1
|
Cousin C, Di Maria J, Hartley S, Vaugier I, Delord V, Bensmail D, Prigent H, Léotard A. Predictive factors and screening strategy for obstructive sleep apnea in patients with advanced multiple sclerosis. Mult Scler Relat Disord 2024; 86:105608. [PMID: 38614056 DOI: 10.1016/j.msard.2024.105608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/22/2024] [Accepted: 04/07/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) screening questionnaires have been evaluated in Multiple Sclerosis (MS) but not yet validated in patients with advanced disease. The aim of this study is to identify OSA predictive factors in advanced MS and to discuss screening strategies. METHODS Oximetry data from 125 patients were retrospectively derived from polysomnographic reports. Univariate and multivariate analysis were used to determine predictive factors for OSA. A two-level screening model was assessed combining the oxygen desaturation index (ODI) and a method of visual analysis. RESULTS multivariate analysis showed that among the clinical factors only age and snoring were associated with OSA. Usual predictive factors such as sleepiness, Body mass index (BMI) or sex were not significantly associated with increased Apnea Hypopnea Index (AHI). The ODI was highly predictive (p < 0.0001) and correctly identified 84.1 % of patients with moderate OSA and 93.8 % with severe OSA. The visual analysis model combined with the ODI did not outperform the properties of ODI used alone. CONCLUSION As the usual clinical predictors are not associated with OSA in patients with advanced MS, questionnaires developed for the general population are not appropriate in these patients. Nocturnal oximetry seems a pertinent, ambulatory and accessible method for OSA screening in this population.
Collapse
Affiliation(s)
- C Cousin
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, Hôpital Raymond Poincaré, Garches, France; Unité de recherche clinique Paris Saclay Ouest, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - J Di Maria
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, Hôpital Raymond Poincaré, Garches, France; « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, 78000, Versailles, France
| | - S Hartley
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - I Vaugier
- Centre d'investigation clinique 1429, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | | | - D Bensmail
- « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, 78000, Versailles, France; Service de médecine physique et de réadaptation, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - H Prigent
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, Hôpital Raymond Poincaré, Garches, France; « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, 78000, Versailles, France
| | - A Léotard
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, Hôpital Raymond Poincaré, Garches, France; « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, 78000, Versailles, France; Sleep Lab Initiative In PMR group (SLIIP), France.
| |
Collapse
|
2
|
Saulnier L, Prigent H, Hartley S, Delord V, Bossard I, Stalens C, Lofaso F, Leotard A. Sleep disordered breathing assessment in patient with slowly progressive neuromuscular disease. Sleep Med 2024; 114:229-236. [PMID: 38237410 DOI: 10.1016/j.sleep.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/18/2023] [Accepted: 01/07/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Sleep-disordered breathing (SDB) is common in patients with neuromuscular diseases (NMD). Focusing on hypercapnia may lead to the neglect of other SDB such as obstructive and/or central sleep apnea syndrome (SAS). Our objectives were to assess the risk of inappropriate SDB management according to different screening strategies and to evaluate the prevalence and determinants of isolated and overlapping sleep apnea in patients with slowly progressive NMD. METHODS This monocentric, cross-sectional, retrospective study analyzed medical records of adult NMD patients referred to a sleep department. Diagnostic strategies, including respiratory polygraphy (RP), nocturnal transcutaneous capnography (tcCO2), and blood gases (BG), were assessed for their performance in diagnosing SDB. Demographics and pulmonary function test results were compared between patients with or without SDB to identify predictors. RESULTS Among the 149 patients who underwent a full diagnostic panel (RP + tcCO2 + BG), 109 were diagnosed with SDB. Of these, 33% had isolated SAS, and central apneas were predominant. Using single diagnostic strategies would lead to inappropriate SDB management in two thirds of patients. A combination of 2 diagnostic tools resulted respectively in 21.1, 22.9 and 42.2 % of inappropriate SDB management for RP + tcCO2, RP + BG and tcCO2 + BG. CONCLUSION The significant prevalence of sleep apnea syndrome in patients with slowly progressive NMD highlights the need for increased awareness among clinicians. Improved diagnostics involve a systematic approach addressing both sleep apnea and diurnal and nocturnal alveolar hypoventilation to avoid inappropriate management and limit the consequences of SDB.
