Value of gas exchange recording at home in children receiving noninvasive ventilation
Résumé
Noninvasive positive pressure ventilation (NPPV) is preferentially performed at home. The objectives of the study were to evaluate the feasibility of an overnight gas exchange recording at home and to compare recordings performed in the hospital and at home. Twenty nine pairs of overnight gas exchange recordings during NPPV were performed at home and in the hospital in 11 children with neuromuscular disease and 13 children with other disorders treated with long term NPPV. No technical problem occurred during the recordings performed at home and one pulse oximetry (SpO2) recording failed in the hospital. For the two groups, SpO2 and transcutaneous carbon dioxide (PtcCO2) values did not differ significantly between the hospital and the home. However, correlations between SpO2 and PtcCO2 values obtained in the hospital and at home were better for mean values than for minimal and maximal values, and in patients with other disorders as compared to patients with neuromuscular disease. Overnight gas exchange recordings with NPPV by a combined PtcCO2/SpO2 monitor are feasible at home and show results comparable to hospital recordings. Home PtcCO2/SpO2 recordings may be integrated in the care of children treated with domiciliary NPPV and are associated with less disruption of family life and decreased health care costs.
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