Pediatric Long Term Non Invasive Ventilation

This Research Topic has received financial support from Phillips and Air Liquide.

Noninvasive mechanical ventilation is an effective technique for the management of patients with acute or chronic respiratory failure. This comprehensive and up-to-date book explores all aspects of the subject. The opening sections are devoted to theory and equipment, with detailed attention to the use of full-face masks or helmets, the range of available ventilators, and patient-ventilator interactions. Clinical applications are then considered in depth in a series of chapters that address the use of noninvasive mechanical ventilation in chronic settings and in critical care, both within and outside of intensive care units. Due attention is also paid to weaning from conventional mechanical ventilation, potential complications, intraoperative applications, and staff training. The closing chapters examine uses of noninvasive mechanical ventilation in neonatal and pediatric care. This book, written by internationally recognized experts, will be an invaluable guide for both clinicians and researchers.

Now in full-colour, this eagerly-anticipated second edition continues to be the most comprehensive resource available on non-invasive ventilation (NIV), both in the hospital and at home. Reflecting a global perspective with expert contributors from more than 15 countries, the book: • provides clinical examples of NIV in practice with insightful vignettes • covers home- and intensive care-based ventilation • details NIV use in acute and chronic respiratory failure, plus paediatric and other specialty applications. Disease-specific sections provide best practice in the science, diagnostics and management of conditions such as COPD, cardiac failure, neuromuscular disease and obesity, while features such as ‘Common Clinical Questions & Answers’, abundant tables and illustrations, chapter summaries and new clinical vignettes showcase the realities of NIV in practice. This is essential reading for pulmonologists, critical care physicians and intensive care medicine specialists.

The ERS Practical Handbook of Noninvasive Ventilation provides a concise ‘why and how to’ guide to NIV from the basics of equipment and patient selection to discharge planning and community care. Editor Anita K. Simonds has brought together leading clinicians and researchers in the field to provide an easy-to-read guide to all aspects of NIV. Topics covered include: equipment, patient selection, adult and paediatric indications, airway clearance and physiotherapy, acute NIV monitoring, NIV in the ICU, long-term NIV, indications for tracheostomy ventilation, symptom palliation, discharge planning and community care, and setting up an NIV service.

This issue of Sleep Medicine Clinics, guest-edited by Drs. Amen Sergew and Lisa F. Wolfe, focuses on Noninvasive Ventilation and Sleep Medicine. This issue is one of four selected each year by series Consulting Editor, Dr. Teofilo Lee-Chiong. Articles include: Obesity hypoventilation - Traditional vs Non Traditional Populations; Spinal cord injury; Peri-Operative Care and Medication Related Hypoventilation; Lifetime Care of Duchenne Muscular Dystrophy; Management of Chronic Respiratory Failure in COPD - High and Low Intensity Ventilation; Management of Rare Causes Pediatric Chronic Respiratory Failure; Noninvasive Ventilator Management of ALS - Bulbar vs non Bulbar; Parsonage Turner; Noninvasive Ventilator Devices and Modes; Tailoring the Sleep Lab for Chronic Respiratory Failure; Long-Term Follow Up of Noninvasive Ventilation: Downloads and Troubleshooting; Extubating to Noninvasive Ventilation – NIV from ICU to Home; and From Tracheostomy to Noninvasive Ventilation – NIV from Long Term Acute Care to Home.

Preterm birth interrupts the normal developmental progression of most organs, particularly when birth occurs at the lowest level of viability. An immediate task is to successfully transition to a post-natal life without a placental circulation. To do this demands careful management of the cardiorespiratory systems. To best help the fragile preterm infant at this demanding time, care-givers must remember two most pressing goals. These are first to maintain adequacy of gas exchange and delivery, while simultaneously minimizing any secondary injury to the fragile preterm lung. However, after these immediate priorities in the delivery room, the longer term effects of an immature lung development and its associated problems come to the forefront. These problems include the inflammation of perinatal infection, oxygen, and invasive mechanical ventilation. Both the immaturity itself, and secondary lung injury and its inflammation – collectively will often lead to the condition termed bronchopulmonary dysplasia (BPD). Although many of these infants may eventually be discharged to home without a need for oxygen supplementation or pulmonary medications, the long-term impact of interrupted lung development and secondary lung injury remain serious concerns. It is now well recognized that mechanical ventilation is pivotal to developing secondary lung injury and BPD. Consequently, a great deal of time and effort has been put into the development and application of non-invasive ventilator (NIV) approaches to supporting respiratory function in neonates. Since the landmark publication by Gregory and colleagues in 1967, nasal continuous positive airway pressure (nCPAP) has been the most commonly applied approach to NIV. This approach has been supported by the recent generation of randomized controlled trials. However, cumulatively these trials have shown only a small reduction in rates of BPD. Outside of the trial data, despite the wider application of nCPAP, rates of BPD remain relatively unchanged over recent years. This has led to investigations of other NIV approaches including nasal ventilation and high flow nasal cannula therapy. Not only have available modes increased, but so have the interfaces through which these modes may be applied. In the issue of Clinic in Perinatology, readers will find an up-to-date review of non-invasive approaches to supporting preterm respiratory function. This draws on the expertise of leading investigators in the field. This issue reviews the physiologic mechanisms by which the various approaches to NIV may support respiratory function; the evidence base supporting different NIV approaches; and adjunctive aspects of NIV therapy including their use during neonatal transport and the application of other supportive therapies such as inhaled NO.