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

Brigitte Fauroux (1, 2) , Sonia Khirani (1, 2) , Alessandro Amaddeo (1, 2) , Bruno Massenavette (3, 4) , Priscille Bierme (3) , Jessica Taytard (5, 6) , Nathalie Stremler (7) , Melisande Baravalle-Einaudi (7) , Julie Mazenq (7) , Iulia Ioan (8, 9) , Cyril Schweitzer (8, 9) , Marie Emilie Lampin (10) , Alexandra Binoche (10) , Clemence Mordacq (10, 11) , Jean Bergounioux (12) , Blaise Mbieleu (12) , Robert Rubinsztajn (1) , Elodie Sigur (13) , Geraldine Labouret (13) , Aline Genevois (13) , Arnaud Becourt (14) , Eglantine Hullo (15) , Isabelle Pin (16, 15) , Stéphane Debelleix (17, 18) , François Galodé (17, 18) , Stéphanie Bui (17, 18) , Johan Moreau (19, 20) , Marie Catherine Renoux (20) , Stefan Matecki (19, 20) , Marc Lubrano Lavadera (21) , Rachel Heyman (22) , Michael Pomedio (23) , Laurence Le Clainche (24) , Plamen Bokov (24) , Alexandra Masson (25) , Pauline Hangard (25) , Celine Menetrey (25) , Mikael Jokic (26) , Elsa Gachelin (27) , Caroline Perisson (28) , Anne Pervillé (29) , Agnes Fina (30) , Lisa Giovannini-Chami (30) , Emmanuelle Fleurence , Audrey Barzic (31) , Audrey Breining (32) , Morgane Ollivier (33) , Guillaume Labbé (34) , Laurianne Coutier (3, 4) , Guillaume Aubertin (35)

1 Hôpital Necker - Enfants Malades [AP-HP]
2 VIFASOM (URP_7330) - Sommeil-Vigilance-Fatigue et Santé Publique
3 HCL - Hospices Civils de Lyon
4 HFME - Hôpital Femme Mère Enfant [CHU - HCL]
5 UMRS 1158 - Neurophysiologie Respiratoire Expérimentale et Clinique
6 CHU Trousseau [APHP]
7 TIMONE - Hôpital de la Timone [CHU - APHM]
8 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
9 DevAH - Développement, Adaptation et Handicap. Régulations cardio-respiratoires et de la motricité
10 Hôpital Jeanne de Flandres
11 CIIL - Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204
12 Hôpital Raymond Poincaré [AP-HP]
13 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
14 CHU Amiens-Picardie
15 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
16 IAB - Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble)
17 Hôpital Pellegrin
18 CIC Bordeaux
19 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
20 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
21 Hôpital Charles Nicolle [Rouen]
22 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
23 Hôpital universitaire Robert Debré [Reims]
24 Hôpital Robert Debré
25 Hôpital de la Mère et de l'Enfant
26 CHU Caen
27 Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion]
28 CHU Sud Saint Pierre [Ile de la Réunion]
29 Hopital d'enfants
30 CHU-Lenval - Hôpitaux Pédiatriques de Nice Lenval
31 CHU - BREST - Hôpital Morvan - CHRU de Brest
32 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
33 CHU Angers - Centre Hospitalier Universitaire d'Angers
34 CHU Estaing [Clermont-Ferrand]
35 CRSA - Centre de Recherche Saint-Antoine

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

Mots clés: Continuous positive airway pressure; Home care; Noninvasive ventilation; Obstructive sleep apnea; Sleep-disordered breathing

Domaines: Cardiologie et système cardiovasculaire; Pneumologie et système respiratoire

Brigitte Fauroux, Sonia Khirani, Alessandro Amaddeo, Bruno Massenavette, Priscille Bierme, et al.. Paediatric long term continuous positive airway pressure and noninvasive ventilation in France: A cross-sectional study. Respiratory Medicine, 2021, 181, pp.106388. ⟨10.1016/j.rmed.2021.106388⟩. ⟨hal-03198216⟩