Interfaces for non invasive ventilation in children

Background: Over recent years the improvement of non-invasive ventilation (NIV) use in pediatrics is also the result of the availability of more sophisticated materials and new specific pediatric mask interfaces. Selection and assessment of optimal mask interfaces currently relies on the expertise and knowledge of those choosing the mask. Respiratory physiotherapists (PTs) are increasingly involved in the use of NIV, contributing to its introduction and proper selection of the interface. Aims & Objectives: The aim of the study is  to investigate the most used interfaces in children when initiating an home NIV program Methods: Review of the clinical charts of patients who undergone to NIV  in AOU Meyer Children Hospital, with the supervision of a PT, from june 2014 to june 2019.  Diagnosis of Cystic Fibrosis and Central Congenital Hypoventilation Syndrome were excluded. Result: Forty-nine patient (23 Male, 5,78 +/- 5,38 years mean age) were initiated on NIV with the involvement of a PT, majority of patient were treated as in-patient (87,8%). Most common diagnostic categories included: cerebral palsy and neurological disorders (20,4% n=10), metabolic disorders (14,8% n=7) & neuromuscular disease (12,24% n=5); nasal-mask was the most used (65,3% n=32), followed by full-face mask (24,5% n=12). Spontaneous/timed mode (38,78% n=19) and continuous positive pressure (26,53%, n= 13) were the most used ventilation mode; full face mask was correlated with higher median IPAP (13[3]) values  compared to nasal mask (p=0.047) Conclusion: Consistent with existing literature, nasal-mask is the first choice for children who start NIV; however oro-nasal mask could be an alternative for higher IPAP values.