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Early use of Nasal‐BiPAP in two infants with Congenital Central Hypoventilation syndrome
Author(s) -
Migliori C,
Cavazza A,
Motta M,
Bottino R,
Chirico G
Publication year - 2003
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2003.tb02540.x
Subject(s) - medicine , congenital central hypoventilation syndrome , anesthesia , hypoventilation , tracheotomy , intubation , positive airway pressure , ventilation (architecture) , positive pressure , discontinuation , surgery , respiratory system , obstructive sleep apnea , mechanical engineering , engineering
Aim : To reduce the problems caused by prolonged artificial ventilation in babies with Congenital Central Hypoventilation syndrome (CCHS). Methods : Two term infants with CCHS, weighing 4030 g and 3100 g, respectively, at the beginning of treatment and aged 53 and 31 d, respectively, were successfully ventilated with a Nasal Bilevel Positive Airway Pressure (N‐BiPAP) device. Results : In the first patient the tcPO 2 recordings (mean ± SD) during sleep were 46 ± 12 mmHg before using N‐BiPAP and 58 ± 13 mmHg after using the device, while those for tcPCO 2 were 75 ± 9 mmHg and 49 ±11 mmHg, respectively. In the second patient tcPO 2 during sleep was 42 ± 3 mmHg before, and 55 ± 5 after N‐BiPAP, and for tcPCO 2 the recordings were 119 ± 24 mmHg and 55 ± 6 mmHg, respectively, showing a significant improvement. One infant had persistent gastro‐oesophageal reflux, and frontal skin abrasion caused by the face mask. Nevertheless, these complications did not necessitate the discontinuation of N‐BiPAP ventilation, thus precluding prolonged use of intubation and tracheotomy. Conclusion : In infants with CCHS, early use of non‐invasive, positive‐pressure ventilation with N‐BiPAP, in association with careful monitoring, can decrease problems caused by prolonged intubation and tracheotomy.