补充氧气治疗阻塞性睡眠呼吸暂停的婴儿。
Supplemental Oxygen for Treatment of Infants With Obstructive Sleep Apnea.
机构信息
Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia.
Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
出版信息
J Clin Sleep Med. 2019 Aug 15;15(8):1115-1123. doi: 10.5664/jcsm.7802.
STUDY OBJECTIVES
Supplemental oxygen has been shown to decrease the frequency of obstructive respiratory events during sleep, but may result in alveolar hypoventilation. Limited information exists on the effect of supplemental oxygen on sleep and respiratory events in infants with obstructive sleep apnea (OSA).
METHODS
We conducted a retrospective study of infants with OSA who had sleep studies performed from 2007-2012. All infants underwent a room air diagnostic sleep study (RA-PSG), followed by a sleep study while breathing supplemental oxygen via nasal cannula (O₂-PSG) on a separate night. Infants with split-night studies or with inadequate sleep time were excluded.
RESULTS
Fifty-nine infants met criteria for entry into analysis. The mean age of infants at the time of RA-PSG was 13.0 ± 11.7 weeks and at O₂-PSG was 15.4 ± 13.0 weeks. The obstructive AHI decreased from 19.7 ± 13.0 during RA-PSG to 10.6 ± 11.7 during O₂-PSG (P < .001). The duration of longest obstructive apnea increased from 11.0 ± 4.2 seconds to 13.4 ± 7.4 seconds (P = .01). The lowest saturation associated with obstructive apneas increased from 80.7 ± 6.8% to 90.0 ± 6.7% (P < .001). Carbon dioxide data showed no difference in ventilation after supplemental oxygen administration. There was no significant change in the spontaneous arousal index, however, the percentage of respiratory events associated with arousal increased from 20.7 ± 11.1% to 35.7 ± 19.7% (P < .001).
CONCLUSIONS
Infants with OSA who received supplemental oxygen had a significant decrease in the frequency of obstructive respiratory events and improved oxygenation without adverse effect on alveolar ventilation. These data suggest that supplemental oxygen may be an effective treatment for infants with OSA who are not good candidates for continuous positive airway pressure or surgery.
CITATION
Brockbank J, Astudillo CL, Che D, Tanphaichitr A, Huang G, Tomko J, Simakajornboon N. Supplemental oxygen for treatment of infants with obstructive sleep apnea. J Clin Sleep Med. 2019;15(8):1115-1123.
研究目的
补充氧气已被证明可减少睡眠期间阻塞性呼吸事件的频率，但可能导致肺泡通气不足。关于补充氧气对阻塞性睡眠呼吸暂停（OSA）婴儿睡眠和呼吸事件的影响，信息有限。
方法
我们对 2007 年至 2012 年期间进行睡眠研究的 OSA 婴儿进行了回顾性研究。所有婴儿均接受了空气诊断性睡眠研究（RA-PSG），然后在另一个晚上通过鼻插管呼吸补充氧气（O₂-PSG）进行睡眠研究。排除了分夜研究或睡眠时间不足的婴儿。
结果
59 名婴儿符合进入分析的标准。RA-PSG 时婴儿的平均年龄为 13.0 ± 11.7 周，O₂-PSG 时为 15.4 ± 13.0 周。RA-PSG 时阻塞性 AHI 从 19.7 ± 13.0 降至 O₂-PSG 时的 10.6 ± 11.7（P <.001）。最长阻塞性呼吸暂停的持续时间从 11.0 ± 4.2 秒增加到 13.4 ± 7.4 秒（P =.01）。与阻塞性呼吸暂停相关的最低饱和度从 80.7 ± 6.8%增加到 90.0 ± 6.7%（P <.001）。补充氧气后二氧化碳数据显示通气无差异。然而，自发觉醒指数没有明显变化，但与觉醒相关的呼吸事件百分比从 20.7 ± 11.1%增加到 35.7 ± 19.7%（P <.001）。
结论
接受补充氧气的 OSA 婴儿，其阻塞性呼吸事件的发生频率显著降低，氧合改善，而肺泡通气无不良影响。这些数据表明，补充氧气可能是不适合持续气道正压通气或手术的 OSA 婴儿的有效治疗方法。
引用
Brockbank J, Astudillo CL, Che D, Tanphaichitr A, Huang G, Tomko J, Simakajornboon N. 补充氧气治疗阻塞性睡眠呼吸暂停婴儿。J 临床睡眠医学。2019;15(8):1115-1123。
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