Paediatric long term continuous positive airway pressure and noninvasive ventilation in France: A cross-sectional study - 21/05/21

Doi : 10.1016/j.rmed.2021.106388

Brigitte Fauroux ^a,^b,^⁎ , Sonia Khirani ^a,^b,^c, Alessandro Amaddeo ^a,^b, Bruno Massenavette ^d, Priscille Bierme ^e, Jessica Taytard ^f,^g, Nathalie Stremler ^h, Melisande Baravalle-Einaudi ^h, Julie Mazenq ^h, Iulia Ioan ⁱ, Cyril Schweitzer ⁱ, Marie Emilie Lampin ^j, Alexandra Binoche ^j, Clemence Mordacq ^k, Jean Bergounioux ^l, Blaise Mbieleu ^l, Robert Rubinsztajn ^m, Elodie Sigur ⁿ, Geraldine Labouret ⁿ, Aline Genevois ⁿ, Arnaud Becourt ^o, Eglantine Hullo ^p, Isabelle Pin ^p,^q,^r, Stéphane Debelleix ^s, François Galodé ^s, Stéphanie Bui ^s, Johan Moreau ^t,^u, Marie Catherine Renoux ^t, Stefan Matecki ^t,^v, Marc Lubrano Lavadera ^w, Rachel Heyman ^x, Michael Pomedio ^y, Laurence Le Clainche ^z, Plamen Bokov ^z, Alexandra Masson ^aa, Pauline Hangard ^aa, Celine Menetrey ^aa, Mikael Jokic ^ab, Elsa Gachelin ^ac, Caroline Perisson ^ad, Anne Pervillé ^ae, Agnes Fina ^af, Lisa Giovannini-Chami ^af, Emmanuelle Fleurence ^ag, Audrey Barzic ^ah, Audrey Breining ^ai, Morgane Ollivier ^aj, Guillaume Labbé ^ak, Laurianne Coutier ^d, Guillaume Aubertin ^e,^al,^am
^a Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, F-75015, Paris, France
^b Université de Paris, VIFASOM, F-75004, Paris, France
^c ASV Santé, F-92000, Gennevilliers, France
^d Paediatric Intensive Care Unit, Hospices Civils de Lyon, Hôpital Femme-Mère-Enfant, 69677, Bron, France
^e Pediatric Pulmonology and Allergology Unit, Hospices Civils de Lyon, 69677, Bron, France
^f Pediatric Pulmonology Department, AP-HP, Hôpital Armand Trousseau, F-75012, Paris, France
^g Sorbonne Université, INSERM UMR-S, 1158, Paris, France
^h Pediatric Ventilation Unit, Pediatric Department, AP-HM, Hôpital La Timone, 13385, Marseille, France
ⁱ Pediatric Department, University Children's Hospital, CHRU Nanc, Université de Lorraine, DevAH, F-54000, Nancy, France
^j Pediatric Intensive Care Unit, Hôpital Jeanne de Flandre, CHU Lille, Avenue Eugène Avinée, 59037, Lille Cédex, France
^k Pediatic Pulmonology and Allergology Unit, Hôpital Jeanne de Flandre, CHU Lille, Avenue Eugène Avinée, 59037, Lille Cédex, France
^l Pediatric Intensive Care Unit, AP-HP, Hôpital Raymond Poincaré, F-92380, Garches, France
^m Hôpital Necker-Enfants Malades, F-75015, Paris, France
ⁿ Pediatric Pulmonology and Allergology Unit, Hôpital des Enfants, 31000, Toulouse, France
^o Pediatric Pulmonology, CHU Amiens Picardie, 80054, France
^p Pediatric Pulmonology Unit, Hôpital Couple-Enfant, CHU Grenoble, 38000, Grenoble, France
^q INSERM, Institute for Advanced Biosciences, 38000, Grenoble, France
^r Grenoble Alpes University, 38000, Grenoble, France
^s Pediatric Pulmonology Unit, Hôpital Pellegrin-Enfants, CIC-P Bordeaux 1401, CHU de Bordeaux, 33076, Bordeaux, France
^t Pediatric Cardiology and Pulmonology Department, Montpellier University Hospital, 34000, Montpellier, France
^u Physiology and Experimental Biology of Heart and Muscles Laboratory-PHYMEDEXP, UMR CNRS 9214, INSERM U1046, University of Montpellier, 34000, Montpellier, France
^v Functional Exploration Laboratory, Physiology Department, University Hospital, 34000, Montpellier, France
^w Respiratory Diseases, Allergy and CF Unit, Pediatric Department, University Hospital Charles Nicolle, 76000, Rouen, France
^x Pediatric Unit, Department of Physical Medicine and Rehabilitation, Hôpital Pontchaillou, Rennes, 35033, Rennes, France
^y Pediatric Intensive Care Unit, American Memorial Hospital, CHU Reims, 51000, Reims, France
^z Pediatric Noninvasive Ventilation, AP-HP, Hôpital Robert Debré, F-75018, Paris, France
^aa Pediatric Unit, Hôpital de la Mère et de l'Enfant, 87042, Limoges, France
^ab Pediatric Intensive Care Unit, CHU de Caen Normandie, 14033, Caen, France
^ac Pediatric Department, CHU Félix Guyon, F-97404, Saint Denis, La Réunion, France
^ad Pediatric Department, CHU Sud Réunion, F-97448, Saint Pierre, La Réunion, France
^ae Hôpital d'Enfants – ASFA, F-97404, Saint Denis, La Réunion, France
^af Pediatric Pulmonology and Allergology Department, Hôpitaux Pédiatriques de Nice CHU-Lenval, Nice, France
^ag ESEAN-APF, Health Center for Children and Adolescents, 44200, Nantes, France
^ah Pediatric Department, CHU Brest, 29200, Brest, France
^ai Pediatric Department, CHU Strasbourg, 67000, Strasbourg, France
^aj Pediatric Intensive Care Unit, CHU Angers, 49100, Angers, France
^ak Pediatric Pulmonology and Allergology Unit, CHU d’Estaing, 63003, Clermont-Ferrand, France
^al Sorbonne Université, INSERM UMR-S 938, Centre de Recherche Saint-Antoine (CRSA), F-75014, Paris, France
^am Centre de Pneumologie de l'enfant, Ramsay Générale de Santé, 92100, Boulogne-Billancourt, France

