Khirani Sonia, Griffon Lucie, Le Anais, La Regina Domenico Paolo, Dosso Marine, Poirault Clément, Fauroux Brigitte
ASV Santé, Gennevilliers, France; Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP Necker Hospital, Paris, France; Université de Paris Cité, EA 7330 VIFASOM, Paris, France.
Pediatric Noninvasive Ventilation and Sleep Unit, AP-HP Necker Hospital, Paris, France; Université de Paris Cité, EA 7330 VIFASOM, Paris, France.
Sleep Med. 2025 Jan;125:18-20. doi: 10.1016/j.sleep.2024.11.015. Epub 2024 Nov 12.
Noninvasive ventilation (NIV) is widely used in children. The spontaneous/timed (S/T) mode is the most common used mode for home NIV. Different devices are available, and the manufacturers are free to name the modes and define the settings, with no regulation. In particular, the definitions of the trigger sensitivities still differ between manufacturers and/or devices. The inspiratory trigger (TgI) sensitivity may be set according to a numerical or word-rating scale, while the expiratory trigger (TgE) sensitivity may be set as a percentage of the peak inspiratory flow, or using a numerical or word rating scale which correspond to specific predefined percentages of inspiratory flow. Moreover, the TgE sensitivity may be set according to the peak inspiratory flow or to the diminution of peak inspiratory flow, which may be very confusing. Patient-ventilator asynchrony (PVA) may be due to an inadequate comprehension of the settings by the user, which is challenging. We report here the cases of four children and adolescents with an incorrect setting of the TgI and/or TgE, leading to PVA. This pleads for a harmonization of the definitions of the settings, and in particular of the trigger sensitivities. In the meanwhile, NIV professionals should be aware of the different definitions to avoid setting errors leading to PVA.
无创通气（NIV）在儿童中广泛应用。自主/定时（S/T）模式是家庭无创通气最常用的模式。有多种不同的设备可供选择，制造商可以自由命名模式并定义设置，且没有相关规定。特别是，不同制造商和/或设备之间触发敏感度的定义仍然存在差异。吸气触发（TgI）敏感度可以根据数字或文字评级量表来设置，而呼气触发（TgE）敏感度可以设置为吸气峰值流量的百分比，或者使用对应于特定预定义吸气流量百分比的数字或文字评级量表。此外，TgE敏感度可以根据吸气峰值流量或吸气峰值流量的减少来设置，这可能会非常令人困惑。患者 - 呼吸机不同步（PVA）可能是由于用户对设置理解不足导致的，这具有挑战性。我们在此报告4例儿童和青少年因TgI和/或TgE设置错误导致PVA的病例。这呼吁对设置的定义进行统一，特别是触发敏感度的定义。同时，无创通气专业人员应了解不同的定义，以避免因设置错误导致PVA。
