Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia; Child Health Research Group, University Malaya, 50603, Kuala Lumpur, Malaysia; Department of Paediatrics, Royal London Hospital, Whitechapel Rd, Whitechapel, London, E1 1BB, United Kingdom.
Department of Paediatrics, University Malaya, 50603, Kuala Lumpur, Malaysia.
Int J Pediatr Otorhinolaryngol. 2021 Dec;151:110930. doi: 10.1016/j.ijporl.2021.110930. Epub 2021 Sep 22.
Overnight pulse oximetry is an alternative to polysomnography (PSG) in diagnosing obstructive sleep apnoea syndrome, but its sensitivity is reported to be low.
To determine the (a) diagnostic accuracy, interobserver reliability and reliable oxygen desaturation index of 4% (ODI) score at diagnosing obstructive sleep apnoea syndrome in children and (b) correlation between the apnoea hypopnoea index (AHI) with ODI and oxygen nadir between both PSG and oximetry.
This cross-sectional study included children aged 1-18 years old, undergoing a fully attended overnight PSG for suspected obstructive sleep apnoea syndrome. The Nonin 3150 WristOx ™ [Fig. 2] was worn simultaneously during the PSG. Poor oximetry recordings were excluded. Pulse oximetry was scored using the McGill Oximetry Score (MOS) whereby a score of 2-4 was positive for OSAS. Specificity, sensitivity, positive predictive values (PPV), negative predictive values (NPV) and interobserver reliability of the WristOx were calculated.
One hundred and sixty-two children with a mean (SD) age of 9.3 (±3.5) years (range 2 years 6 months old - 17 years old) were included after excluding 18 children (poor oximetry data [n = 16] and incomplete PSG [n = 2]). Interobserver agreement of the WristOx was 0.8763 (95% CI:0.80, 0.95). WristOx had a sensitivity 50%, specificity 96.7%, PPV 96% and NPV 53% at diagnosing OSAS. ODI ≥ 2 events/hour in oximetry had a sensitivity of 97.6% and negative predictive value of 85.7% at diagnosing OSA.
Overnight pulse oximetry with the Nonin 3150 WristOx ™ is an accurate and reliable tool in diagnosing significant OSAS in children.
整夜脉搏血氧饱和度测定是诊断阻塞性睡眠呼吸暂停综合征（OSAS）的替代方法，但据报道其灵敏度较低。
确定（a）在儿童中诊断阻塞性睡眠呼吸暂停综合征时，4%（ODI）评分的诊断准确性、观察者间可靠性和可靠的氧减饱和指数，以及（b）PSG 和血氧饱和度仪之间的呼吸暂停低通气指数（AHI）与 ODI 和氧饱和度仪的氧饱和度最低点之间的相关性。
本横断面研究纳入了年龄在 1 至 18 岁之间、因疑似阻塞性睡眠呼吸暂停综合征而行全夜 PSG 检查的儿童。在 PSG 期间同时佩戴 Nonin 3150 WristOx ™（图 2）。排除了脉搏血氧饱和度记录不佳的儿童。使用 McGill 血氧饱和度评分（MOS）对脉搏血氧饱和度进行评分，MOS 评分 2-4 分为 OSAS 阳性。计算了 WristOx 的特异性、敏感性、阳性预测值（PPV）、阴性预测值（NPV）和观察者间可靠性。
排除了 16 例（脉搏血氧饱和度数据不佳[n=16]和 PSG 不完整[n=2]）儿童后，共纳入了 162 例年龄均数（标准差）为 9.3（±3.5）岁（范围 2 岁 6 个月-17 岁）的儿童。WristOx 的观察者间一致性为 0.8763（95%可信区间：0.80，0.95）。WristOx 诊断 OSAS 的敏感性为 50%，特异性为 96.7%，PPV 为 96%，NPV 为 53%。血氧饱和度测定中 ODI≥2 事件/小时诊断 OSA 的敏感性为 97.6%，阴性预测值为 85.7%。
使用 Nonin 3150 WristOx ™ 的整夜脉搏血氧饱和度测定是一种准确可靠的工具，可用于诊断儿童中显著的 OSAS。
