Adult patients with heart failure (HF) have an increased work of breathing and are at increased risk for obstructive and/or central apnea during sleep. Noninvasive continuous positive airway pressure (CPAP) has proved its efficacy in decreasing the work of breathing and improving sleep-disordered breathing in these patients. The aim of the study is to analyze the work of breathing and objective and subjective sleep quality in children with HF and to evaluate the ability of noninvasive CPAP to decrease the work of breathing and improve cardiac output during wakefulness.
The study starts with the measurement during wakefulness of * the breathing pattern and work of breathing * and cardiac function during 5 min after 10 min of stable and calm spontaneous breathing (SB) Then the same measurement are made during 5 min after 10 min of stable and calm breathing during non-invasive CPAP Then a third measurement is made of * the breathing pattern and work of breathing * and cardiac function during 5 min after 10 min a stable and calm SB Polysomnography is then performed during the following night during SB in order to assess objective sleep quality. Subjective sleep quality is assessed on the following morning in children \> 6 years of age by validated sleep questionnaires.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
30
Comparison of three periods of 3 hours 1. st period: Spontaneous breathing for 10 minutes 2. nd period: CPAP for 10 minutes 3. rd period: Spontaneous breathing for 10 minutes to check the return to baseline. After each period, the following parameters will be recorded during 5 minutes: * oesogastric pressures * air flow * gas exchange * right and left cardiac function Patients \> 6 years old will assess their dyspnea on a visual analogue scale
Comparison of three periods of 3 hours 1. st period: Spontaneous breathing for 10 minutes 2. nd period: CPAP for 10 minutes 3. rd period: Spontaneous breathing for 10 minutes to check the return to baseline. After each period, the following parameters will be recorded during 5 minutes: * oesogastric pressures * air flow * gas exchange * right and left cardiac function Patients \> 6 years old will assess their dyspnea on a visual analogue scale
Comparison of three periods of 3 hours 1. st period: Spontaneous breathing for 10 minutes 2. nd period: CPAP for 10 minutes 3. rd period: Spontaneous breathing for 10 minutes to check the return to baseline. After each period, the following parameters will be recorded during 5 minutes: * oesogastric pressures * air flow * gas exchange * right and left cardiac function Patients \> 6 years old will assess their dyspnea on a visual analogue scale
Necker - Enfants Malades Hospital (Assistance Publique des Hopitaux de Paris)
Paris, France
oesophageal pressure during spontaneous breathing and during continuous positive airway pressure
Time frame: up to 5 days
trans-diaphragmatic pressure during spontaneous breathing and during continuous positive airway pressure
Time frame: up to 5 days
Ultrasound cardiac function indices during spontaneous breathing and during continuous positive airway pressure
Time frame: up to 5 days
Polysomnography during spontaneous breathing
Time frame: up to 5 days
sleep questionnaire
Time frame: up to 5 days
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