The Ventilatory Management of Paediatric Central Sleep Apnoea: A Systematic Review

Hodge, Kane S.;Jones, Anne

Abstract

Purpose: Paediatric central sleep apnoea (CSA) occurs more frequently in the presence of another medical condition. This systematic review aimed to determine the effectiveness of oxygen therapy and non-invasive ventilation (NIV) for children with CSA and additional underlying comorbidities. Method: A search was undertaken of CINAHL Complete, Emcare, Scopus, MEDLINE, and PubMed with forward and backward citations for studies published between database inception and the 5th of May 2022. Articles of any study design or quality were included, excluding systematic reviews, letters, or study protocols. Articles had to involve only paediatric patients with a diagnosis of CSA with another underlying pathology and incorporate a detailed treatment protocol involving oxygen therapy or NIV to be eligible for inclusion. Relevant articles selected for the review were thoroughly analysed and appraised using the Crowe Critical Appraisal Tool. Using the Synthesis Without Meta-analysis (SWiM) reporting guideline, a narrative synthesis was utilised due to heterogeneity in the populations, interventions, outcomes, and designs of included studies. Results: Of 3295 identified articles, 13 were eligible, with critical appraisal detecting common weaknesses in the areas of ethical matters, results, and discussion sections of articles (mean total score of 69%). Nocturnal oxygen therapy and NIV positively impacted polysomnography results. A wide range of underlying diagnoses were associated with CSA, however, definitive conclusions surrounding the interventions’ effectiveness and applicability to specific presentations could not be drawn. Conclusions: Research quality was generally poor, with studies’ external validity, strengths/limitations, and suggestions for future research rarely described. The presence of reporting bias and a lack of analysis, integration, and interpretation methods were also limitations. Future research should include larger samples through the organisation of multi-centred trials to increase the generalisability and validity of the results. The impact of patient adherence to interventions should also be explored.

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1540-580X

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Nova Southeastern University

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