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法国儿科长期持续气道正压通气和无创通气:一项横断面研究。

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

机构信息

Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, F-75015, Paris, France; Université de Paris, VIFASOM, F-75004, Paris, France.

Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP, Hôpital Necker-Enfants Malades, F-75015, Paris, France; Université de Paris, VIFASOM, F-75004, Paris, France; ASV Santé, F-92000, Gennevilliers, France.

出版信息

Respir Med. 2021 May;181:106388. doi: 10.1016/j.rmed.2021.106388. Epub 2021 Apr 3.

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 (PtcCO), while 23% had only a pulse oximetry (SpO) with PtcCO recording. The decision of CPAP/NIV initiation during an elective setting was based on the apnea-hypopnea index (AHI) in 41% of patients, SpO and PtcCO in 25% of patients, and AHI with PtcCO 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.

摘要

目的

描述在法国接受长期持续气道正压通气(CPAP)或无创通气(NIV)治疗的儿童的特征。

设计

全国性横断面调查。

地点

法国 28 家三级大学医院的儿科 CPAP/NIV 团队。

患者

2019 年 6 月 1 日至少接受 CPAP/NIV 治疗 3 个月的年龄<20 岁的儿童。

干预措施

对每位患者填写匿名问卷。

结果

共分析了 1447 名(60%为男性)患儿的数据,平均年龄为 9.8±5.8 岁。最常见的基础疾病为:上呼吸道梗阻(46%)、神经肌肉疾病(28%)、中枢神经系统疾病(13%)、心肺疾病(7%)和先天性骨病(4%)。45%的患者接受 CPAP 治疗,55%接受 NIV 治疗。92%的患儿为择期治疗,8%的患儿在急性疾病期间开始治疗。26%的患儿在治疗开始前进行多导睡眠图(PSG)检查,36%的患儿进行 PSG 检查并进行经皮二氧化碳监测(PtcCO),23%的患儿仅进行脉搏血氧饱和度(SpO)检查并记录 PtcCO。在择期设置中启动 CPAP/NIV 的决策基于 41%的患儿的呼吸暂停低通气指数(AHI),25%的患儿基于 SpO 和 PtcCO,25%的患儿基于 AHI 和 PtcCO。客观依从性极好,平均使用时间为 7.6±3.2 小时/夜。在调查时,CPAP/NIV 的持续时间为 2.7±2.9 年。

结论

本调查显示法国有大量儿童接受长期 CPAP/NIV 治疗,其中许多患儿存在神经肌肉疾病以外的疾病。

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