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Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience

INTRODUCTION: Children with severe tracheobronchomalacia may need placements of tracheostomies and long-term mechanical ventilation. Due to financial constraints, continuous positive airway pressure (CPAP) machines commonly used to treat obstructive sleep apnea in adults have been utilized to delive...

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Autores principales: Sriboonyong, Tidarat, Preutthipan, Aroonwan, Nugboon, Malinee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10266409/
https://www.ncbi.nlm.nih.gov/pubmed/37325360
http://dx.doi.org/10.3389/fped.2023.1169613
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author Sriboonyong, Tidarat
Preutthipan, Aroonwan
Nugboon, Malinee
author_facet Sriboonyong, Tidarat
Preutthipan, Aroonwan
Nugboon, Malinee
author_sort Sriboonyong, Tidarat
collection PubMed
description INTRODUCTION: Children with severe tracheobronchomalacia may need placements of tracheostomies and long-term mechanical ventilation. Due to financial constraints, continuous positive airway pressure (CPAP) machines commonly used to treat obstructive sleep apnea in adults have been utilized to deliver positive distending pressure to such children at our institution for more than 20 years with favorable outcomes. We, therefore, reported our experience with 15 children using this machine. METHODS: This is a retrospective study during 2001–2021. RESULTS: Fifteen children, 9 boys, aged ranged 3 months–5.6 years, were discharged home with CPAP via tracheostomies. All had co-morbidities including gastroesophageal reflux (n = 9, 60%), neuromuscular disorders (n = 6, 40%), genetic abnormalities (n = 6, 40%), cardiac diseases (n = 4, 27%) and chronic lungs (n = 3, 20%). Eight (53%) children were aged less than 1 year old. The smallest child was aged 3 months old, weighing 4.9 kg. All caregivers were relatives and non-medical health professionals. The 1-month and 1-year readmission rates were 13% and 66% respectively. No factor-associated unfavorable outcomes were statistically identified. No complications related to CPAP malfunction were found. Five (33%) were weaned off CPAP, and 3 died (2 from sepsis and 1 from a sudden unknown cause). CONCLUSION: We first reported the use of sleep apnea CPAP via tracheostomy in children with severe tracheomalacia. In limited-resource countries, this simple device may be another option for long-term invasive ventilatory support. The CPAP use in children with tracheobronchomalacia requires adequately trained caregivers.
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spelling pubmed-102664092023-06-15 Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience Sriboonyong, Tidarat Preutthipan, Aroonwan Nugboon, Malinee Front Pediatr Pediatrics INTRODUCTION: Children with severe tracheobronchomalacia may need placements of tracheostomies and long-term mechanical ventilation. Due to financial constraints, continuous positive airway pressure (CPAP) machines commonly used to treat obstructive sleep apnea in adults have been utilized to deliver positive distending pressure to such children at our institution for more than 20 years with favorable outcomes. We, therefore, reported our experience with 15 children using this machine. METHODS: This is a retrospective study during 2001–2021. RESULTS: Fifteen children, 9 boys, aged ranged 3 months–5.6 years, were discharged home with CPAP via tracheostomies. All had co-morbidities including gastroesophageal reflux (n = 9, 60%), neuromuscular disorders (n = 6, 40%), genetic abnormalities (n = 6, 40%), cardiac diseases (n = 4, 27%) and chronic lungs (n = 3, 20%). Eight (53%) children were aged less than 1 year old. The smallest child was aged 3 months old, weighing 4.9 kg. All caregivers were relatives and non-medical health professionals. The 1-month and 1-year readmission rates were 13% and 66% respectively. No factor-associated unfavorable outcomes were statistically identified. No complications related to CPAP malfunction were found. Five (33%) were weaned off CPAP, and 3 died (2 from sepsis and 1 from a sudden unknown cause). CONCLUSION: We first reported the use of sleep apnea CPAP via tracheostomy in children with severe tracheomalacia. In limited-resource countries, this simple device may be another option for long-term invasive ventilatory support. The CPAP use in children with tracheobronchomalacia requires adequately trained caregivers. Frontiers Media S.A. 2023-05-30 /pmc/articles/PMC10266409/ /pubmed/37325360 http://dx.doi.org/10.3389/fped.2023.1169613 Text en © 2023 Sriboonyong, Preutthipan and Nugboon. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Sriboonyong, Tidarat
Preutthipan, Aroonwan
Nugboon, Malinee
Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience
title Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience
title_full Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience
title_fullStr Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience
title_full_unstemmed Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience
title_short Long-term sleep apnea CPAP via tracheostomy in children with tracheomalacia: 20-year experience
title_sort long-term sleep apnea cpap via tracheostomy in children with tracheomalacia: 20-year experience
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10266409/
https://www.ncbi.nlm.nih.gov/pubmed/37325360
http://dx.doi.org/10.3389/fped.2023.1169613
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