Indications, benefits, and practical realization of long-term noninvasive ventilation in children

Abstract

Long-term noninvasive ventilation (NIV) is increasingly used in children. It requires the delivery of a ventilatory assistance by an interface that connects the patient’s airways, such as a nasal or facial mask, or rarely a nasal canula. NIV is indicated in diseases causing chronic alveolar hypoventilation, including neuromuscular disorders, maxillo-facial or upper airway abnormalities, thoracic deformities, some lung diseases, and disorders of respiratory control. In these diseases, NIV is the first-line treatment when chronic respiratory failure occurs because it is noninvasive and can be applied on demand, preferentially during sleep. The increasing use of NIV in children is explained by the improvement of the diagnosis of chronic alveolar hypoventilation, the availability of pediatric interfaces, and the increasing performance of home ventilators.