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  1. Article ; Online: Positive end-expiratory pressure in chronic care of children with obstructive sleep apnoea.

    Fauroux, Brigitte / Vedrenne-Cloquet, Meryl

    Paediatric respiratory reviews

    2023  Volume 49, Page(s) 2–4

    Abstract: Positive end-expiratory pressure (PEEP) consists of the delivery of a constant positive pressure in the airways by means of a noninvasive interface aiming to maintain airway patency throughout the entire respiratory cycle. PEEP is increasingly used in ... ...

    Abstract Positive end-expiratory pressure (PEEP) consists of the delivery of a constant positive pressure in the airways by means of a noninvasive interface aiming to maintain airway patency throughout the entire respiratory cycle. PEEP is increasingly used in the chronic care of children with anatomical or functional abnormalities of the upper airways to correct severe persistent obstructive sleep apnea despite optimal management which commonly includes adenotonsillectomy in young children. PEEP may be used at any age, due to improvements in equipment and interfaces. Criteria for CPAP/NIV initiation, optimal setting, follow-up and monitoring, as well as weaning criteria have been established by international experts, but validated criteria are lacking. As chronic PEEP is a highly specialised treatment, patients should be managed by an expert pediatric multidisciplinary team.
    MeSH term(s) Child ; Humans ; Child, Preschool ; Positive-Pressure Respiration ; Sleep Apnea, Obstructive/therapy ; Adenoidectomy ; Tonsillectomy ; Continuous Positive Airway Pressure
    Language English
    Publishing date 2023-01-11
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2147664-0
    ISSN 1526-0550 ; 1526-0542
    ISSN (online) 1526-0550
    ISSN 1526-0542
    DOI 10.1016/j.prrv.2023.01.001
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    Zs.A 5919: Show issues Location:
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  2. Article: Accuracy of tidal volume delivery by paediatric intensive care ventilators: A bench-model study.

    Vedrenne-Cloquet, Meryl / Tuffet, Samuel / Louis, Bruno / Khirani, Sonia / Collignon, Charlotte / Renolleau, Sylvain / Fauroux, Brigitte / Carteaux, Guillaume

    Australian critical care : official journal of the Confederation of Australian Critical Care Nurses

    2024  

    Abstract: Background: Tidal volume (Vt) delivery during mechanical ventilation is influenced by gas compression, humidity, and temperature.: Objectives: This bench study aimed at assessing the accuracy of Vt delivery by paediatric intensive care ventilators ... ...

    Abstract Background: Tidal volume (Vt) delivery during mechanical ventilation is influenced by gas compression, humidity, and temperature.
    Objectives: This bench study aimed at assessing the accuracy of Vt delivery by paediatric intensive care ventilators according to the humidification system. Secondary objectives were to assess the following: (i) the accuracy of Vt delivery in ventilators with an integrated Y-piece pneumotachograph and (ii) the ability of ventilators to deliver and maintain a preset positive end-expiratory pressure.
    Methods: Six latest-generation intensive care ventilators equipped with a paediatric mode were tested on the ASL5000 test lung in four simulated paediatric bench models (full-term neonate, infant, preschool-age chile, and school-age child), under volume-controlled mode with a heated humidifier (HH) or a heat moisture exchanger, with various loading conditions. Three ventilators equipped with a Y-piece pneumotachograph were tested with or without the pneumotachograph in the neonatal and infant models. "Accurate Vt" delivery was defined as a volume error (percentage of the preset Vt under body temperature and pressure and saturated water vapour conditions) being ≤10 % of the absolute preset value.
    Results: Vt accuracy varied significantly across ventilators but was acceptable in almost all the ventilators and all the models, except the neonatal model. The humidification system had an impact on Vt delivery in the majority of the tested conditions (p < 0.05). The use of an HH was associated with a better Vt accuracy in four ventilators (V500, V800, R860, and ServoU) and allowed to achieve an acceptable level of volume error in the neonatal model as compared to the use of heat moisture exchanger. The use of an integrated pneumotachograph was associated with lower volume error in only one ventilator (p < 0.01). All the tested ventilators were able to maintain adequate positive end-expiratory pressure levels.
    Conclusion: The humidification system affects Vt accuracy of paediatric intensive care ventilators, especially in the youngest patients for whom the HH should be preferred.
    Language English
    Publishing date 2024-01-23
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1159493-7
    ISSN 1878-1721 ; 1036-7314
    ISSN (online) 1878-1721
    ISSN 1036-7314
    DOI 10.1016/j.aucc.2023.12.007
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  3. Article ; Online: Work of breathing: A tool for the respiratory management of severe bronchopulmonary dysplasia.

