Polysomnographic evaluation of non‐invasive ventilation in children with neuromuscular disease

Abstract

In the last 20 years, research efforts have been focused on the use of non-invasive ventilation (NIV) as a mean of avoiding tracheostomy in patients affected by neuromuscular diseases (NMD). Nocturnal NIV has been a particular focus as sleep is a risk factor for respiratory failure in NMD patients. The objective of our study was to evaluate the efficacy of nocturnal NIV in improving the respiratory function of NMD patients evaluated by polysomnography (PSG) and arterial blood gas (ABG) analysis parameters. Ten children affected by NMD underwent PSG and ABG analysis evaluation at the onset of their respiratory failure and during nocturnal NIV therapy. We found a statistically significant improvement of the lowest oxygen desaturation (nadir SaO2 ), apnoea-hypopnoea index (AHI) and oxygen desaturation index (ODI) after NIV treatment in all patients. Mean SaO2 also improved, although this result was not statistical significant, while the percentage of episodes of desaturation with a SaO2 <90% and <80% decreased with a statistical significance (P < 0.0001). After NIV, only one patient showed an episode of desaturation lasting more than 5 min (10.6 min length), and we also found an improvement of daytime blood gas parameters with a normalization of these indexes. NIV was effective in improving respiratory parameters at night in patients affected by respiratory muscular weakness, as evaluated by PSG and ABG analysis.