{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T16:03:34Z","timestamp":1771430614811,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Continuous Positive Airway Pressure (CPAP) initiation should ideally be conducted through CPAP titration in a sleep laboratory according to the American Academy of sleep Medicine recommendations. The objective of this retrospective study was to evaluate the efficacy of two continuous positive airway pressure (CPAP) titration methods\u2014short\u2010supervised in\u2010sleep\u2010laboratory titration and longer, unsupervised hospitalization\u2010based titration\u2014in children under 2 years requiring noninvasive ventilation (NIV) for severe obstructive sleep apnea syndrome (OSAS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The participants were allocated based on sleep laboratory availability, with the short\u2010supervised procedure involving in\u2010lab nap polysomnography and pressure adjustments, while the long\u2010unsupervised approach involved hospitalization, the ventilator's built\u2010in software analysis, and overnight gas exchange\u2010based guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 46 infants between January 2022 and November 2024. Both groups were similar in terms of OSAS severity, achieved similar pressure levels at discharge, and demonstrated comparable outcomes in home nocturnal gas exchange (HNGE), including oxygen saturation and CO\n                      <jats:sub>2<\/jats:sub>\n                      levels. Adherence was higher in the long\u2010unsupervised group, potentially due to a higher number of therapeutic education sessions afforded by the longer hospitalization. Importantly, no significant differences were observed in the primary outcome of HNGE, with failure of titration observed in two patients (8%) in the short\u2010supervised titration group and four patients (19%) in the long\u2010unsupervised titration group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.390).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings suggest that both titration procedures are feasible and equally effective for initial CPAP\/NIV management in infants. Therefore, the choice of method can be tailored to clinical settings and resource availability, with the longer hospital\u2010based titration offering an acceptable alternative to traditional laboratory titration, potentially reducing medical supervision demands while maintaining treatment efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71233","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T11:48:10Z","timestamp":1754653690000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Is Positive Airway Pressure Lab\u2010Titration Always Necessary to Start Noninvasive Respiratory Support in Infants?"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0827-616X","authenticated-orcid":false,"given":"Benjamin","family":"Dudoignon","sequence":"first","affiliation":[{"name":"Physiology and Pediatric Sleep Unit, Robert Debr\u00e9 Hospital, AP\u2010HP \u2013 Centre de R\u00e9f\u00e9rence Constitutif Maladies respiratoires rares \u2013 Hypoventilations alv\u00e9olaires rares \u2013 Syndrome d'Ondine INSERM NeuroDiderot Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rim","family":"Abdelkarim","sequence":"additional","affiliation":[{"name":"Pediatric Unit Centre Hospitalier Rene Dubos Pontoise France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2786-0812","authenticated-orcid":false,"given":"Christophe","family":"Delclaux","sequence":"additional","affiliation":[{"name":"Physiology and Pediatric Sleep Unit, Robert Debr\u00e9 Hospital, AP\u2010HP \u2013 Centre de R\u00e9f\u00e9rence Constitutif Maladies respiratoires rares \u2013 Hypoventilations alv\u00e9olaires rares \u2013 Syndrome d'Ondine, INSERM NeuroDiderot Universit\u00e9 Paris\u2010Cit\u00e9 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Plamen","family":"Bokov","sequence":"additional","affiliation":[{"name":"Physiology and Pediatric Sleep Unit, Robert Debr\u00e9 Hospital, AP\u2010HP \u2013 Centre de R\u00e9f\u00e9rence Constitutif Maladies respiratoires rares \u2013 Hypoventilations alv\u00e9olaires rares \u2013 Syndrome d'Ondine, INSERM NeuroDiderot Universit\u00e9 Paris\u2010Cit\u00e9 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(16)30151-5"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01404-2021"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00985-2017"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.08.020"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10366"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.1021"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27133"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24138"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000330598"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.07488"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2013.06.020"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6576"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.5600"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.01.023"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24555"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.1.e19"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleh.2014.12.010"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-016-1400-6"},{"key":"e_1_2_12_20_1","article-title":"Fixed CPAP at 10\u2009cmH2O May Replace Manual Titration in Moderate to Severe OSA Patients: A Preliminary Randomised Controlled Trial","author":"Lu W.","year":"2025","journal-title":"Respirology"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.116.1.10"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2025.107983"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.3.379"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.88.1.132"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10222"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71233","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71233","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71233","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T15:10:18Z","timestamp":1771427418000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71233"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/ppul.71233"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71233","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2025-05-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71233"}}