title: Early use of Nasal-BiPAP in two infants with Congenital Central Hypoventilation syndrome.
abstract: OBJECTIVE
  To reduce the problems caused by prolonged artificial ventilation in babies with Congenital Central Hypoventilation syndrome (CCHS).
  
  
  METHODS
  Two term infants with CCHS, weighing 4030 g and 3100 g, respectively, at the beginning of treatment and aged 53 and 31 d, respectively, were successfully ventilated with a Nasal Bilevel Positive Airway Pressure (N-BiPAP) device.
  
  
  RESULTS
  In the first patient the tcPO2 recordings (mean +/- SD) during sleep were 46 +/- 12 mmHg before using N-BiPAP and 58 +/- 13 mmHg after using the device, while those for tcPCO2 were 75 +/- 9 mmHg and 49 +/- 11 mmHg, respectively. In the second patient tcPO2 during sleep was 42 +/- 3 mmHg before, and 55 +/- 5 after N-BiPAP, and for tcPCO2 the recordings were 119 +/- 24 mmHg and 55 +/- 6 mmHg, respectively, showing a significant improvement. One infant had persistent gastro-oesophageal reflux, and frontal skin abrasion caused by the face mask. Nevertheless, these complications did not necessitate the discontinuation of N-BiPAP ventilation, thus precluding prolonged use of intubation and tracheotomy.
  
  
  CONCLUSIONS
  In infants with CCHS, early use of non-invasive, positive-pressure ventilation with N-BiPAP, in association with careful monitoring, can decrease problems caused by prolonged intubation and tracheotomy.
authors.affiliation: Division of Neonatology and Neonatal Intensive Care, Spedali Civili, Brescia, Italy. claudio.migliori@tin.it
authors.forename: C
authors.initials: C
authors.lastname: Migliori
authors.forename: A
authors.initials: A
authors.lastname: Cavazza
authors.forename: M
authors.initials: M
authors.lastname: Motta
authors.forename: R
authors.initials: R
authors.lastname: Bottino
authors.forename: G
authors.initials: G
authors.lastname: Chirico
mesh_terms: D001049:Apnea / Q000175:diagnosis; D001921:Brain / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008279:Magnetic Resonance Imaging; D008297:Male; D017286:Polysomnography; D011175:Positive-Pressure Respiration / Q000379:methods*; D020182:Sleep Apnea, Central / Q000151:congenital* / Q000628:therapy*