• Lucie Griffon, Alessandro Amaddeo, Guillaume Mortamet, Christine Barnerias, Véronique Abadie, Jorge Olmo Arroyo, Livio de Sanctis, Sylvain Renolleau, and Brigitte Fauroux.
• Pediatric noninvasive ventilation and sleep unit, AP-HP, Hôpital Necker Enfants-Malades, Paris, France.
• J Crit Care. 2017 Dec 1; 42: 317-323.

PurposeThe aim of the study was to analyze the diagnostic and therapeutic value of a polygraphy (PG) in infants hospitalized for unexplained respiratory failure or life-threatening events in the PICU.Material And MethodsThe PG of 13 infants (4 girls), mean age 6.8±7.7months, were analyzed.ResultsEight infants were admitted for unexplained respiratory failure and 5 for life-threatening events. PG showed features suggestive of respiratory muscle weakness in 5 infants whose final diagnoses were nemaline rod myopathy (n=2), congenital myasthenia (n=2), and diaphragmatic dysfunction (n=1). Four of these patients were successfully treated with noninvasive ventilation (NIV). PG was suggestive of brainstem dysfunction in 4 infants; 2 were treated successfully with NIV and another with caffeine. PG showed obstructive sleep apnea in 3 infants; 2 were treated successfully with NIV and one patient was lost during follow up. A typical pattern of congenital central hypoventilation syndrome was observed in the last patient who was treated successfully with invasive ventilation. One patient with diaphragmatic dysfunction and one with brain stem dysfunction died.ConclusionsPG may assist the diagnosis and guide the management of unexplained respiratory failure or life-threatening events in infants hospitalized in the PICU.Copyright © 2016 Elsevier Inc. All rights reserved.

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