High flow nasal cannula treatment for obstructive sleep apnea in infants and young children

被引:28
作者
Ignatiuk, Daniel [1 ]
Schaer, Britta [2 ]
McGinley, Brian [2 ]
机构
[1] Cincinnati Childrens Hosp Med Ctr, Div Pulm Med, 3333 Burnett Ave,MLC 7041, Cincinnati, OH 45229 USA
[2] Univ Utah, Div Pediat Pulm & Sleep Med, Salt Lake City, UT USA
关键词
high flow nasal cannula; obstructive sleep apnea treatment; pediatric obstructive sleep apnea; sleep medicine; upper airway obstruction; POSITIVE AIRWAY PRESSURE; ADHERENCE; THERAPY; ADENOTONSILLECTOMY; DISORDER;
D O I
10.1002/ppul.25009
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background Continuous positive airway pressure (CPAP) is the nonsurgical treatment of choice for children with obstructive sleep apnea (OSA). However, CPAP limitations include difficulty with adherence and midface hypoplasia risk. We, therefore, sought to assess the effect of warm humidified air delivered via open nasal cannula (HFNC) on OSA in children in the sleep laboratory and at home. Methods A retrospective review was performed among children recommended treatment of OSA with HFNC. Reasons for HFNC recommendation included poor surgical candidacy, residual OSA following surgery, and CPAP intolerance. Children underwent both diagnostic and HFNC titration sleep studies and were prescribed HFNC for home use. Standard sleep architecture, arousals, and apnea-hypopnea indices (AHI) were assessed with the evaluation of reported adherence and complications over 12 months of treatment. Results Twenty-two children (average 12.8 months, 95% confidence interval [95% CI: 7.0, 18.6]) with OSA (obstructive AHI [OAHI] range: 4.8-89.2 events/h) underwent HFNC titration with significant reduction in OAHI (28.9 events/h [17.6, 40.2] vs 2.6 [1.1, 4.0];P < .001) (mean [95% CI]). Nineteen patients received home HFNC treatment. By 12 months, four patients were lost to follow-up and OSA resolved in three patients (16%). Of 12 remaining patients, 7 (58%) continued therapy while 5 (42%) discontinued due to intolerance. The most common treatment complication was cannula dislodgement. Additional complications included skin irritation, dry mucus membranes, restlessness, oxygen desaturation, and increased central apneas. Conclusion HFNC offers a treatment alternative to CPAP in infants and young children with OSA and was well tolerated at home in our study.
引用
收藏
页码:2791 / 2798
页数:8
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