Division of Respiratory Diseases, Children's Hospital Boston, Boston, MA 02115, USA.
J Clin Sleep Med. 2010 Dec 15;6(6):603-4.
Noninvasive ventilation is widely used for chronic respiratory failure in children with neuromuscular disorders, thus avoiding the need for tracheostomy. However, the pressures required to support ventilation in these children may be considerably higher than those necessary to treat obstructive sleep apnea. The complications of nasal positive airway pressure are numerous, including skin breakdown, conjunctivitis, nasal congestion, airway dryness, pneumothorax, and bowel obstruction. Ophthalmologic complaints are particularly common, largely attributed to an air leak in the mask. In the present case, we demonstrate, through two modalities-video and CT scan-retrograde airflow through the nasolacrimal duct causing sleep disruption and eye irritation in a profoundly hypotonic 14-month-old boy with chronic respiratory failure on bilevel ventilation during sleep.
无创通气广泛应用于伴有神经肌肉疾病的慢性呼吸衰竭儿童，从而避免了气管切开术的需要。然而，为这些儿童提供通气支持所需的压力可能远远高于治疗阻塞性睡眠呼吸暂停所需的压力。鼻正压通气的并发症很多，包括皮肤破裂、结膜炎、鼻塞、气道干燥、气胸和肠梗阻。眼科投诉特别常见，主要归因于面罩中的空气泄漏。在本病例中，我们通过视频和 CT 扫描两种方式证明，在睡眠中使用双水平通气的慢性呼吸衰竭的 14 个月大的极度低张患儿中，经鼻泪管逆行气流导致睡眠中断和眼部刺激。
