Mihai Rebecca, Vandeleur Moya, Pecoraro Sally, Davey Margot J, Nixon Gillian M
Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Australia.
The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, Australia.
J Clin Sleep Med. 2017 May 15;13(5):713-719. doi: 10.5664/jcsm.6590.
Few studies have assessed autotitrating positive airway pressure (autoPAP) for treatment of obstructive sleep apnea (OSA) in children. We aimed to review our use of autoPAP for initiation of continuous positive airway pressure (CPAP) therapy in children, and compare autoPAP-derived treatment pressures to CPAP treatment pressure determined by attended polysomnography (PSG).
Retrospective review of children initiated on autoPAP from 2013 to 2015. Mean autoPAP pressure (AutoMean pressure) and average device pressure ≤ 90% of time (Auto90 pressure) were taken from downloaded data and compared to the recommended treatment pressure following titration PSG (PSG pressure).
Fifty-two children started CPAP, of whom 26 (age ± standard deviation 11.9 ± 3.4 years) used autoPAP and had titration PSG. AutoPAP was used on average 84% of nights (standard deviation 20%) in the first month, with a mean ± standard deviation 6.3 ± 2.0 hours of use on nights used. The median (interquartile range) obstructive apnea-hypopnea index decreased from 16.6 (11, 35) events/h before treatment to 2.2 (0.4, 3.8) events/h on the titration PSG. Median (interquartile range) PSG pressure was 9.0 cm HO (7.0, 10.0), AutoMean pressure was 6.3 cm HO (5.3, 7.5), and Auto90 pressure was 8.1 cm HO (7.1, 9.5). These were significantly different ( < .001), with the significant difference lying between AutoMean and the other two pressures. PSG pressure was greater than or equal to the AutoMean pressure in all cases, and greater than or equal to the Auto90 pressure in 20 out of 26 cases (77%).
AutoPAP is a safe and effective means of initiating CPAP in children. AutoMean and Auto90 pressures are usually below treatment pressure determined by titration PSG.
很少有研究评估自动调压气道正压通气（autoPAP）治疗儿童阻塞性睡眠呼吸暂停（OSA）的效果。我们旨在回顾我们使用autoPAP启动儿童持续气道正压通气（CPAP）治疗的情况，并将autoPAP得出的治疗压力与通过有医护人员参与的多导睡眠图（PSG）确定的CPAP治疗压力进行比较。
对2013年至2015年开始使用autoPAP的儿童进行回顾性研究。从下载的数据中获取平均autoPAP压力（AutoMean压力）和设备压力≤90%时间的平均压力（Auto90压力），并与滴定PSG后推荐的治疗压力（PSG压力）进行比较。
52名儿童开始使用CPAP，其中26名（年龄±标准差11.9±3.4岁）使用autoPAP并进行了滴定PSG。在第一个月，autoPAP平均在84%的夜间使用（标准差20%），使用autoPAP的夜间平均使用时间为±标准差6.3±2.0小时。治疗前阻塞性呼吸暂停低通气指数的中位数（四分位间距）从16.6（11，35）次/小时降至滴定PSG时的2.2（0.4，3.8）次/小时。PSG压力的中位数（四分位间距）为9.0 cm HO（7.0，10.0），AutoMean压力为6.3 cm HO（5.3，7.5），Auto90压力为8.1 cm HO（7.1，9.5）。这些差异具有统计学意义（<0.001），显著差异存在于AutoMean与其他两个压力之间所有病例中，PSG压力均大于或等于AutoMean压力，26例中有20例（77%）大于或等于Auto90压力。
AutoPAP是启动儿童CPAP治疗的一种安全有效的方法。AutoMean和Auto90压力通常低于滴定PSG确定的治疗压力。
