Facial Side Effects During Noninvasive Positive Pressure Ventilation in Children

Overview

Journal Intensive Care Med

Specialty Critical Care

Date 2005 Jun 1

PMID 15924228

Citations 34

Authors

Brigitte Fauroux

Jean-Francois Lavis

Frederic Nicot

Arnaud Picard

Pierre-Yves Boelle

Annick Clement

Marie-Paule Vazquez

Affiliations

Soon will be listed here.

Abstract

Objective: The study quantified the side effects of nasal masks use for noninvasive positive pressure ventilation (NPPV) in children.

Design And Setting: Cross-sectional retrospective study in a tertiary pediatric university hospital.

Patients: Patients with obstructive sleep apnea (n=16), neuromuscular disorders (n=14), and cystic fibrosis (n=10).

Interventions: Clinical evaluation of facial tolerance.

Measurements And Results: A skin injury was observed in 19 patients (48%), with a transient erythema in 7 (18%), prolonged erythema in 9 (23%), and skin necrosis in 3 (8%). Skin injury was associated with age over 10 years (OR=16) and use of a commercial mask (OR=15) and was less frequent in patients with obstructive sleep apnea. The change of a commercial mask for a custom-made mask was associated with reduction in the skin injury score. Global facial flattening was present in 68% of the patients. No correlation was observed with age, daily or cumulative use of NPPV, or the type of mask. A maxillary retrusion was present in 37% of patients. No correlation was observed with age or the type of mask or the underlying disease, but an association was found with a longer daily use of NPPV (OR=6.3).

Conclusions: The prevalence of facial side effects is clinically significant in children using NPPV. Systematic maxillofacial follow-up enables these effects to be identified. Remedial measures could include the change of the interface or reducing the daily use of NPPV.

Citing Articles

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Maxillary Hypoplasia and Non-Invasive Ventilation: Literature Review and Proposed New Treatment Protocol.

Meazzini M, Moretti M, Canzi G, Sozzi D, Novelli G, Mazzoleni F Children (Basel). 2024; 11(6).

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Ehsan Z, Ishman S, Soghier I, Almeida F, Boudewyns A, Camacho M Am J Respir Crit Care Med. 2023; 209(3):248-261.

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Tyler G, Machaalani R, Waters K J Clin Sleep Med. 2022; 19(2):275-282.

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Home mechanical ventilation in children with chronic respiratory failure: a narrative review.

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