Efficacy and Adherence of noninvasive ventilation treatment
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Children with Down syndrome (DS) have an increased prevalence of obstructive sleep apnea (OSA). Noninvasive ventilation (NIV) is a common modality of OSA treatment in this cohort. This study aimed to measure adherence and efficiency of NIV delivery in children with DS.

This was a retrospective cohort study involving 106 children with confirmed OSA and home NIV with downloadable data capacity. Children were divided into DS (n=44) and non DS cohorts (n=62). Adherence, clinical outcomes apnea hypopnoea index (AHI), positive airway pressure delivery, and leakage were recorded and compared between DS and non DS cohorts and within the DS cohort based on past surgical history.

Results:
--Significantly greater NIV usage was observed in the DS cohort, they showed more consistent use with an increased percentage of days used relative to their non DS counterparts (78.95 ± 2.26 vs. 72.11 ± .14).

--However, despite greater usage, poorer clinical outcomes in the form of increased AHI was observed in the DS cohort, where significantly greater leakage was also shown 41.00±1.61 L/min versus 36.52 ± 1.18 L/min.

--20 children with DS had prior cardiac surgery; compliance across all parameters was significantly reduced relative to those without.

These results indicate that adequate NIV adherence is possible in children with DS. Excessive device leak at the machinepatient interface, on the other hand, has been described by researchers as a factor that could undermine NIV efficacy in children with DS.

Source: https://onlinelibrary.wiley.com/doi/10.1002/ppul.25308?af=R
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