PT  - JOURNAL ARTICLE
AU  - Surendran Thavagnanam
AU  - Hartmut Grasemann
AU  - Melinda Solomon
AU  - Indra Narang
TI  - The use of non-invasive ventilation in paediatric lung transplantation
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P2050
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P2050.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P2050.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Introduction: Progressive deterioration in paediatric patients (pts) with end-stage lung disease may result in diurnal hypoventilation. There are paucity of data describing polysomnography (PSG) & the benefits of Bilevel Positive Airway Pressure (BiPAP) therapy in these children.Aim: To evaluate cardiorespiratory data & gas exchange using PSG in children awaiting lung transplantation (LTx) prior to & after BIPAP therapy.Methods: Retrospective review of PSGs on these patients between 2005 & 2012 was performed. Change in cardiorespiratory parameters during PSG following BiPAP initiation was assessed & analysed using a paired t-test.Results: Of the 31 pts identified, 24 underwent LTx & 7 were on a wait list (WL). 13 were male pts with mean age of 12 years (9 to 15). 9 LTX and 3 WL pts had PSGs & 10 pts were on supplemental oxygen. 9 pts had cystic fibrosis, 2 had interstitial lung disease & 1 had pulmonary venous occlusive disease (PVOD).10 pts had evidence of nocturnal hypoventilation in the absence of obstructive or central apneas & were initiated on BIPAP. After titration of BiPAP to optimal settings, there was a significant increase in mean SaO2 [91% (SD 2.4) to 96% (SD 0.9),p=0.0001], decrease in heart rate [111 (SD 18.3) to 96 (SD 15) beats per minute, p=0.02], respiratory rate [35 (SD 5) to 28 (SD 6) breaths per minute, p=0.003] and transcutaneous carbon dioxide recordings [74 (SD17) to 67 (SD 14) mmHg, p=0.006] from baseline.Conclusion: All pts had significant nocturnal hypoventilation with improved clinical parameters & gas exchange abnormalities following BiPAP. Further research is needed to assess the role of PSG & BIPAP therapy as a bridge to transplant in children with severe chronic lung disease.