Brigitte Fauroux

and 50 more

Objective The aim of the study was to describe the characteristics of otherwise healthy children with obstructive sleep apnea (OSA; OSA-I) and children with OSA and obesity (OSA-II) treated with long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) in 2019 in France. Design National cross-sectional survey. Patients Children with OSA-I and OSA-II. Main outcome measures Initiation criteria, age, adherence, equipment and settings Results Patients with OSA-I and OSA-II represented 6% (n=84, 71% males) and 10% (n=144, 72% males) of the national cohort, respectively. The apnea-hypopnea index (63% vs 76%), alone or combined with nocturnal gas exchange (25% vs 21%, for OSA-II and OSA-I patients respectively) were used as initiation criteria of CPAP/NIV. OSA-II patients were older at CPAP/NIV initiation (mean age 11.0±4.0 vs 6.8±4.5 years, p<0.001) and were treated for a longer time (2.3±2.6 vs 1.3±1.5 years, p=0.008) than OSA-I patients. NIV was used in 6% of OSA-I patients and 13% of OSA-II patients (p=0.142). Nasal mask was the most used interface in both groups. Mean CPAP level was higher in OSA-II patients as compared to OSA-I patients (8.7±2.0 vs 7.7±2.4 cmH 2O, p=0.02). Objective compliance was comparable (mean use 6.8±2.6 vs 5.9±3.0 hours/night in OSA-I and OSA-II, respectively, p=0.054). Conclusion Six and 10% of children treated with long term CPAP/NIV in France in 2019 had OSA-I and OSA-II, respectively. Both groups were preferentially treated with CPAP and were comparable except for age, with OSA-II patients being older.

Hortense Petat

and 3 more

Background: Cystic fibrosis (CF) is the most common autosomal recessive disease in Caucasian population. Allergic bronchopulmonary aspergillosis (ABPA) is one of the severe complications of CF, on which diagnosis is based on symptoms and blood IgE levels. Many techniques of specific IgG levels measures are used, which signification is still unclear. We evaluated evolution of patients who presented a first aspergillosis IgG seroconversion. Methods: Monocentric pediatric case-control study led in Rouen, France. Every patient with a first aspergillosis IgG seroconversion was paired with a seronegative patient. Clinical data, functional respiratory investigations, CT-scan and biologic data were collected a year before (Y -1), a year after (Y +1) and at the moment of the first aspergillosis seroconversion. Results: 36 cases, paired with 36 controls. Median age was 8. Forced expiratory volume in 1 second was significantly lower at Y +1 (p=0,025) and Vital Capacity was significantly lower at Y 0 (p= 0.027) in the case-population. More respiratory exacerbations were observed in the case-population (p=0,047). Higher specific IgE against A. fumigatus levels were observed at Y 0 (p=0,014), Y -1 (p=0,001) and Y +1 (p=0,04) in the case-population. Total IgG were significantly higher at Y 0 in the case-population. On the CT-scan, bronchiectasis and pulmonary infiltrates were more important in the case-population (p=0,01 and p=0,003 respectively). Conclusion: Aspergillosis seroconversion is associated with changes of clinical, respiratory functional, biologic and radiologic parameters in CF population. Aspergillosis seroconversion is a milestone in the evolution of CF. A systematic research is needed, to evaluate actions to be taken.