McNamara F, Sullivan C E
David Read Laboratory, Department of Medicine, University of Sydney, NSW, Australia.
Chest. 1999 Jul;116(1):10-6. doi: 10.1378/chest.116.1.10.
Nasal continuous positive airway pressure (nCPAP) is the most common treatment for obstructive sleep apnea (OSA) in adults, and it has been effective in the treatment of OSA in children. We wanted to determine the effectiveness of long-term nCPAP therapy for OSA in infants.
Twenty-four infants who had OSA were treated with nCPAP via nose mask. These infants had clinical histories that included a family history of sudden infant death syndrome, an apparent life-threatening event, or facial and upper airway anatomic abnormalities.
Overnight polysomnographic studies were performed to assess the severity of OSA in each infant and to determine the appropriate level of continuous positive airway pressure (CPAP). Studies were repeated to determine the progress of OSA and the continuing need for CPAP in each infant.
nCPAP pressures between 4 and 6 cm H2O prevented obstruction and reversed sleep disturbances that were associated with OSA. Eighteen of the infants continued treatment at home from 1 month to > 4 years. CPAP therapy was discontinued in 13 infants after their OSA resolved. Five infants who have upper airway anatomic abnormalities remain on CPAP, and the pressure level required to prevent obstructive events during sleep has needed to be increased to as high as 10 cm H2O.
nCPAP is an effective therapy for the management of OSA in infants, and it can be used effectively in the home environment. Regular follow-up is necessary, because the requirements for CPAP and pressure levels change with the infant's growth and development.
鼻持续气道正压通气（nCPAP）是成人阻塞性睡眠呼吸暂停（OSA）最常见的治疗方法，且已被证明对儿童OSA治疗有效。我们旨在确定长期nCPAP治疗对婴儿OSA的有效性。
24例患有OSA的婴儿通过鼻面罩接受nCPAP治疗。这些婴儿的临床病史包括婴儿猝死综合征家族史、明显危及生命的事件或面部及上呼吸道解剖异常。
进行夜间多导睡眠图研究，以评估每个婴儿OSA的严重程度，并确定合适的持续气道正压通气（CPAP）水平。重复进行研究以确定每个婴儿OSA的进展情况以及对CPAP的持续需求。
4至6厘米水柱的nCPAP压力可防止阻塞，并逆转与OSA相关的睡眠障碍。18例婴儿在家中持续治疗1个月至4年以上。13例婴儿在OSA缓解后停止了CPAP治疗。5例有上呼吸道解剖异常的婴儿仍在使用CPAP，且为防止睡眠期间发生阻塞性事件所需的压力水平已增至高达10厘米水柱。
nCPAP是治疗婴儿OSA的有效方法，且可在家中有效使用。由于CPAP需求和压力水平会随着婴儿的生长发育而变化，因此定期随访是必要的。
