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Case Reports
. 2020 Sep 27;4(3):222-224.
doi: 10.1002/ped4.12221. eCollection 2020 Sep.

Non-invasive home ventilation using the average volume assured pressure support feature in an infant with severe bronchopulmonary dysplasia and chronic respiratory failure

Vishal Saddi  1   2 , Ganesh Thambipillay  1   2 , Arthur Teng  1   2
Affiliations
Case Reports

Non-invasive home ventilation using the average volume assured pressure support feature in an infant with severe bronchopulmonary dysplasia and chronic respiratory failure

Vishal Saddi et al. Pediatr Investig. .

Abstract

Introduction: While majority of infants with bronchopulmonary dysplasia (BPD) can be discharged home without low flow oxygen or on supplemental low flow oxygen, some require long term home mechanical ventilation.

Case presentation: We present a case of an extremely premature infant with severe bronchopulmonary dysplasia who was successfully managed at home on a new feature of non-invasive ventilation called average volume assured pressure support (AVAPS) without the need for tracheostomy. The AVAPS feature enables the machine to deliver a consistent tidal volume by automatically adjusting the inspiratory pressure within a set range.

Conclusion: The use of AVAPS feature in our case improved ventilation as indicated by a more stable gas exchange profile, making home non-invasive ventilation a more practicable method of managing severe BPD in this infant.

Keywords: Average volume assured pressure support (AVAPS); Bronchopulmonary dysplasia; Home ventilation; Infant.

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Conflict of interest statement

We have no conflict of interest to report.

Figures

FIGURE 1
FIGURE 1
Hypnogram with oxygen saturation and transcutaneous carbon dioxide (TcCO2) on split study (low flow oxygen and conventional bi‐level positive airway pressure [BPAP]) and average volume assured pressure support (AVAPS) titration study. (A) Study was commenced on low flow oxygen and changed to conventional BPAP with 2 L/min of supplemental oxygen through the BPAP circuit after the first REM sleep. Note disrupted sleep with high TcCO2 and frequent oxygen desaturation. (B) TcCO2 trace on polysomnography using AVAPS. Note improvement in TcCO2, oxygen saturation and sleep efficiency.
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