Document Detail

Facial side effects during noninvasive positive pressure ventilation in children.
MedLine Citation:
PMID:  15924228     Owner:  NLM     Status:  MEDLINE    
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.
Brigitte Fauroux; Jean-François Lavis; Frédéric Nicot; Arnaud Picard; Pierre-Yves Boelle; Annick Clément; Marie-Paule Vazquez
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-05-28
Journal Detail:
Title:  Intensive care medicine     Volume:  31     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-29     Completed Date:  2005-11-15     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  965-9     Citation Subset:  IM    
Pediatric Pulmonary Department, Armand Trousseau Hospital, Assistance Publique Hôpitaux de Paris, University Paris 6, 28 avenue du Docteur Arnold Netter, 75012, Paris, France.
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MeSH Terms
Child, Preschool
Cross-Sectional Studies
Facial Injuries / etiology*
Masks / adverse effects*
Positive-Pressure Respiration / methods*
Retrospective Studies
Skin / injuries*

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