Collapse
Affiliation(s)
- Lucas Saulnier
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Garches, France; Unité de Recherche Clinique Paris Saclay Ouest, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - Hélène Prigent
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Garches, France; « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France
| | - Sarah Hartley
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Garches, France
| | | | - Isabelle Bossard
- Centre d'investigation Clinique 1429, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - Caroline Stalens
- AFM-Téléthon, Direction des Actions Médicales, Evry, 91000, France
| | - Frédéric Lofaso
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Garches, France; Université Paris-Saclay, UVSQ, ERPHAN, Versailles, 78000, France
| | - Antoine Leotard
- Service de Physiologie et d'Explorations Fonctionnelles, AP-HP, GHU Paris Saclay, Hôpital Raymond Poincaré, Garches, France; « End:icap » U1179 Inserm, UVSQ-Université Paris-Saclay, Versailles, 78000, France.
| |
Collapse
|
3
|
Léotard A, Delorme M, Delord V, Niel-Duriez M, Orlikowski D, Annane D, Prigent H, Lofaso F. Expiratory obstruction in patients with Duchenne muscular dystrophy under non-invasive ventilation: A step-by-step analysis of a new obstructive pattern. Chron Respir Dis 2021; 18:14799731211036901. [PMID: 35289675 PMCID: PMC8981231 DOI: 10.1177/14799731211036901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Non-invasive ventilation (NIV) is the reference standard for managing chronic hypoventilation in patients with Duchenne muscular dystrophy (DMD). In these patients, upper airway obstruction under NIV may compromise efficacy and adherence. We aim to describe a novel pattern of expiratory obstructive events occurring during nocturnal barometric NIV. METHODS We retrospectively included all patients with DMD who underwent full-night polygraphy during NIV as part of their usual follow-up between May 2018 and July 2019. RESULTS We provide a step-by-step description of this previously undescribed pattern of obstruction. Expiratory obstructions lead to end-inspiratory breath-holding and impossibility to take another inspiratory breath with a barometric mode until expiration occurs. These events were observed in 4 (36%) of 11 DMD patients under barometric NIV. CONCLUSION Expiratory obstructions may be common in DMD patients receiving NIV and should be sought out routinely. This previously undescribed variant of obstructive event must be identified.
Collapse
Affiliation(s)
- Antoine Léotard
- Département de Physiologie, Explorations Fonctionnelles, Unité des Pathologies du Sommeil, 26930AP-HP, Hôpital Raymond Poincaré, Garches, France.,30133Université Versailles-Saint-Quentin-en-Yvelines, END:ICAP U1179 Inserm, UFR des Sciences de la Sante-Simone-Veil, Versailles, France
| | - Mathieu Delorme
- UVSQ, ERPHAN, 27048Université Paris-Saclay, Versailles, France
| | - Vincent Delord
- Département de Physiologie, Explorations Fonctionnelles, Unité des Pathologies du Sommeil, 26930AP-HP, Hôpital Raymond Poincaré, Garches, France.,SOS Oxygène, Nice, France
| | - Myriam Niel-Duriez
- Service de Médecine Intensive Réanimation - Unité Fonctionnelle de Ventilation à Domicile, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - David Orlikowski
- 30133Université Versailles-Saint-Quentin-en-Yvelines, END:ICAP U1179 Inserm, UFR des Sciences de la Sante-Simone-Veil, Versailles, France.,Service de Médecine Intensive Réanimation - Unité Fonctionnelle de Ventilation à Domicile, AP-HP, Hôpital Raymond Poincaré, Garches, France.,Centre d'Investigation Clinique 1429, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - Djillali Annane
- Service de Médecine Intensive Réanimation - Unité Fonctionnelle de Ventilation à Domicile, AP-HP, Hôpital Raymond Poincaré, Garches, France
