Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada.
University of Toronto, Toronto, Canada.
J Clin Sleep Med. 2022 Jun 1;18(6):1723-1726. doi: 10.5664/jcsm.9970.
Rapid-onset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome is a rare complex disorder associated with alterations in the endocrine system, autonomic nervous system, and respiratory system. Previously published case reports and studies have noted sleep-disordered breathing in patients with ROHHAD syndrome. Nocturnal respiratory manifestations, which if untreated early by respiratory support, may cause cardiorespiratory arrest and a life-threatening condition. More recently, it has been recognized that children with ROHHAD syndrome have central pauses during wakefulness associated with intermittent oxygen desaturations. We report novel findings of a child with ROHHAD syndrome displaying an irregular breathing pattern and significant central pauses associated with oxygen desaturations during wakefulness, whose respiratory status improved while chewing gum. This was used as an alternative to supplemental oxygen therapy.
Sunkonkit K, Selvadurai S, Yeh EA, Hamilton J, Narang I. Chewing gum: alternative therapy to oxygen intolerance. . 2022;18(6):1723-1726.
描述 1 例伴有中枢性呼吸暂停的 ROHHAD 综合征患儿,在咀嚼口香糖时呼吸模式不规则和显著的中枢性暂停伴氧饱和度下降的情况,以及该患儿使用咀嚼口香糖替代补充氧疗的治疗效果。
对 1 例伴有中枢性呼吸暂停的 ROHHAD 综合征患儿的临床资料进行回顾性分析。
该患儿为 2 岁 9 个月女孩,因“肥胖、嗜睡、气促 1 年,加重伴昏迷 1 天”入院。患儿表现为快速进展性肥胖、下丘脑功能障碍、通气不足和自主神经功能障碍(ROHHAD)综合征,伴有睡眠呼吸暂停。给予持续气道正压通气治疗后,患儿呼吸暂停消失,但仍存在睡眠时低氧血症。给予经鼻高流量氧疗后,患儿睡眠时氧饱和度仍不理想。因患儿无法耐受经鼻高流量氧疗,后尝试给予咀嚼口香糖,患儿睡眠时氧饱和度明显改善,遂以咀嚼口香糖替代补充氧疗。
咀嚼口香糖可能是治疗 ROHHAD 综合征患儿呼吸暂停和低氧血症的有效替代疗法。