Bi-level positive airway pressure (BiPAP) ventilation in an infant with central hypoventilation syndrome

Maria Pia Villa, Andrea Dotta, Domenico Castello, Silvana Piro, Jacopo Pagani, Sabrina Palamides, Roberto Ronchetti

Research output: Contribution to journalArticlepeer-review

Abstract

Summary. A 4-month-old baby girl, after a period of apparent good health, began to have aphonia, dyspnea, difficulties with swallowing, cyanosis, apnea, and hypopnea during sleep that resulted in admission to an intensive care unit for intubation and mechanical ventilation. At the age of 9 months she was admitted to our hospital with a possible diagnosis of central hypoventilation syndrome. A polysomnographic study showed apnea and hypopnea (apnea + hypopnea index = 47.1), hypercapnia (mean end-tidal Pco2 89 ± 15.0 mmHg), and arterial denaturation (mean Sao2 91 ± 1.7%; lowest Sao2 <50%; 68% of total sleep time at Sao2 below 93%); the study also showed an absent ventilatory response to CO2, absent cardiac responses to apnea during sleep, and right ventricular hypertrophy. Nocturnal nasal bi- level positive airway pressure (BiPAP), applied initially at 6 cmH2O and gradually increased to 16 cmH2O, caused the sleep-related abnormal respiratory events to disappear. End-tidal PCO2 decreased to 39 mmHg, and Sao2 increased to 94%. After 6 months of nocturnal BiPAP ventricular fight hypertrophy reversed and arrested growth and hypotonia normalized. The child has tolerated and has remained on BiPAP support up to her current age of 3 years and continues to use this form of ventilatory assistance without difficulties.

Original languageEnglish
Pages (from-to)66-69
Number of pages4
JournalPediatric Pulmonology
Volume24
Issue number1
DOIs
Publication statusPublished - Jul 1997

Keywords

  • BiPAP ventilation
  • Central hypoventilation syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

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