| | - Hélène Prigent
- Département de Physiologie, Explorations Fonctionnelles, Unité des Pathologies du Sommeil, 26930AP-HP, Hôpital Raymond Poincaré, Garches, France.,30133Université Versailles-Saint-Quentin-en-Yvelines, END:ICAP U1179 Inserm, UFR des Sciences de la Sante-Simone-Veil, Versailles, France
| | - Frédéric Lofaso
- Département de Physiologie, Explorations Fonctionnelles, Unité des Pathologies du Sommeil, 26930AP-HP, Hôpital Raymond Poincaré, Garches, France.,30133Université Versailles-Saint-Quentin-en-Yvelines, END:ICAP U1179 Inserm, UFR des Sciences de la Sante-Simone-Veil, Versailles, France
| |
Collapse
|
4
|
Levy J, Léotard A, Lawrence C, Paquereau J, Bensmail D, Annane D, Delord V, Lofaso F, Bessis S, Prigent H. A model for a ventilator-weaning and early rehabilitation unit to deal with post-ICU impairments following severe COVID-19. Ann Phys Rehabil Med 2020; 63:376-378. [PMID: 32315800 PMCID: PMC7165266 DOI: 10.1016/j.rehab.2020.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/11/2020] [Accepted: 04/11/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Jonathan Levy
- Ventilator weaning unit-AP-HP, Hôpital Raymond-Poincaré, Garches, France; Department of Physical and Rehabilitation Medicine-AP-HP, Hôpital Raymond-Poincaré, Garches, France; UFR des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.
| | - Antoine Léotard
- Ventilator weaning unit-AP-HP, Hôpital Raymond-Poincaré, Garches, France; Department of Physiology-AP-HP, Hôpital Raymond-Poincaré, Garches, France; UFR des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Christine Lawrence
- Microbiology laboratory-AP-HP, Hôpital Raymond-Poincaré, Garches, France
| | - Julie Paquereau
- Ventilator weaning unit-AP-HP, Hôpital Raymond-Poincaré, Garches, France; Department of Physical and Rehabilitation Medicine-AP-HP, Hôpital Raymond-Poincaré, Garches, France
| | - Djamel Bensmail
- Department of Physical and Rehabilitation Medicine-AP-HP, Hôpital Raymond-Poincaré, Garches, France; UFR des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Djillali Annane
- Intensive Care Unit-AP-HP, Hôpital Raymond-Poincaré, Garches, France; UFR des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Vincent Delord
- Ventilator weaning unit-AP-HP, Hôpital Raymond-Poincaré, Garches, France; Department of Physiology-AP-HP, Hôpital Raymond-Poincaré, Garches, France; SOS Oxygène, Nice, France
| | - Frédéric Lofaso
- Ventilator weaning unit-AP-HP, Hôpital Raymond-Poincaré, Garches, France; Department of Physiology-AP-HP, Hôpital Raymond-Poincaré, Garches, France; UFR des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Simon Bessis
- Infectious diseases unit-AP-HP, Hôpital Raymond-Poincaré, Garches, France; UFR des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Hélène Prigent
- Ventilator weaning unit-AP-HP, Hôpital Raymond-Poincaré, Garches, France; Department of Physiology-AP-HP, Hôpital Raymond-Poincaré, Garches, France; UFR des Sciences de la Santé Simone-Veil, Université de Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| |
Collapse
|
5
|
Khirani S, Delord V, Olmo Arroyo J, De Sanctis L, Frapin A, Amaddeo A, Fauroux B. Can the analysis of built-in software of CPAP devices replace polygraphy in children? Sleep Med 2017; 37:46-53. [DOI: 10.1016/j.sleep.2017.05.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/16/2017] [Accepted: 05/21/2017] [Indexed: 11/16/2022]
|
6
|
