Home paediatric CPAP/NIV: the basics.

The use of home continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) is constantly growing in children. CPAP comprises constant CPAP and auto CPAP (APAP), while NIV comprises several modes of ventilation, among which barometric modes are nowadays the most used. Initiation criteria, indications, initiation location and strategies, and CPAP/NIV settings will be reviewed for both CPAP and NIV. The equipment, comprising the devices, interfaces, circuits and humidifiers, has to be mastered, particularly in paediatrics, with the knowledge of their advantages and limits. A close follow-up is mandatory, and strategies exist to compensate for the lack of resources, such as the availability of hospital beds. Adherence to CPAP/NIV, and the management of unintentional leaks, residual respiratory events, and/or patient-ventilator asynchronies are the clues for treatment efficacy, and need to be addressed on a regular basis.