0886 LONG-TERM NON-INVASIVE VENTILATION THERAPIES IN CHILDREN: A SCOPING REVIEW

• Published in: Sleep (New York, N.Y.) Vol. 40; no. suppl_1; p. A329
• Main Authors: Castro Codesal, ML, Dehaan, K, Featherstone, R, Bedi, P, Martinez Carrasco, C, Katz, SL, Chan, EY, Bendiak, GN, Almeida, F, Olmstead, D, Young, R, Waters, K, Sullivan, C, Hartlin, L, MacLean, JE
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 28-04-2017
• Subjects: Chi-square test; Continuous positive airway pressure; Neuromuscular diseases; Ostomy; Oxygen therapy; Scholarships & fellowships; Sleep; Systematic review
• DOI: 10.1093/sleepj/zsx050.885
• EISSN: 1550-9109
• ISSN: 0161-8105

Abstract
Introduction:
Long-term non-invasive ventilation (NIV) is a common modality of breathing support used for a range of sleep and respiratory disorders. The aim of this scoping review was to provide a summary of the literature relevant to long-term NIV use in children.
Methods:
We used systematic methodology to identify 11581 studies with final inclusion of 289. The search was run in nine databases with additional grey literature sources. The search was limited to human studies published between 1990–2016. Inclusion criteria were: children 0–18 years; and NIV use greater than 3 months outside acute settings. Study design or outcomes assessed were not limited.
Results:
We identified 76 terms referencing to NIV. Study design characteristics were most often single center (84%), observational (63%), and retrospective (54%). NIV use was reported for 73 medical conditions with obstructive sleep apnea (29%) and spinal muscular atrophy (8%) as the most common conditions. There were significant differences in medical conditions across ages (Pearson Chi-square 112.4, p<0.05). Continuous positive airway pressure (CPAP) was used in 25% of studies, versus 19% bilevel positive airway pressure, 2% auto-PAP, and 42% combination of CPAP and bilevel. Descriptive data, including NIV incidence (61%) and patient characteristics (51%), were most commonly reported. Outcomes from sleep studies were reported in 27% of studies followed by outcomes on respiratory morbidity such as improvement of respiratory symptoms, tracheostomy avoidance or decannulation, or reduction in post-operative complications in 15%. Reduction in other symptoms including sleep, neurocognition, mood, behavior and quality of life were reported in less than 5% of studies. Mortality was an outcome of interest in 6% of studies. Outcomes assessed differed by disease category (Pearson Chi-square 19.6, p<0.05). Adverse events and adherence were reported in 20% and 26% of articles respectively. Authors reported positive conclusions for 73% of studies.
Conclusion:
Long-term use of NIV has been documented in a large variety of pediatric patient groups with studies of lower methodological quality. Data was unevenly available across medical conditions.
Support (If Any):
Stollery Clinical Research Fellowship funded by the Stollery Children’s Hospital Foundation.Women. Children’s Health Research Institute (WCHRI) through the Alberta Research Centre for Health.