Early use of Nasal-BiPAP in two infants with Congenital Central Hypoventilation syndrome

Acta Paediatr. 2003 Jul;92(7):823-6. doi: 10.1080/08035250310002849.


Aim: To reduce the problems caused by prolonged artificial ventilation in babies with Congenital Central Hypoventilation syndrome (CCHS).

Methods: Two term infants with CCHS, weighing 4030 g and 3100 g, respectively, at the beginning of treatment and aged 53 and 31 d, respectively, were successfully ventilated with a Nasal Bilevel Positive Airway Pressure (N-BiPAP) device.

Results: In the first patient the tcPO2 recordings (mean +/- SD) during sleep were 46 +/- 12 mmHg before using N-BiPAP and 58 +/- 13 mmHg after using the device, while those for tcPCO2 were 75 +/- 9 mmHg and 49 +/- 11 mmHg, respectively. In the second patient tcPO2 during sleep was 42 +/- 3 mmHg before, and 55 +/- 5 after N-BiPAP, and for tcPCO2 the recordings were 119 +/- 24 mmHg and 55 +/- 6 mmHg, respectively, showing a significant improvement. One infant had persistent gastro-oesophageal reflux, and frontal skin abrasion caused by the face mask. Nevertheless, these complications did not necessitate the discontinuation of N-BiPAP ventilation, thus precluding prolonged use of intubation and tracheotomy.

Conclusion: In infants with CCHS, early use of non-invasive, positive-pressure ventilation with N-BiPAP, in association with careful monitoring, can decrease problems caused by prolonged intubation and tracheotomy.

Publication types

  • Case Reports

MeSH terms

  • Apnea / diagnosis
  • Brain / anatomy & histology
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Magnetic Resonance Imaging
  • Male
  • Polysomnography
  • Positive-Pressure Respiration / methods*
  • Sleep Apnea, Central / congenital*
  • Sleep Apnea, Central / therapy*