Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience
IntroductionChildren with severe tracheobronchomalacia may need placements of tracheostomies and long-term mechanical ventilation. Due to financial constraints, continuous positive airway pressure (CPAP) machines commonly used to treat obstructive sleep apnea in adults have been utilized to deliver...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2023.1169613/full |
| _version_ | 1797815097016451072 |
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| author | Tidarat Sriboonyong Aroonwan Preutthipan Malinee Nugboon |
| author_facet | Tidarat Sriboonyong Aroonwan Preutthipan Malinee Nugboon |
| author_sort | Tidarat Sriboonyong |
| collection | DOAJ |
| description | IntroductionChildren with severe tracheobronchomalacia may need placements of tracheostomies and long-term mechanical ventilation. Due to financial constraints, continuous positive airway pressure (CPAP) machines commonly used to treat obstructive sleep apnea in adults have been utilized to deliver positive distending pressure to such children at our institution for more than 20 years with favorable outcomes. We, therefore, reported our experience with 15 children using this machine.MethodsThis is a retrospective study during 2001–2021.ResultsFifteen children, 9 boys, aged ranged 3 months–5.6 years, were discharged home with CPAP via tracheostomies. All had co-morbidities including gastroesophageal reflux (n = 9, 60%), neuromuscular disorders (n = 6, 40%), genetic abnormalities (n = 6, 40%), cardiac diseases (n = 4, 27%) and chronic lungs (n = 3, 20%). Eight (53%) children were aged less than 1 year old. The smallest child was aged 3 months old, weighing 4.9 kg. All caregivers were relatives and non-medical health professionals. The 1-month and 1-year readmission rates were 13% and 66% respectively. No factor-associated unfavorable outcomes were statistically identified. No complications related to CPAP malfunction were found. Five (33%) were weaned off CPAP, and 3 died (2 from sepsis and 1 from a sudden unknown cause).ConclusionWe first reported the use of sleep apnea CPAP via tracheostomy in children with severe tracheomalacia. In limited-resource countries, this simple device may be another option for long-term invasive ventilatory support. The CPAP use in children with tracheobronchomalacia requires adequately trained caregivers. |
| first_indexed | 2024-03-13T08:16:31Z |
| format | Article |
| id | doaj.art-5588040f5444415c96c5ad04369796cb |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-03-13T08:16:31Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-5588040f5444415c96c5ad04369796cb2023-05-31T15:05:32ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-05-011110.3389/fped.2023.11696131169613Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experienceTidarat Sriboonyong0Aroonwan Preutthipan1Malinee Nugboon2Division of Pediatric Pulmonology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDivision of Pediatric Pulmonology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandNursing Affairs, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandIntroductionChildren with severe tracheobronchomalacia may need placements of tracheostomies and long-term mechanical ventilation. Due to financial constraints, continuous positive airway pressure (CPAP) machines commonly used to treat obstructive sleep apnea in adults have been utilized to deliver positive distending pressure to such children at our institution for more than 20 years with favorable outcomes. We, therefore, reported our experience with 15 children using this machine.MethodsThis is a retrospective study during 2001–2021.ResultsFifteen children, 9 boys, aged ranged 3 months–5.6 years, were discharged home with CPAP via tracheostomies. All had co-morbidities including gastroesophageal reflux (n = 9, 60%), neuromuscular disorders (n = 6, 40%), genetic abnormalities (n = 6, 40%), cardiac diseases (n = 4, 27%) and chronic lungs (n = 3, 20%). Eight (53%) children were aged less than 1 year old. The smallest child was aged 3 months old, weighing 4.9 kg. All caregivers were relatives and non-medical health professionals. The 1-month and 1-year readmission rates were 13% and 66% respectively. No factor-associated unfavorable outcomes were statistically identified. No complications related to CPAP malfunction were found. Five (33%) were weaned off CPAP, and 3 died (2 from sepsis and 1 from a sudden unknown cause).ConclusionWe first reported the use of sleep apnea CPAP via tracheostomy in children with severe tracheomalacia. In limited-resource countries, this simple device may be another option for long-term invasive ventilatory support. The CPAP use in children with tracheobronchomalacia requires adequately trained caregivers.https://www.frontiersin.org/articles/10.3389/fped.2023.1169613/fulltracheostomytracheomalaciachildrencontinuous positive airway pressureinvasive ventilatory support |
| spellingShingle | Tidarat Sriboonyong Aroonwan Preutthipan Malinee Nugboon Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience Frontiers in Pediatrics tracheostomy tracheomalacia children continuous positive airway pressure invasive ventilatory support |
| title | Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience |
| title_full | Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience |
| title_fullStr | Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience |
| title_full_unstemmed | Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience |
| title_short | Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience |
| title_sort | long term sleep apnea cpap via tracheostomy in children with tracheomalacia 20 year experience |
| topic | tracheostomy tracheomalacia children continuous positive airway pressure invasive ventilatory support |
| url | https://www.frontiersin.org/articles/10.3389/fped.2023.1169613/full |
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