    Dudoignon, Benjamin / Khirani, Sonia / Vedrenne-Cloquet, Meryl / Amaddeo, Alessandro / Bokov, Plamen / Renolleau, Sylvain / Fauroux, Brigitte

    Pediatric pulmonology

    2024  Volume 59, Issue 4, Page(s) 1128–1132

    MeSH term(s) Infant, Newborn ; Humans ; Bronchopulmonary Dysplasia/therapy ; Work of Breathing ; Infant, Premature ; Respiration
    Language English
    Publishing date 2024-02-14
    Publishing country United States
    Document type Letter
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26874
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  4. Article ; Online: Detection of Simulated Pediatric Breathing by CPAP/Noninvasive Ventilation Devices.

    Fresnel, Emeline / Vedrenne-Cloquet, Meryl / Lebret, Marius / Griffon, Lucie / Fauroux, Brigitte / Khirani, Sonia

    Respiratory care

    2023  Volume 68, Issue 8, Page(s) 1087–1096

    Abstract: Background: Home CPAP and noninvasive ventilation (NIV) are increasingly used in children. An appropriate choice of the CPAP/NIV device, according to the manufacturer recommendations, should guarantee accurate data collection software. However, not all ... ...

    Abstract Background: Home CPAP and noninvasive ventilation (NIV) are increasingly used in children. An appropriate choice of the CPAP/NIV device, according to the manufacturer recommendations, should guarantee accurate data collection software. However, not all devices display accurate patient data. We hypothesized that the detection of patient breathing may be expressed as a minimal tidal volume (V
    Methods: Twelve level I-III devices were analyzed using a bench test. Pediatric profiles were simulated with increasing V
    Results: V
    Conclusions: Based on the V
    MeSH term(s) Child ; Humans ; Infant ; Continuous Positive Airway Pressure ; Home Care Services ; Noninvasive Ventilation ; Respiration ; Tidal Volume ; Ventilators, Mechanical
    Language English
    Publishing date 2023-05-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.10785
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  5. Article ; Online: Respiratory effort during noninvasive positive pressure ventilation and continuous positive airway pressure in severe acute viral bronchiolitis.

    Vedrenne-Cloquet, Meryl / Khirani, Sonia / Griffon, Lucie / Collignon, Charlotte / Renolleau, Sylvain / Fauroux, Brigitte

    Pediatric pulmonology

    2023  Volume 58, Issue 7, Page(s) 2000–2008

    Abstract: Objectives: To assess if noninvasive positive pressure ventilation (NIPPV) is associated with a greater reduction in respiratory effort as compared to continuous positive airway pressure (CPAP) during severe acute bronchiolitis, with both supports set ... ...

    Abstract Objectives: To assess if noninvasive positive pressure ventilation (NIPPV) is associated with a greater reduction in respiratory effort as compared to continuous positive airway pressure (CPAP) during severe acute bronchiolitis, with both supports set either clinically or physiologically.
    Methods: Twenty infants (median [IQR] age 1.2 [0.9; 3.2] months) treated <24 h with noninvasive respiratory support (CPAP Clin, set at 7 cmH
    Results: NIPPV Clin and Phys were associated with a lower PTP
    Conclusion: NIPPV is associated with a significant reduction in respiratory effort as compared to CPAP set at +7 cmH
    MeSH term(s) Humans ; Infant ; Bronchiolitis, Viral/therapy ; Continuous Positive Airway Pressure ; Cross-Over Studies ; Noninvasive Ventilation ; Pneumonia/therapy ; Prospective Studies ; Infant, Newborn
    Language English
    Publishing date 2023-04-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26424
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  6. Article: Low Dosing Norepinephrine Effects on Cerebral Oxygenation and Perfusion During Pediatric Shock.