^∗Corresponding author. Paediatric noninvasive ventilation and sleep unit, AP-HP, Hôpital Necker, 149 rue de Sèvres, 75015, Paris, France.Paediatric noninvasive ventilation and sleep unitAP-HPHôpital Necker149 rue de SèvresParis75015France

Abstract

Objective

To describe the characteristics of children treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) in France.

Design

Cross-sectional national survey.

Setting

Paediatric CPAP/NIV teams of 28 tertiary university hospitals in France.

Patients

Children aged <20 years treated with CPAP/NIV since at least 3 months on June 1st, 2019.

Intervention

An anonymous questionnaire was filled in for every patient.

Results

The data of 1447 patients (60% boys), mean age 9.8 ± 5.8 years were analysed. The most frequent underlying disorders were: upper airway obstruction (46%), neuromuscular disease (28%), disorder of the central nervous system (13%), cardiorespiratory disorder (7%), and congenital bone disease (4%). Forty-five percent of the patients were treated with CPAP and 55% with NIV. Treatment was initiated electively for 92% of children, while 8% started during an acute illness. A poly(somno)graphy (P(S)G) was performed prior to treatment initiation in 26%, 36% had a P(S)G with transcutaneous carbon dioxide monitoring (PtcCO₂), while 23% had only a pulse oximetry (SpO₂) with PtcCO₂ recording. The decision of CPAP/NIV initiation during an elective setting was based on the apnea-hypopnea index (AHI) in 41% of patients, SpO₂ and PtcCO₂ in 25% of patients, and AHI with PtcCO₂ in 25% of patients. Objective adherence was excellent with a mean use of 7.6 ± 3.2 h/night. Duration of CPAP/NIV was 2.7 ± 2.9 years at the time of the survey.

Conclusion

This survey shows the large number of children treated with long term CPAP/NIV in France with numerous children having disorders other than neuromuscular diseases.

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Highlights

•	1447 children were treated with long term CPAP or NIV in France on June 2019.
•	The number of children treated with CPAP or NIV in France has increased 14-fold between 2000 and 2019.
•	The most frequent disorders were upper airway obstruction (46%) and neuromuscular disease (28%).
•	45% of the children were treated with CPAP and 55% with NIV.

Le texte complet de cet article est disponible en PDF.

Keywords : Continuous positive airway pressure, Noninvasive ventilation, Home care, Sleep-disordered breathing, Obstructive sleep apnea

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Paediatric long term continuous positive airway pressure and noninvasive ventilation in France: A cross-sectional study - 21/05/21

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