用于儿童睡眠呼吸事件评分的气管呼吸音。
Tracheal sounds for the scoring of sleep respiratory events in children.
作者信息
Amaddeo Alessandro, Sabil Abdelkebir, Arroyo Jorge Olmo, De Sanctis Livio, Griffon Lucie, Baffet Guillaume, Khirani Sonia, Fauroux Brigitte
机构信息
AP-HP, Hôpital Necker Enfants-Malades, Pediatric Noninvasive Ventilation and Sleep Unit, Paris, France.
Paris Descartes University, EA 7330, VIFASOM, Paris, France.
出版信息
J Clin Sleep Med. 2020 Mar 15;16(3):361-369. doi: 10.5664/jcsm.8206. Epub 2020 Jan 14.
STUDY OBJECTIVES
Oronasal thermistor and nasal cannula are recommended for the scoring of respiratory events (RE) but these sensors are poorly tolerated in children. The aim of the study was to evaluate tracheal sounds (TS) and suprasternal pressure (SSP) for the scoring of RE during sleep in children.
METHODS
We compared the detection and characterization of RE by AASM-recommended sensors ("AASM" scoring), with the detection and characterization of RE by the combination of TS and SSP with respiratory inductance plethysmography-sum (TS-RIP scoring), and TS and SSP only (TS scoring).
RESULTS
The recordings of 17 patients were analyzed. The TS, SSP, and RIP flow signals were present during 95%, 95%, and 99% of the validated recording time, respectively, as compared to 79% and 86% for nasal cannula and oronasal thermistor. A total of 1,456 RE were scored with the "AASM" scoring, 1,335 with the TS-RIP scoring, and 1,311 with the TS scoring. Sensitivity for apnea and hypopnea detection was 88% and 84% for the TS-RIP scoring, and 86% and 77% for the TS scoring. For apnea characterization, the TS-RIP scoring sensitivities and specificities were 97% and 100%, 76% and 98%, and 95% and 97%, for obstructive, mixed, and central apnea, respectively. For the TS scoring, they were 95% and 100%, 95% and 97%, and 91% and 97%, respectively.
CONCLUSIONS
TS and SSP + RIP-sum has a good sensitivity and specificity for the detection and characterization of apnea and hypopnea in children. TS and SSP alone have good sensitivity and specificity for apnea detection and characterization but lower sensitivity for hypopnea detection.
研究目的
口鼻热敏电阻和鼻导管被推荐用于呼吸事件（RE）评分，但儿童对这些传感器耐受性较差。本研究的目的是评估儿童睡眠期间用于RE评分的气管声音（TS）和胸骨上压力（SSP）。
方法
我们将美国睡眠医学会（AASM）推荐的传感器对RE的检测和特征描述（“AASM”评分），与TS和SSP联合呼吸感应体积描记总和（TS-RIP评分）以及仅TS和SSP（TS评分）对RE的检测和特征描述进行了比较。
结果
分析了17例患者的记录。TS、SSP和RIP流量信号在有效记录时间的95%、95%和99%期间存在，相比之下，鼻导管和口鼻热敏电阻分别为79%和86%。“AASM”评分共记录了1456次RE，TS-RIP评分记录了1335次，TS评分记录了1311次。TS-RIP评分对呼吸暂停和呼吸浅慢的检测敏感性分别为88%和84%，TS评分为86%和77%。对于呼吸暂停的特征描述，TS-RIP评分对阻塞性、混合性和中枢性呼吸暂停的敏感性和特异性分别为97%和100%、76%和98%、95%和97%。对于TS评分，分别为95%和100%、95%和97%、91%和97%。
结论
TS和SSP+RIP总和对儿童呼吸暂停和呼吸浅慢的检测和特征描述具有良好的敏感性和特异性。单独的TS和SSP对呼吸暂停的检测和特征描述具有良好的敏感性和特异性，但对呼吸浅慢的检测敏感性较低。
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