Use of nasal mask CPAP instead of tracheostomy for palliative care in two children.

Nasal continuous positive airways pressure (nCPAP) is recommended in children for the treatment of obstructive sleep apnoea which persists following adenotonsillectomy. Nasal CPAP was successfully used in the palliative care of two severely disabled children with upper airway obstruction as an alternative to tracheostomy. Nasal CPAP resulted in the correction of obstructive apnoea in sleep, with the added benefit of sleep consolidation and fewer nocturnal arousals requiring parental attendance. There was also an unexpected benefit of reduced airway problems in the awake state in these children. Nasal CPAP is an effective form of treating upper airway obstruction for palliative care in association with other major disabilities.