Khirani S, Ramirez A, Delord V, Leroux K, Lofaso F, Hautot S, Toussaint M, Orlikowski D, Louis B, Fauroux B. Evaluation of ventilators for mouthpiece ventilation in neuromuscular disease. Respir Care 2014; 59:1329-37. [PMID: 24847097 DOI: 10.4187/respcare.03031] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Daytime mouthpiece ventilation is a useful adjunct to nocturnal noninvasive ventilation (NIV) in patients with neuromuscular disease. The aims of the study were to analyze the practice of mouthpiece ventilation and to evaluate the performance of ventilators for mouthpiece ventilation. METHODS Practice of mouthpiece ventilation was assessed by a questionnaire, and the performance of 6 home ventilators with mouthpiece ventilation was assessed in a bench test using 24 different conditions per ventilator: 3 mouthpieces, a child and an adult patient profile, and 4 ventilatory modes. RESULTS Questionnaires were obtained from 30 subjects (mean age 33 ± 11 y) using NIV for 12 ± 7 y. Fifteen subjects used NIV for > 20 h/day, and 11 were totally ventilator-dependent. The subject-reported benefits of mouthpiece ventilation were a reduction in dyspnea (73%) and fatigue (93%) and an improvement in speech (43%) and eating (27%). The bench study showed that none of the ventilators, even those with mouthpiece ventilation software, were able to deliver mouthpiece ventilation without alarms and/or autotriggering in each condition. Alarms and/or ineffective triggering or autotriggering were observed in 135 of the 198 conditions. The occurrence of alarms was more common with a large mouthpiece without a filter compared to a small mouthpiece with a filter (P < .001), but it was not related to the patient profile, the ventilatory mode, or the type of ventilator. CONCLUSIONS Subjects are satisfied with mouthpiece ventilation. Alarms are common with home ventilators, although less common in those with mouthpiece ventilation software. Improvements in home ventilators are needed to facilitate the expansion of mouthpiece ventilation.
Collapse
Affiliation(s)
- Sonia Khirani
- Pediatric Pulmonary Department, Assistance Publique-Hôpitaux de Paris, Hôpital Armand Trousseau, Paris, France. S2A Santé, Ivry sur Seine, France
| | - Adriana Ramirez
- Pediatric Pulmonary Department, Assistance Publique-Hôpitaux de Paris, Hôpital Armand Trousseau, Paris, France. Association d'Entraide des Polios et Handicapés Assistance, Suresnes, France
| | | | - Karl Leroux
- Association d'Entraide des Polios et Handicapés Assistance, Suresnes, France
| | - Frédéric Lofaso
- Physiologie-Explorations Fonctionnelles, Services de Réanimation Médicale, and the Centre d'Innovations Technologiques Unité Mixte de Recherche 805, Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris, Garches, France, and EA 4497, Université de Versailles, Saint-Quentin-en-Yvelines, France. Institut National de la Santé et de la Recherche Médicale U955, Université Paris Est, Faculté de Médecine, Centre National de la Recherche Scientifique ERL 7240, Créteil, France
| | - Solène Hautot
- IBIOM, Ingénierie pour le Biomédical, Faculté des Sciences et Techniques, Université de Rouen, Saint-Étienne du Rouvray, France
| | - Michel Toussaint
- Neuromuscular Excellence Center, VUB-Inkendaal, and the Center for Home Mechanical Ventilation, Z.H. Inkendaal Rehabilitation Hospital, Brussels, Belgium
| | - David Orlikowski
- Service de Réanimation Médicale, Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris, Garches, France, and the Université de Versailles, Saint-Quentin-en-Yvelines, France
| | - Bruno Louis
- Institut National de la Santé et de la Recherche Médicale U955, Université Paris Est, Faculté de Médecine, Centre National de la Recherche Scientifique ERL 7240, Créteil, France
| | - Brigitte Fauroux
- Pediatric Pulmonary Department, Assistance Publique-Hôpitaux de Paris, Hôpital Armand Trousseau, Paris, France. Institut National de la Santé et de la Recherche Médicale U955, Université Paris Est, Faculté de Médecine, Centre National de la Recherche Scientifique ERL 7240, Créteil, France. Université Pierre et Marie Curie-Paris 6, Paris, France.
