|Title:||Compliance and efficacy of non-invasive ventilation in children with Down syndrome|
|Author(s):||L MacDonagh L Farrell R O'Reilly P McNally S Javadpour D Cox|
|Institution:||School of Medicine, University College Dublin, Dublin 4|
|Poster:||Click to view poster|
|Category:||General Respiratory and Sleep|
|Abstract:||Children with Down syndrome (DS) have increased prevalence of obstructive sleep apnoea (OSA), for which non-invasive ventilation (NIV) is a cornerstone of management. Compliance has previously been described as a major issue in the therapeutic efficacy of NIV within the DS population. This study aimed to measure adherence and delivery of NIV within a paediatric DS cohort.|
This retrospective cohort study involved 106 children with confirmed OSA and home NIV with downloadable data. Children were divided into DS (n=44) and non-DS cohorts (n=62). Adherence and clinical outcomes, such as apnoea-hypopnoea index (AHI), delivery and system leakage were recorded and compared between DS and non-DS cohorts and within the DS cohort based on age and surgical history.
Significantly greater NIV usage, in the form of percentage days used, was observed in the DS cohort relative to non-DS counterparts (p=0.031). However, children with DS displayed significantly greater system leakage (p=0.022) and increased AHI (p=0.0493). Surprisingly, those with DS with prior cardiothoracic surgery showed significantly reduced compliance.
These data confirm that satisfactory NIV adherence is achievable in children with DS. However, we have identified excessive system leak at the machine-patient interface as a factor, which could undermine NIV efficacy in children with DS.