Long Term Non-Invasive Ventilation (NIV) is increasingly common and is benefitting children with a wider range of conditions. It improves quality of life and life expectancy and reduces hospital admissions and length of stay. Children are at risk however of adverse effects caused by NIV interfaces such as skin injury, facial flattening and eye problems. The correct size interface, that is properly fitted, can decrease the risk of device related injury but it remains difficult to fit interfaces to children with particularly small, syndromic or asymmetrical face shapes. Specialist centres are producing semi-custom and fully custom-made interfaces in an attempt to improve fit and decrease device related injury. Recent advances in modern technology such as facial scanning and 3D printing are making custom made interfaces a more viable solution, but it is not yet known whether these approaches will be cost-effective and what the impact of these interfaces will be on the adverse effects of NIV. KeywordsChildren, Long term non-invasive ventilation, Interface sleep fragmentation with daytime somnolence as well as chronic hypoxia resulting in pulmonary hypertension and cor pulmonale [4].

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