Department of Sleep Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas.
Department of Sleep Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas; Department of Pediatrics, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas.
J Clin Sleep Med. 2019 Aug 15;15(8):1081-1087. doi: 10.5664/jcsm.7794.
Pulmonary hypertension (PH) has been reported as a serious complication of obstructive sleep apnea (OSA) in children; however, estimated prevalence rates vary widely (zero to 85%). The purpose of this study is to determine the prevalence of PH in children with OSA and identify factors that may predict an increased PH risk in children with OSA.
A retrospective review of all pediatric beneficiaries (88,058) in the San Antonio Military Health System with a diagnosis of OSA and a clinical evaluation by a pediatric cardiologist. OSA severity and nadir oxygen saturation were recorded from overnight polysomnography. Reason for referral, comorbid disorders, echocardiogram results, and cardiac diagnoses were obtained from cardiology records.
OSA was identified in 2,020 pediatric patients (2.3%). A pediatric cardiology consultation was reported for 296 patients with OSA. After excluding 95 patients for incorrect OSA diagnoses, incomplete data, or OSA treatment before cardiology evaluation, 163 patients were included in the final analysis. A diagnosis of PH was found in 3 patients with OSA (1.8%). Two of these patients had obesity, and all three had comorbid cardiac disorders.
Prevalence of PH in pediatric patients with OSA is low and none of the patients with PH had severe OSA. Current guidelines recommend PH screening in patients with severe OSA, yet OSA severity may not accurately predict risk. Factors evaluated in this study did not demonstrate an increased PH risk; additional research is necessary to improve screening in pediatric patients with OSA.
Burns AT, Hansen SL, Turner ZS, Aden JK, Black AB, Hsu DP. Prevalence of pulmonary hypertension in pediatric patients with obstructive sleep apnea and a cardiology evaluation: a retrospective analysis. J Clin Sleep Med. 2019;15(8):1081-1087.
阻塞性睡眠呼吸暂停（OSA）可导致肺动脉高压（PH），这已在儿童中得到证实；然而，其发病率的估计范围很广（0 至 85%）。本研究旨在确定 OSA 患儿 PH 的患病率，并确定可能预测 OSA 患儿 PH 风险增加的因素。
对圣安东尼奥军事医疗系统中所有经临床诊断为 OSA 并经儿科心脏病专家进行临床评估的儿科受益人的病历进行回顾性分析。夜间多导睡眠图记录 OSA 严重程度和最低血氧饱和度。从心脏病学记录中获得转诊原因、并存疾病、超声心动图结果和心脏诊断。
在 2020 名儿科患者中发现 OSA（2.3%）。报告有 296 名 OSA 患儿接受了儿科心脏病学咨询。排除 95 名因 OSA 诊断不正确、数据不完整或心脏病学评估前接受 OSA 治疗的患者后，163 名患者纳入最终分析。在 3 名 OSA 患儿中发现 PH（1.8%）。其中 2 名患者肥胖，所有 3 名患者均合并心脏疾病。
在 OSA 患儿中 PH 的患病率较低，且所有 PH 患儿均无严重 OSA。目前的指南建议对严重 OSA 患者进行 PH 筛查，但 OSA 严重程度可能无法准确预测风险。本研究评估的因素并未显示 PH 风险增加；需要进一步研究以改善 OSA 儿科患者的筛查。
Burns AT, Hansen SL, Turner ZS, Aden JK, Black AB, Hsu DP. 儿科阻塞性睡眠呼吸暂停患者并发肺动脉高压的患病率及经心脏病学评估：一项回顾性分析。J Clin Sleep Med. 2019;15(8):1081-1087.