    Vedrenne-Cloquet, Meryl / Chareyre, Judith / Léger, Pierre-Louis / Genuini, Mathieu / Renolleau, Sylvain / Oualha, Mehdi

    Frontiers in pediatrics

    2022  Volume 10, Page(s) 898444

    Abstract: Background: Cerebral hypoperfusion and impaired oxygen delivery during pediatric critical illness may result in acute neurologic injury with subsequent long-term effects on neurodevelopmental outcome. Yet, the impact of norepinephrine on cerebral ... ...

    Abstract Background: Cerebral hypoperfusion and impaired oxygen delivery during pediatric critical illness may result in acute neurologic injury with subsequent long-term effects on neurodevelopmental outcome. Yet, the impact of norepinephrine on cerebral hemodynamics is unknown in children with shock. We aimed to describe the norepinephrine effects on cerebral perfusion and oxygenation during pediatric shock.
    Patients and methods: We conducted an observational multicentre prospective study in 3 French pediatric intensive care units. Children <18 years of age excluding traumatic brain injury were included in the study if they need norepinephrine for shock. Systemic and cerebral hemodynamics were compared between the time of initiation of norepinephrine (T
    Main results: Fourteen children (median [IQR] age of 3.5[1; 13.5] years) were included. Norepinephrine at 0.2[0.1; 0.32] μg/kg/min significantly increased mean arterial blood pressure (61[56; 73] mmHg at T
    Conclusions: Low-dosing norepinephrine, despite a homogeneous and significant increase in arterial blood pressure, had little effects on cerebral perfusion and oxygenation during pediatric shock. This reinforces the need for personalized tailored therapies in this population.
    Trial registration: Clinicaltrials.gov, NCT03731104. Registered 6 November, 2018. https://clinicaltrials.gov/ct2/show/NCT03731104.
    Language English
    Publishing date 2022-07-06
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2022.898444
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  7. Article ; Online: Effect of long term noninvasive ventilation in children on parent's quality of life.

    Sanctis, Livio / Khirani, Sonia / Vedrenne-Cloquet, Meryl / Griffon, Lucie / Cozzo, Mathilde / Olmo Arroyo, Jorge / Sidhoum, Lynda / Ouss, Lisa / Fauroux, Brigitte

    Pediatric pulmonology

    2023  Volume 58, Issue 10, Page(s) 2750–2756

    Abstract: Objective: Improving or maintaining the quality of life of the family of children treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) is a major concern; but studies are scarce. The aim of the study was to ... ...

    Abstract Objective: Improving or maintaining the quality of life of the family of children treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) is a major concern; but studies are scarce. The aim of the study was to evaluate the impact of long term CPAP or NIV in children on anxiety, depression, quality of sleep, and quality of life of their parents.
    Methods: Validated questionnaires evaluating anxiety and depression (hospital anxiety and depression scale), sleep quality (Pittsburgh sleep quality index), daytime sleepiness (Epworth sleepiness scale), and parents' quality of life (PedsQL family impact module) were completed by parents of children who were started on CPAP/NIV before (M0) and after 6-9 months (M6) of treatment.
    Results: The questionnaires of 36 parents (30 mothers, 6 fathers) of 31 children were analyzed. For the entire group, no significant change was observed in anxiety, depression, sleep quality, daytime sleepiness, and quality of life between M0 and M6. When analyzing questionnaire class changes between M0 and M6: anxiety was relieved in 23% of parents and worsened in 29%, depression was relieved in 14% and worsened in 20%, sleep quality improved in 43% and worsened in 27%, sleepiness improved in 26% and worsened in 17%, with no change in the other parents.
    Conclusion: Long term CPAP/NIV in children had no significant effect on parents' anxiety, depression, sleep quality, and quality of life.
    Language English
    Publishing date 2023-07-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26574
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  8. Article ; Online: Why breath-by-breath built-in software data should be used to monitor CPAP/NIV in children?

