OBJECTIVE: To review our experience with home nasal continuous positive airway pressure (CPAP) in infants with small upper airways and abnormal breathing during sleep. STUDY DESIGN: Seventy-four infants with sleep-disordered breathing and narrow upper airways, as identified by nocturnal polygraphic recording and endoscopic evaluation, were treated at home with nasal CPAP. Infants with craniofacial anomalies and trisomy 21, and infants who had been referred to us as having had "apparent life-threatening events," made up the majority of the population. Because of the rapid growth of infants, regular follow-up visits were scheduled to adjust CPAP and mask size. RESULTS: Seventy-two infants were successfully treated at home with nasal CPAP; there were two failures. Follow-up lasted from 5 months to 12 years. Compliance was not a problem, but home nasal CPAP was prescribed only for infants who lived close to our center and whose families and pediatricians were willing to support compliance. COMMENTS: Home nasal CPAP requires careful, in-laboratory titration and regular follow-up to adjust both pressure and mask size. With the support of families and pediatricians, home nasal CPAP can be an effective treatment for infants with upper airway respiratory problems during sleep. In many cases, it can provide an interim solution, enabling physicians to plan surgery at an appropriate time and giving infants time to grow before having to undergo surgical stress.
OBJECTIVE: To review our experience with home nasal continuous positive airway pressure (CPAP) in infants with small upper airways and abnormal breathing during sleep. STUDY DESIGN: Seventy-four infants with sleep-disordered breathing and narrow upper airways, as identified by nocturnal polygraphic recording and endoscopic evaluation, were treated at home with nasal CPAP. Infants with craniofacial anomalies and trisomy 21, and infants who had been referred to us as having had "apparent life-threatening events," made up the majority of the population. Because of the rapid growth of infants, regular follow-up visits were scheduled to adjust CPAP and mask size. RESULTS: Seventy-two infants were successfully treated at home with nasal CPAP; there were two failures. Follow-up lasted from 5 months to 12 years. Compliance was not a problem, but home nasal CPAP was prescribed only for infants who lived close to our center and whose families and pediatricians were willing to support compliance. COMMENTS: Home nasal CPAP requires careful, in-laboratory titration and regular follow-up to adjust both pressure and mask size. With the support of families and pediatricians, home nasal CPAP can be an effective treatment for infants with upper airway respiratory problems during sleep. In many cases, it can provide an interim solution, enabling physicians to plan surgery at an appropriate time and giving infants time to grow before having to undergo surgical stress.
Authors: Natalie DiFeo; Lisa J Meltzer; Suzanne E Beck; Laurie R Karamessinis; Mary Anne Cornaglia; Joel Traylor; John Samuel; Paul R Gallagher; Jerilynn Radcliffe; Heidi Beris; Mary Kate Menello; Carole L Marcus Journal: J Clin Sleep Med Date: 2012-06-15 Impact factor: 4.062
Authors: Carole L Marcus; Suzanne E Beck; Joel Traylor; Mary Anne Cornaglia; Lisa J Meltzer; Natalie DiFeo; Laurie R Karamessinis; John Samuel; Jennifer Falvo; Michelle DiMaria; Paul R Gallagher; Heidi Beris; Mary Kate Menello Journal: J Clin Sleep Med Date: 2012-02-15 Impact factor: 4.062
Authors: Carole L Marcus; Jerilynn Radcliffe; Sofia Konstantinopoulou; Suzanne E Beck; Mary Anne Cornaglia; Joel Traylor; Natalie DiFeo; Laurie R Karamessinis; Paul R Gallagher; Lisa J Meltzer Journal: Am J Respir Crit Care Med Date: 2012-02-09 Impact factor: 21.405
Authors: Caroline Driessen; Koen F M Joosten; Joyce M G Florisson; Maarten Lequin; Marie-Lise C van Veelen; Rúben Dammers; Hansje Bredero-Boelhouwer; Robert C Tasker; Irene M J Mathijssen Journal: Childs Nerv Syst Date: 2012-09-25 Impact factor: 1.475