Physiotherapy Department, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil.
Clinics (Sao Paulo). 2009;64(12):1205-10. doi: 10.1590/S1807-59322009001200011.
To investigate hypoxia and sleep disordered breathing in infants with congenital heart disease.
Prospective study. In-hospital full polysomnography was performed on 14 infants with congenital heart disease, age 7 +/-1 months, and in 7 normal infants, age 10 +/-2 months. Congenital heart disease infants were classified as acyanotic (n=7) or cyanotic (n=7).
Nutritional status, assessed by the Gomez classification and expressed as % weight for age, was 70 +/-7, 59 +/-11 and 94 +/-16 in the acyanotic, cyanotic congenital heart disease and control infants, respectively (p<0.001). The respiratory disturbance index (AHI, events per hour) was [median (25-75%)]: 2.5 (1.0-3.4), 2.4 (1.5-3.1) and 0.7 (0.7-0.9) in acyanotic, cyanotic CHD infants and controls, respectively (p=0.013). Almost all congenital heart disease infants (11 out of 14) and only one control infant had an AHI >1 event/hour. The minimum oxygen saturation was 79% (74-82), 73% (57-74) and 90% (90-91) in the acyanotic, cyanotic congenital heart disease infants and controls, respectively (p <0.001). The arousal index (events/hour) was similar among the three groups at 8.4 +/-2.4, 10.3 +/-8.7 and 6.5 +/-3, respectively (p=0.451).
Infants with congenital heart disease frequently present with sleep-disordered breathing associated with oxygen desaturations but not arousals. Therefore, sleep may represent a significant burden to infants with congenital heart disease.
研究先天性心脏病婴儿的缺氧和睡眠呼吸障碍。
前瞻性研究。对 14 名年龄为 7±1 个月的先天性心脏病婴儿和 7 名年龄为 10±2 个月的正常婴儿进行住院全睡眠多导睡眠图检查。先天性心脏病婴儿分为非发绀组（n=7）和发绀组（n=7）。
营养状况用 Gomez 分类法评估，体重与年龄的比值（%）分别为非发绀组 70±7、发绀组 59±11 和对照组 94±16（p<0.001）。呼吸紊乱指数（呼吸暂停低通气指数，每小时事件数）为[中位数（25%-75%）]：非发绀组 2.5（1.0-3.4）、发绀组 2.4（1.5-3.1）和对照组 0.7（0.7-0.9）（p=0.013）。几乎所有的先天性心脏病婴儿（14 例中有 11 例）和只有 1 例对照组婴儿的呼吸暂停低通气指数>1 次/小时。最低氧饱和度分别为非发绀组 79%（74-82）、发绀组 73%（57-74）和对照组 90%（90-91）（p<0.001）。三组的觉醒指数（每小时事件数）分别为 8.4±2.4、10.3±8.7 和 6.5±3，差异无统计学意义（p=0.451）。
先天性心脏病婴儿常出现睡眠呼吸障碍，伴有氧饱和度下降而无觉醒。因此，睡眠可能对先天性心脏病婴儿造成显著负担。
