加热湿化高流量鼻导管在婴儿阻塞性睡眠呼吸暂停中的应用。

Use of heated humidified high flow nasal cannula for obstructive sleep apnea in infants.

作者信息

Kwok Ka-Li, Lau Mei-Yee, Leung Shuk-Yu, Ng Daniel Kwok-Keung

机构信息

Department of Paediatrics, Kwong Wah Hospital, Hong Kong, China.

出版信息

Sleep Med. 2020 Oct;74:332-337. doi: 10.1016/j.sleep.2020.08.005. Epub 2020 Aug 8.

DOI:10.1016/j.sleep.2020.08.005

PMID:32905994

Abstract

OBJECTIVE

Heated humidified high flow nasal cannula (HHHFNC) has gained popularity in the treatment of children with respiratory distress and bronchiolitis in the past decade. Its efficacy as a mode of non-invasive respiratory support has been demonstrated in both adults and children. However, reports on its use in the treatment of obstructive sleep apnea (OSA) in infants are limited. We aimed to evaluate the efficacy of HHHFNC therapy as treatment in infants with OSA.

METHODS

A retrospective analysis of OSA infants who had undergone polysomnographic titration between 2015 and 2017 was undertaken. Data about the age, gender, AHI, co-morbid conditions and flow used for each patient were retrieved.

RESULTS

Ten infants were included in this study (median age 34 weeks; IQR 27-38 weeks). The median optimal HHHFNC flow rate was 8.0 L/min (IQR 6.7-8.0 L/min). HHHFNC significantly reduced median obstructive apnea-hypopnea index (OAHI) from 9.1 (IQR 5.1-19.3) to 0.9 (IQR 0-1.6; P = 0.005) events/h; median obstructive apnea index (OAI) from 5.8 (IQR 1.1-13.4) to 0 (IQR 0-0.9; P = 0.021) events/h; median obstructive hypopnea index (OHI) from 4.1 (IQR 0.9-6.8) to 0.1 (0-0.9; P = 0.017) events/h; and median oxygen saturation (SpO2) nadir increased from 88% (IQR 83-94%) to 94% (IQR 93-96%; P = 0.040).

CONCLUSION

HHHFNC significantly reduced respiratory events and improved oxygenation in infants with OSA.

摘要

目的

在过去十年中，温热湿化高流量鼻导管（HHHFNC）在治疗呼吸窘迫和细支气管炎患儿方面越来越受欢迎。其作为一种无创呼吸支持模式的疗效已在成人和儿童中得到证实。然而，关于其用于治疗婴儿阻塞性睡眠呼吸暂停（OSA）的报道有限。我们旨在评估HHHFNC治疗婴儿OSA的疗效。

方法

对2015年至2017年间接受多导睡眠图滴定的OSA婴儿进行回顾性分析。检索了每位患者的年龄、性别、呼吸暂停低通气指数（AHI）、合并症和使用的流量数据。

结果

本研究纳入了10名婴儿（中位年龄34周；四分位间距27 - 38周）。HHHFNC的中位最佳流速为8.0 L/分钟（四分位间距6.7 - 8.0 L/分钟）。HHHFNC显著降低了中位阻塞性呼吸暂停低通气指数（OAHI）从9.1（四分位间距5.1 - 19.3）至0.9（四分位间距0 - 一、6；P = 0.005）次/小时；中位阻塞性呼吸暂停指数（OAI）从5.8（四分位间距1.1 - 13.4）至0（四分位间距0 - 0.9；P = 0.021）次/小时；中位阻塞性低通气指数（OHI）从4.1（四分位间距0.9 - 6.8）至0.1（0 - 0.9；P = 0.017）次/小时；并且中位氧饱和度（SpO2）最低点从88%（四分位间距83 - 94%）升至94%（四分位间距93 - 96%；P = 0.040）。