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Long term ventilation into pediatric central apneas: etiologies, profiles and therapeutic approaches over a decade
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  • Santiago Presti,
  • Martino Pavone,
  • Elisabetta Verrillo,
  • Maria Giovanna Paglietti,
  • Anna Del Colle,
  • Salvatore Leonardi,
  • Renato Cutrera
Santiago Presti
Ospedale Pediatrico Bambino Gesu

Corresponding Author:[email protected]

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Martino Pavone
Ospedale Pediatrico Bambino Gesu
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Elisabetta Verrillo
Ospedale Pediatrico Bambino Gesu
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Maria Giovanna Paglietti
Ospedale Pediatrico Bambino Gesu
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Anna Del Colle
Ospedale Pediatrico Bambino Gesu
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Salvatore Leonardi
Universita degli Studi di Catania Dipartimento di Medicina Clinica e Sperimentale
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Renato Cutrera
Ospedale Pediatrico Bambino Gesu
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Abstract

Central apneas are a prevalent yet complex phenomenon, particularly among children. This retrospective study, conducted over a decade (from 2012 to 2022), analyzed central apneas in a cohort of 612 pediatric patients who underwent ventilation at the Sleep Medicine and Long-Term Ventilation Unit of the Bambino Gesù Children’s Hospital in Rome, Italy. Among this group, 67 patients met the inclusion criteria for central apneas. Central apneas often arise within the context of various underlying pathologies, including neurological disorders, genetic syndromes, and brain tumors. We categorized patients into three main groups including patients with “exclusively central apneas”, “predominantly central apneas”, and “predominantly obstructive apneas”. Ventilation modes were diverse, with pressure-controlled ventilation and pressure support being commonly used, reflecting the individualized nature of therapy. The choice of ventilation mode has been influenced by the underlying diagnosis and the severity of central apneas, with pressure support ventilation being the most frequently employed mode. Continuous Positive Airway Pressure was also employed in select cases. A statistically significant reduction (p<0.05) in mean cAHI was observed in patients with multimalformation syndromes, hypoxic-ischemic encephalopathy and Prader-Willi Syndrome. The reduction in mean cAHI was not statistically significant in the case of patients with brain tumors. While non-invasive ventilation was commonly used, invasive mechanical ventilation was selectively employed in more severe cases. The study highlights the need for personalized therapeutic strategies when managing central apneas in pediatric patients.
05 Feb 2024Submitted to Pediatric Pulmonology
05 Feb 2024Submission Checks Completed
05 Feb 2024Assigned to Editor
05 Feb 2024Review(s) Completed, Editorial Evaluation Pending
08 Feb 2024Reviewer(s) Assigned
02 Mar 2024Editorial Decision: Revise Major
03 Jun 2024Review(s) Completed, Editorial Evaluation Pending
07 Oct 20242nd Revision Received
10 Oct 2024Submission Checks Completed
10 Oct 2024Assigned to Editor
10 Oct 2024Review(s) Completed, Editorial Evaluation Pending
10 Oct 2024Reviewer(s) Assigned