    Khirani, Sonia / Dosso, Marine / Gerin, Lorène / Basa, Mihail / Collignon, Charlotte / Vedrenne-Cloquet, Meryl / Griffon, Lucie / Fauroux, Brigitte

    Pediatric pulmonology

    2023  Volume 59, Issue 2, Page(s) 506–509

    MeSH term(s) Child ; Humans ; Respiratory System ; Software ; Noninvasive Ventilation ; Continuous Positive Airway Pressure
    Language English
    Publishing date 2023-11-03
    Publishing country United States
    Document type Letter
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26740
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  9. Article ; Online: Limitations of the apnea-hypopnea index in children and young adults with neuromuscular disorders.

    Ronco, Lucia / Khirani, Sonia / Vedrenne-Cloquet, Meryl / Barrois, Remi / Barnerias, Christine / Desguerre, Isabelle / Bignamini, Elisabetta / Fauroux, Brigitte

    Neuromuscular disorders : NMD

    2023  Volume 33, Issue 6, Page(s) 468–473

    Abstract: There are no validated criteria to initiate noninvasive ventilation (NIV) in children and young adults with neuromuscular disease (NMD). In order to analyze NIV initiation criteria, we reviewed the polysomnography (PSG) criteria that led to the ... ...

    Abstract There are no validated criteria to initiate noninvasive ventilation (NIV) in children and young adults with neuromuscular disease (NMD). In order to analyze NIV initiation criteria, we reviewed the polysomnography (PSG) criteria that led to the initiation of NIV in 61 consecutive patients with NMD, median age 4.1 (0.8-21) years, who had a PSG during their routine care. NIV was initiated on abnormal PSG data (apnea-hypopnea index (AHI) > 10 events/h and/or a transcutaneous carbon dioxide pressure > 50 mmHg and/or a pulse oximetry 〈 90%, both during at least 2% sleep time or 〉 5 consecutive minutes) in 11 (18%) patients. Six of these 11 patients had an AHI ≤ 10 events/h and would not have been ventilated if only AHI was retained. However, one of these 6 patients had isolated nocturnal hypoxemia, 3 isolated nocturnal hypercapnia and 2 abnormal respiratory events. Six (10%) patients with a normal PSG were started on NIV on clinical criteria. Our results show the limitation of the AHI when taken as the unique PSG criterion for NIV initiation in young patients with NMD and underline the need to include also abnormalities of overnight gas exchange into the NIV decision-making process.
    MeSH term(s) Humans ; Child ; Young Adult ; Child, Preschool ; Sleep Apnea Syndromes ; Respiration, Artificial ; Noninvasive Ventilation ; Hypercapnia/diagnosis ; Neuromuscular Diseases/diagnosis ; Neuromuscular Diseases/therapy
    Language English
    Publishing date 2023-05-05
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 1077681-3
    ISSN 1873-2364 ; 0960-8966
    ISSN (online) 1873-2364
    ISSN 0960-8966
    DOI 10.1016/j.nmd.2023.05.001
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  10. Article ; Online: Why home NIV devices should have a Ti min/Ti max?

    Khirani, Sonia / Dosso, Marine / Collignon, Charlotte / Tommesani, Chiara / Vedrenne-Cloquet, Meryl / Griffon, Lucie / Fauroux, Brigitte

    Pediatric pulmonology

    2023  Volume 58, Issue 8, Page(s) 2417–2421

    MeSH term(s) Humans ; Titanium ; Respiratory Insufficiency ; Noninvasive Ventilation ; Pulmonary Disease, Chronic Obstructive
    Chemical Substances Titanium (D1JT611TNE)
    Language English
    Publishing date 2023-05-19
    Publishing country United States
    Document type Letter
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26492
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