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无创通气对呼吸功能不全的雷特综合征患者的疗效。

The Efficacy of Noninvasive Ventilation in Patients Affected by Rett Syndrome With Hypoventilation.

机构信息

Pediatric Pulmonology & Respiratory Intermediate Care Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital IRCCS, Rome, Italy; Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy.

Pediatric Pulmonology & Respiratory Intermediate Care Unit, Academic Department of Pediatrics, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

出版信息

Pediatr Neurol. 2024 Sep;158:81-85. doi: 10.1016/j.pediatrneurol.2024.05.005. Epub 2024 May 9.

Abstract

BACKGROUND

Rett syndrome is a progressive neurological disorder associated to several comorbidities that contribute significantly to impair lung function. Respiratory morbidity represents a major cause of death in this population. Little is known about the benefit of noninvasive ventilation.

METHODS

We retrospectively enrolled patients with Rett syndrome who underwent a pneumological evaluation combined with a cardiorespiratory polygraphy and/or a pulse oximetry and capnography from 2012 to 2022.

RESULTS

Medical records of 11 patients with Rett syndrome, mean age 13 ± 6 years, were evaluated. Most patients presented with both epilepsy and scoliosis. Five patients showed a pathologic sleep study and/or impaired night gas exchange: mean obstructive apnea-hypopnea index was 4 ± 3 events/hour; mean and minimal SpO were, respectively, 93% ± 2% and 83% ± 6%, while mean and maximal transcutaneous carbon dioxide monitoring (PtcCO) were, respectively, 51 ± 5 mm Hg and 55 ± 8 mm Hg; and mean oxygen desaturation index was 13 ± 11 events/hour. These patients started noninvasive ventilation with clinical benefit and improved gas exchange mostly in terms of PtcCO (mean PtcCO 51 ± 5 mm Hg before and 46 ± 6 mm Hg after noninvasive ventilation).

CONCLUSIONS

Noninvasive ventilation is a suitable option for patients with Rett syndrome.

摘要

背景

Rett 综合征是一种进行性神经疾病,与多种合并症相关,这些合并症显著影响肺功能。呼吸系统疾病是该人群死亡的主要原因。关于无创通气的益处知之甚少。

方法

我们回顾性纳入了 2012 年至 2022 年间接受过肺功能评估(联合心肺多导睡眠图和/或脉搏血氧饱和度和二氧化碳描记术)的 Rett 综合征患者。

结果

评估了 11 例 Rett 综合征患者的病历,平均年龄 13±6 岁。大多数患者既有癫痫又有脊柱侧凸。5 例患者睡眠研究和/或夜间气体交换受损:平均阻塞性睡眠呼吸暂停低通气指数为 4±3 次/小时;平均和最低 SpO2 分别为 93%±2%和 83%±6%,而平均和最大经皮二氧化碳监测(PtcCO)分别为 51±5mmHg 和 55±8mmHg;平均氧减指数为 13±11 次/小时。这些患者开始接受无创通气治疗,具有临床获益,并改善了气体交换,主要体现在 PtcCO 方面(无创通气前平均 PtcCO 为 51±5mmHg,无创通气后为 46±6mmHg)。

结论

无创通气是 Rett 综合征患者的一种合适选择。

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