[From tracheostomy to non-invasive mask ventilation: a study in children with congenital central hypoventilation syndrome].
BACKGROUND
Children with congenital central hypoventilation syndrome (CCHS) have to be ventilated during sleep due to respiratory insensitivity to CO2. This long-term mechanical ventilation sometimes requires a tracheostomy during infancy, leading to increased risk of infections and of tracheal problems, and later on to stigmatization and restrictions in social life.


METHODS
We therefore evaluated non-invasive mask ventilation in 4 children between 6 and 15 years of age, who had been ventilated via tracheal canula since early infancy under polysomnographic control.


RESULTS
Best results were obtained with standard face masks in connection with pressure controlled timed ventilation. In 1 child we used a volume-controlled ventilator. The lack of dyspnea in these patients can worsen the acceptance of a face mask, which is more uncomfortable than a tracheal cannula. In 2 children we waited with the definite closure of the tracheostomy due to pavor-like symptoms and laryngeal closure during sleep and problems in acceptance of the mask, respectively. In the other 2 children we could demonstrate effective non-invasive mask ventilation during temporary tracheal closure for several nights. Therefore the tracheostomy was definitely closed. Long-term follow-up with home monitoring showed effectiveness of non-invasive ventilation in these cases.
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Abteilung für angewandte Physiologie, Ruhr-Universität Bochum. Thorsten.Schaefer@ruhr-uni-bochum.de
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D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012891:Sleep Apnea Syndromes / Q000151:congenital / Q000628:therapy*; D014139:Tracheostomy / Q000379:methods*; D014691:Ventilation / Q000379:methods*
Vom Tracheostoma zur nasalen Maskenbeatmung--Erfahrungen bei Kindern mit zentralem Hypoventilationssyndrom.