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Noninvasive Ventilation in Pediatric Obstructive Sleep Apnea: What’s New?

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Noninvasive Ventilation in Sleep Medicine and Pulmonary Critical Care

Abstract

Obstructive sleep apnea syndrome (OSAS) is a common breathing disorder in otherwise healthy children, and adenotonsillectomy successfully treats most of these patients. A small number of children, however, have comorbidities that increase the risk of OSA persisting after surgery or that contraindicate surgery; for these patients noninvasive ventilatory treatment is the first-line therapy. Untreated OSA can result in serious cardiovascular complications; affect cognitive, learning, and behavioral functions; and impact on growth. Early recognition is essential and requires a good knowledge of physiological and maturational changes of breathing in children to understand pathophysiological mechanisms, recognize signs and symptoms, and interpret instrumental examination and the polysomnography data. An update on pathophysiology, innovative investigations, and treatments are presented below as a result of a systematic search on most recent studies focusing on OSAS in pediatric age. The major differences in clinical manifestations, risk factors, and treatment options for OSA, both between pediatric and adults and infants and children, are discussed.

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Abbreviations

AHI:

Apnea-hypopnea index

AT:

Adenotonsillectomy

CPAP:

Continuous positive airway pressure therapy

FRC:

Functional residual capacity

HFNC:

High-flow nasal cannula

NAFLD:

Non-alcoholic fatty liver disease

NPPV:

Noninvasive positive pressure ventilation

OSAS:

Obstructive sleep apnea syndrome

PAP:

Positive airway pressure therapy

PSG:

Polysomnography

REM:

Rapid eye movement

SDB:

Sleep disordered breathing

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Authors and Affiliations

  1. Service of Anesthesia and Critical Care, Department of Woman’s, Child’s and Urological Diseases, S. Orsola-Malpighi Policlinic University Hospital, Bologna, Italy

    Maria Cristina Mondardini, Maria Elena Latrofa, Leonardo Costa & Fabio Caramelli

Authors
  1. Maria Cristina Mondardini
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  2. Maria Elena Latrofa
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  3. Leonardo Costa
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  4. Fabio Caramelli
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Corresponding author

Correspondence to Maria Cristina Mondardini .

Editor information

Editors and Affiliations

  1. Intensive Care Unit, Hospital General Universitario Morales Meseguer, Murcia, Spain

    Antonio M. Esquinas

  2. Department of Pathophysiology and Pulmonary Rehab, Azienda Ospedaliera dei Colli PO Monaldi, Napoli, Italy

    Giuseppe Fiorentino

  3. Innovative Technologies for the Study of Sleep Breathing Disorders, Institute for Biomedical Research and Innovation (IRIB), Italian National Research Council, Palermo, Italy

    Giuseppe Insalaco

  4. Department of Pulmonary and CC Medicine, Lenox Hill Hospital, New York, NY, USA

    Bushra Mina

  5. Department of Respiratory and CC Medicine, First Affiliated Hospital of Chongqing M, Chongqing, China

    Jun Duan

  6. Anestesia and Pediatric Intensive Care Department, University Hospital Policlinico S. Orsola-Malpighi, Bologna, Italy

    Maria Cristina Mondardini

  7. Anestesia and Pediatric Intensive Care Department, University Hospital Policlinico S. Orsola-Malpighi, Bologna, Italy

    Fabio Caramelli

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Mondardini, M.C., Latrofa, M.E., Costa, L., Caramelli, F. (2020). Noninvasive Ventilation in Pediatric Obstructive Sleep Apnea: What’s New?. In: Esquinas, A.M., et al. Noninvasive Ventilation in Sleep Medicine and Pulmonary Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-42998-0_57

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  • DOI: https://doi.org/10.1007/978-3-030-42998-0_57

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-42997-3

  • Online ISBN: 978-3-030-42998-0

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