emine Atag Uros Krivec Refika Ersu |
| author_facet | Emine Atag Uros Krivec Refika Ersu |
| author_sort | Emine Atag |
| collection | DOAJ |
| description | Advances in medical care and supportive care options have contributed to the survival of children with complex disorders, including children with chronic lung disease. By delivering a positive pressure or a volume during the patient's inspiration, NIV is able to reverse nocturnal alveolar hypoventilation in patients who experience hypoventilation during sleep, such as patients with chronic lung disease. Bronchopulmonary dysplasia (BPD) is a common complication of prematurity, and despite significant advances in neonatal care over recent decades its incidence has not diminished. Most affected infants have mild disease and require a short period of oxygen supplementation or respiratory support. However, severely affected infants can become dependent on positive pressure support for a prolonged period. In case of established severe BPD, respiratory support with non-invasive or invasive positive pressure ventilation is required. Patients with cystic fibrosis (CF) and advanced lung disease develop hypoxaemia and hypercapnia during sleep and hypoventilation during sleep usually predates daytime hypercapnia. Hypoxaemia and hypercapnia indicates poor prognosis and prompts referral for lung transplantation. The prevention of respiratory failure during sleep in CF may prolong survival. Long-term oxygen therapy has not been shown to improve survival in people with CF. A Cochrane review on the use NIV in CF concluded that NIV in combination with oxygen therapy improves gas exchange during sleep to a greater extent than oxygen therapy alone in people with moderate to severe CF lung disease. Uncontrolled, non-randomized studies suggest survival benefit with NIV in addition to being an effective bridge to transplantation. Complications of NIV relate mainly to prolonged use of a face or nasal mask which can lead to skin trauma, and neurodevelopmental delay by acting as a physical barrier to social interaction. Another associated risk is pulmonary aspiration caused by vomiting whilst wearing a face mask. Adherence to NIV is one of the major barriers to treatment in children. This article will review the current evidence for indications, adverse effects and long term follow up including adherence to NIV in children with chronic lung disease. |
| first_indexed | 2024-12-19T12:12:57Z |
| format | Article |
| id | doaj.art-061c413219844eea84cdcd655d8de4c3 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-19T12:12:57Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-061c413219844eea84cdcd655d8de4c32022-12-21T20:22:06ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602020-11-01810.3389/fped.2020.561639561639Non-invasive Ventilation for Children With Chronic Lung DiseaseEmine Atag0Uros Krivec1Refika Ersu2Division of Pediatric Pulmonology, Medipol University, Istanbul, TurkeyDivision of Pediatric Pulmonology, University Children's Hospital, University Medical Centre, Ljubljana, SloveniaDivision of Pediatric Respirology, Children's Hospital of Ontario, University of Ottawa, Ottawa, ON, CanadaAdvances in medical care and supportive care options have contributed to the survival of children with complex disorders, including children with chronic lung disease. By delivering a positive pressure or a volume during the patient's inspiration, NIV is able to reverse nocturnal alveolar hypoventilation in patients who experience hypoventilation during sleep, such as patients with chronic lung disease. Bronchopulmonary dysplasia (BPD) is a common complication of prematurity, and despite significant advances in neonatal care over recent decades its incidence has not diminished. Most affected infants have mild disease and require a short period of oxygen supplementation or respiratory support. However, severely affected infants can become dependent on positive pressure support for a prolonged period. In case of established severe BPD, respiratory support with non-invasive or invasive positive pressure ventilation is required. Patients with cystic fibrosis (CF) and advanced lung disease develop hypoxaemia and hypercapnia during sleep and hypoventilation during sleep usually predates daytime hypercapnia. Hypoxaemia and hypercapnia indicates poor prognosis and prompts referral for lung transplantation. The prevention of respiratory failure during sleep in CF may prolong survival. Long-term oxygen therapy has not been shown to improve survival in people with CF. A Cochrane review on the use NIV in CF concluded that NIV in combination with oxygen therapy improves gas exchange during sleep to a greater extent than oxygen therapy alone in people with moderate to severe CF lung disease. Uncontrolled, non-randomized studies suggest survival benefit with NIV in addition to being an effective bridge to transplantation. Complications of NIV relate mainly to prolonged use of a face or nasal mask which can lead to skin trauma, and neurodevelopmental delay by acting as a physical barrier to social interaction. Another associated risk is pulmonary aspiration caused by vomiting whilst wearing a face mask. Adherence to NIV is one of the major barriers to treatment in children. This article will review the current evidence for indications, adverse effects and long term follow up including adherence to NIV in children with chronic lung disease.https://www.frontiersin.org/articles/10.3389/fped.2020.561639/fullchildrenchronic lung disease in childhoodNon-invasive Ventilation (NIV)cystic fibrosisBronchopulmonary Dysplasia (BPD) |
| spellingShingle | Emine Atag Uros Krivec Refika Ersu Non-invasive Ventilation for Children With Chronic Lung Disease Frontiers in Pediatrics children chronic lung disease in childhood Non-invasive Ventilation (NIV) cystic fibrosis Bronchopulmonary Dysplasia (BPD) |
| title | Non-invasive Ventilation for Children With Chronic Lung Disease |
| title_full | Non-invasive Ventilation for Children With Chronic Lung Disease |
| title_fullStr | Non-invasive Ventilation for Children With Chronic Lung Disease |
| title_full_unstemmed | Non-invasive Ventilation for Children With Chronic Lung Disease |
| title_short | Non-invasive Ventilation for Children With Chronic Lung Disease |
| title_sort | non invasive ventilation for children with chronic lung disease |
| topic | children chronic lung disease in childhood Non-invasive Ventilation (NIV) cystic fibrosis Bronchopulmonary Dysplasia (BPD) |
| url | https://www.frontiersin.org/articles/10.3389/fped.2020.561639/full |
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