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无创通气是否会改变阻塞性睡眠呼吸暂停患儿的代谢指标?一项系统评价和荟萃分析研究方案。

Does non-invasive ventilation change metabolic markers in children with obstructive sleep apnoea? A systematic review and meta-analysis study protocol.

作者信息

Gerdung Christopher, Rodriguez-Lopez Sara, Palkowski Stefan, Keto-Lambert Diana, Sebastianski Meghan, Castro Codesal Maria Luisa

机构信息

Pediatrics, University of Alberta Faculty of Medicine and Dentistry, Edmonton, Alberta, Canada.

Stollery Children's Hospital, Edmonton, Alberta, Canada.

出版信息

BMJ Open. 2020 Aug 23;10(8):e039655. doi: 10.1136/bmjopen-2020-039655.

Abstract

INTRODUCTION

Obstructive sleep apnoea (OSA) is not only common within paediatrics but is associated with critical childhood metabolic morbidity such as obesity, cardiovascular disease and glucose tolerance impairment. Increasing evidence suggests an association between childhood OSA and metabolic syndrome such as markers of cardiovascular disease, systemic hypertension, glucose intoleranceand increased lipid profile. Recent studies have targeted changes in metabolic markers in children using non-invasive ventilation (NIV) but no systematic reviews are available to summarise this emerging evidence. The purpose of this systematic review is to provide systematic synthesis of the evidence on the effect of NIV use on metabolic markers in children with OSA.

METHODS AND ANALYSIS

A systematic search of electronic databases and grey literature will include paediatric interventional studies (random controlled trials, cohort studies) with and without a comparison group. Two reviewers will independently undertake the two step process of title/abstract and full-text screening. Data will be extracted and assessed, with aggregate data being reported. When the data allow, meta-analysis will be performed.

ETHICS AND DISSEMINATION

There are no ethical concerns with this systematic review, as data have previously been published. This review will inform clinicians taking care of children with OSA and obesity/metabolic syndrome about the potential effects of NIV therapies on metabolic markers and has the potential to change the approach to childhood OSA and obesity. Results of this systematic review will be submitted for dissemination in abstract and manuscript form.

摘要

引言

阻塞性睡眠呼吸暂停(OSA)在儿科中不仅常见,而且与儿童期严重的代谢性疾病相关,如肥胖、心血管疾病和糖耐量受损。越来越多的证据表明儿童OSA与代谢综合征之间存在关联,如心血管疾病标志物、系统性高血压、葡萄糖不耐受和血脂升高。最近的研究针对使用无创通气(NIV)的儿童代谢标志物变化展开,但尚无系统评价来总结这一新兴证据。本系统评价的目的是系统综合关于NIV对OSA儿童代谢标志物影响的证据。

方法与分析

对电子数据库和灰色文献进行系统检索,将纳入有或无对照组的儿科干预研究(随机对照试验、队列研究)。两名评价者将独立进行标题/摘要和全文筛选的两步过程。将提取和评估数据,并报告汇总数据。若数据允许,将进行荟萃分析。

伦理与传播

由于数据此前已发表,本系统评价不存在伦理问题。本评价将告知照顾OSA及肥胖/代谢综合征儿童的临床医生NIV治疗对代谢标志物的潜在影响,并有可能改变儿童OSA和肥胖的治疗方法。本系统评价的结果将以摘要和手稿形式提交发表。

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