| |
Collapse
|
7
|
Ramirez A, Khirani S, Aloui S, Delord V, Borel JC, Pépin JL, Fauroux B. Continuous positive airway pressure and noninvasive ventilation adherence in children. Sleep Med 2013; 14:1290-4. [PMID: 24157098 DOI: 10.1016/j.sleep.2013.06.020] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 06/03/2013] [Accepted: 06/08/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adherence to continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) is crucial for the successful treatment of sleep-disordered breathing. The aim of our study was to analyze the adherence of children to long-term home CPAP/NIV treatment. METHODS We analyzed data from all consecutive patients older than the age of 2years, in whom CPAP/NIV treatment was initiated in a specialized pediatric NIV and in those who were receiving CPAP/NIV treatment at home for at least 1month. Data of the memory cards of the ventilators and nocturnal gas exchange were analyzed during a routine CPAP/NIV overnight control in the hospital. CPAP/NIV adherence during the previous month was analyzed according to patient's age, ventilatory mode, type of interface, nocturnal gas exchange, and duration of treatment. RESULTS The data of 62 children (mean age, 10±5years) with obstructive sleep apnea (n=51) treated with CPAP and neuromuscular disease (n=6) or lung diseases (n=5) treated with NIV were analyzed. Mean adherence was 8:17±2:30h:min per night, and the results did not significantly differ between CPAP and NIV adherence. Seventy-two percent of the patients used their device >8h per night. The mean number of nights of CPAP/NIV use during the last month was 26±5 nights per month. Treatment adherence was not correlated to age, the type of underlying disease, the type of interface (nasal, facial mask, or nasal cannula), nocturnal gas exchange, and duration of CPAP/NIV treatment. CONCLUSION Long-term CPAP/NIV adherence at home was extremely high in this group of children followed in a pediatric NIV unit. This finding may explain the lack of effect of the interface, nocturnal gas exchange, and duration of CPAP/NIV treatment.
Collapse
Affiliation(s)
- Adriana Ramirez
- ADEP ASSISTANCE, Suresnes, France; AP-HP, Hôpital Armand Trousseau, Pediatric Pulmonary Department, Paris, France
| | | | | | | | | | | | | |
Collapse
|
8
|
Khirani S, Kadlub N, Delord V, Picard A, Fauroux B. Nocturnal mouthpiece ventilation and medical hypnosis to treat severe obstructive sleep apnea in a child with cherubism. Pediatr Pulmonol 2013; 48:927-9. [PMID: 23129383 DOI: 10.1002/ppul.22686] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 08/30/2012] [Accepted: 09/03/2012] [Indexed: 11/07/2022]
Abstract
A 4-year old boy presented severe obstructive sleep apnoea due to complete nasal obstruction secondary to cherubism. Because of anticipatory anxiety due to numerous surgical interventions, medical hypnosis was proposed to facilitate non-invasive continuous positive pressure ventilation (CPAP) acceptance. CPAP by means of an oral interface was completely accepted after three hypnosis sessions and resulted in the correction of his obstructive sleep apnea (OSA) syndrome. This report highlights the benefit of medical hypnosis in facilitating CPAP acceptance as well as the efficacy of mouthpiece ventilation in a severe form of cherubism with complete nasal obstruction.
Collapse
Affiliation(s)
- Sonia Khirani
- Inserm U 955 Pierre et Marie Curie-Paris 6 University, Paris, France
| | | | | | | | | |
Collapse
|
9
|
Delord V, Khirani S, Ramirez A, Joseph EL, Gambier C, Belson M, Gajan F, Fauroux B. Medical Hypnosis as a Tool to Acclimatize Children to Noninvasive Positive Pressure Ventilation. Chest 2013; 144:87-91. [DOI: 10.1378/chest.12-2259] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
10
|
Ramirez A, Khirani S, Delord V, Aubertin G, Pépin JL, Fauroux B. Assessment of sleep quality by pulse wave amplitude and actigraphy in children with sleep-disordered breathing: evaluation at diagnosis and under non-invasive ventilation. Sleep Breath 2012; 17:827-35. [DOI: 10.1007/s11325-012-0771-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 10/01/2012] [Accepted: 10/01/2012] [Indexed: 11/27/2022]
|
11
|
Ramirez A, Delord V, Khirani S, Leroux K, Cassier S, Kadlub N, Aubertin G, Picard A, Fauroux B. Interfaces for long-term noninvasive positive pressure ventilation in children. Intensive Care Med 2012; 38:655-62. [DOI: 10.1007/s00134-012-2516-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 01/05/2012] [Indexed: 11/30/2022]
|