Reshma Amin, MD, FRCPC, MSc
The Hospital for Sick Children and University of Toronto, Toronto, ON

This 30-minute case-based session will provide an approach to the monitoring of patients with NIV including clinic visit frequency, polysomnograms and NIV data download interpretation in children with neuromuscular disease and other comorbidities. Clinic visit frequency and the utility of polysomnography/gas exchange measurements will be discussed. In addition, a stepwise approach to the interpretation of ventilatory data downloads will be reviewed including adherence, leak management and efficacy. The metrics to consider for adherence in pediatric patients will be discussed. Key concepts for leak management including intentional and unintentional leak and differences between manufacturers will be reviewed. Learners will also be provided with an approach to the interpretation of efficacy metrics including tidal volumes, rapid shallow breathing index and percentage spontaneous triggered and cycled breaths as well as inspiratory times. Combined ventilator data download reports with oximetry and heart rate will also be reviewed. The clinical cases will include a wide range of NIV devices and modes.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Appreciate the importance of routine polysomnograms/gas exchange evaluation to continually evaluate the necessity and efficacy of NIV therapy in conjunction with NIV data download interpretation;
  • Use a stepwise approach to NIV data download interpretation (adherence, leak and efficacy) to augment the clinical management of children using NIV at home; and
  • Troubleshoot common clinical issues identified on NIV data downloads and have an approach to their management.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar