Division of Pediatric Pulmonology and Sleep Disorders Laboratory, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece.
Pediatr Pulmonol. 2020 Aug;55(8):2089-2096. doi: 10.1002/ppul.24899. Epub 2020 Jun 22.
Evidence for nocturnal oximetry interpretation in patients with abnormal neuromuscular function is limited. We aimed to compare children with neuromuscular disease (NMD) or Prader-Willi syndrome (PWS) to otherwise healthy subjects with obstructive sleep-disordered breathing (SDB) or without respiratory disorder (controls) regarding nocturnal oximetry parameters.
We analyzed recordings from children with: (a) NMD; (b) PWS; (c) snoring and adenotonsillar hypertrophy and/or obesity (SDB); and (d) controls. Outcomes included: (a) basal SpO ; (b) proportions of subjects with McGill oximetry score (MOS) >1 (clusters of desaturations); and (c) desaturation index (SpO drops ≥3%/h-ODI3).
Data of 12 subjects with NMD (median age, 5.2 years; IQR, 2.7, 8.2), 14 children with PWS (5 years; 2.3, 6.9), 21 children with SDB (5.8 years; 4.6, 9.6), and 20 controls (6.2 years; 5.4, 11.2) were analyzed. Children with NMD, PWS, and SDB had lower basal SpO than controls (95.6% [94.5%, 96.9%], 96.2% [95.1%, 97.4%], 96.1% [95.8%, 97.5%] vs 97.8% [97.2%, 97.9%], respectively; (P < .01). NMD and PWS showed the greatest negative effect on basal SpO (P < .05). Children with SDB or PWS had a higher risk of MOS >1 than patients with NMD (OR, 25.9 [95% CI, 3.4-200.4] and 9.5 [1.5-62.6]). NMD, PWS, and SDB were similar regarding ODI3, which was elevated compared to ODI3 in controls (P < .05). Frequent desaturations predominated in NMD, while periods of sustained desaturation were noted in NMD and PWS.
PWS and NMD have a negative effect on basal SpO , while clusters of desaturations are prevalent in patients with PWS or obstructive SDB.
针对神经肌肉功能异常患者，夜间血氧仪解读的证据有限。本研究旨在比较神经肌肉疾病（NMD）或普拉德-威利综合征（PWS）患儿与阻塞性睡眠呼吸障碍（SDB）或无呼吸障碍（对照组）的夜间血氧仪参数。
我们分析了以下患儿的记录：（a）NMD；（b）PWS；（c）打鼾和腺样体扁桃体肥大及/或肥胖（SDB）；以及（d）对照组。结果包括：（a）基础 SpO₂；（b）McGill 血氧仪评分（MOS）>1 的患者比例（缺氧簇）；以及（c）脱氧指数（SpO₂下降≥3%/h-ODI3）。
共分析了 12 名 NMD 患儿（中位年龄 5.2 岁；IQR，2.7，8.2）、14 名 PWS 患儿（5 岁；2.3，6.9）、21 名 SDB 患儿（5.8 岁；4.6，9.6）和 20 名对照组患儿（6.2 岁；5.4，11.2）的数据。与对照组相比，NMD、PWS 和 SDB 患儿的基础 SpO₂较低（分别为 95.6%[94.5%，96.9%]、96.2%[95.1%，97.4%]和 96.1%[95.8%，97.5%]，P<0.01）。NMD 和 PWS 对基础 SpO₂的负面影响最大（P<0.05）。与 NMD 患儿相比，SDB 或 PWS 患儿 MOS>1 的风险更高（OR，25.9[95%CI，3.4-200.4]和 9.5[1.5-62.6]）。与对照组相比，NMD、PWS 和 SDB 的 ODI3 升高（P<0.05），但 ODI3 相似。NMD 患儿中频繁出现缺氧，而 NMD 和 PWS 患儿中则出现持续缺氧。
PWS 和 NMD 对基础 SpO₂有负面影响，而 PWS 或阻塞性 SDB 患者中常见缺氧簇。
