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Intensive Care Medicine
Published in: Intensive Care Medicine 7/2005

01-07-2005 | Pediatric Original

Facial side effects during noninvasive positive pressure ventilation in children

Authors: Brigitte Fauroux, Jean-François Lavis, Frédéric Nicot, Arnaud Picard, Pierre-Yves Boelle, Annick Clément, Marie-Paule Vazquez

Published in: Intensive Care Medicine | Issue 7/2005

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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.
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Metadata
Title
Facial side effects during noninvasive positive pressure ventilation in children
Authors
Brigitte Fauroux
Jean-François Lavis
Frédéric Nicot
Arnaud Picard
Pierre-Yves Boelle
Annick Clément
Marie-Paule Vazquez
Publication date
01-07-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 7/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2669-2

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