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Intensive Care Med. 2005 Jul;31(7):965-9. Epub 2005 May 28.

Facial side effects during noninvasive positive pressure ventilation in children.

Author information

1
Pediatric Pulmonary Department, Armand Trousseau Hospital, Assistance Publique Hôpitaux de Paris, University Paris 6, 28 avenue du Docteur Arnold Netter, 75012, Paris, France. brigitte.fauroux@trs.ap-hop-paris.fr

Abstract

OBJECTIVE:

The study quantified the side effects of nasal masks use for noninvasive positive pressure ventilation (NPPV) in children.

DESIGN AND SETTING:

Cross-sectional retrospective study in a tertiary pediatric university hospital.

PATIENTS:

Patients with obstructive sleep apnea (n=16), neuromuscular disorders (n=14), and cystic fibrosis (n=10).

INTERVENTIONS:

Clinical evaluation of facial tolerance.

MEASUREMENTS AND RESULTS:

A skin injury was observed in 19 patients (48%), with a transient erythema in 7 (18%), prolonged erythema in 9 (23%), and skin necrosis in 3 (8%). Skin injury was associated with age over 10 years (OR=16) and use of a commercial mask (OR=15) and was less frequent in patients with obstructive sleep apnea. The change of a commercial mask for a custom-made mask was associated with reduction in the skin injury score. Global facial flattening was present in 68% of the patients. No correlation was observed with age, daily or cumulative use of NPPV, or the type of mask. A maxillary retrusion was present in 37% of patients. No correlation was observed with age or the type of mask or the underlying disease, but an association was found with a longer daily use of NPPV (OR=6.3).

CONCLUSIONS:

The prevalence of facial side effects is clinically significant in children using NPPV. Systematic maxillofacial follow-up enables these effects to be identified. Remedial measures could include the change of the interface or reducing the daily use of NPPV.

PMID:
15924228
DOI:
10.1007/s00134-005-2669-2
[Indexed for MEDLINE]

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