Editorial: Pediatric Long-Term Non-invasive Ventilation

term non-invasive ventilation Editorial on the Research Topic Pediatric Long-Term Non-invasive VentilationLong-term non-invasive mechanical ventilation consists in the delivery of non-invasive mechanical ventilation (NIV) at least 6 h per day for more than 3 weeks (1).Long term NIV is increasing world-wide, with broader indications, and is associated with an increase in survival rate in children with chronic conditions.In this Research Topic different experts in the field deepen the topic of long-term NIV in children.Praud reviewed the current use of home NIV.He focused on the advantages of long-term home NIV compared to prolonged hospitalization and to home invasive ventilation in different countries.He reported interesting data of two scoping reviews about this topic (2, 3).In addition, Basa et al. have brought to the topic their experience in a middle-income country.Their experience could be considered as a model of setting up a home mechanical ventilation center: since 2001 the number of patients on ventilation has increased rapidly.They reported their numbers and their high proportion of invasively ventilated patients (about a half of the patients).As can be seen from other works in literature, the increase in NIV experience is associated with a reduction of invasively ventilated patients (4).Certainly, NIV is increasing its popularity in the last few years due to its relative simplicity.However, technical knowledge of machines, interfaces, circuits as well as indications is required.Ferreira deepened the topic of interfaces and circuits.NIV is usually well-tolerated but may be associated with some side effects.An experienced team confident with tricks and possible complications related to NIV is crucial to avoid NIV failure.Main adverse events are discomfort, skin lesions, unintentional leaks, or disturbed facial growth (midface hypoplasia).On the one hand, skin lesions and unintentional leaks may be reduced by changing interface periodically, using protective dressings and selecting the appropriate mask type.On the other hand, discomfort may be reduced using active humidification finally improving adherence (5, 6).Pavone et al., provided a comprehensive report of different ventilators available on the market and the different ventilatory modes.Nowadays, new hybrid modes are flanking the traditional pressure-target and volume-target modes.Hybrid modes require more studies in pediatrics but the small literature available shows that they may reduce asynchronies and facilitate management of children poorly adapted to traditional modes (7).Moreover, new ventilators are equipped with built-in software and allow remote monitoring of ventilation parameters: these data supply information about trends of patients on home ventilation and are useful for the clinician to understand possible causes of suboptimal ventilation (8).It is evident that new technologies are constantly improving information given to clinicians about home NIV.Those new possibilities are changing type of

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