Sleep related hypoventilation: should the paediatric definition be revised?
| Autor: | Andreia Descalço, Ângela Drago, Lia Oliveira, Ana Lemos, Rosário Ferreira |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Sleep related hypoventilation
Upper airway resistance syndrome Pediatrics medicine.medical_specialty Neuromuscular disease medicine.diagnostic_test business.industry Polysomnography medicine.disease Obesity Hypoventilation Central nervous system disease Interquartile range medicine medicine.symptom business |
| Zdroj: | Paediatric respiratory physiology and sleep. |
| DOI: | 10.1183/13993003.congress-2020.1180 |
| Popis: | Background: Sleep related hypoventilation(SRH) in children is defined by AASM as CO2 level >50mmHg for >25% of TST (PtCO2>50mmHg[>25%]). In adults, definitions are far less restrictive. Aims: To evaluate the prevalence of SRH according to AASM and less restrictive definitions. To compare diagnostic groups. Methods: Retrospective evaluation of transcutaneous CO2(PtcCO2) during polysomnography(PS) in a period of 2 years. AASM hypoventilation definition for children and several adults’ definitions analysed: percentage of PtCO2>55mmHg ≥10min, (PtcCO2>55mmHg[≥10’]), sleep PtCO2≥10mmHg above baseline level (PtcCO2[≥10mmHg]), percentage of PtCO2≥50mmHg >2% of TST (PtcCO2≥50[>2%]), peak value PtcCO2>49 mmHg (PtcCO2>49[peak]), mean PtcCO2>50 mmHg (PtcCO2>50[mean]). Results: 114 patients, 61% male, median(interquartile range) age 8.43(10.63) years old. Referral diagnosis: sleep breathing disorders(36%), syndromic disease(25%), neuromuscular disease(22%), central nervous system disease(4%), craniofacial anomalies(4%), obesity(4%), upper airway disorder(3%), other sleep disorders(2%). Sleep breathing disorders were diagnosed in 93%: primary snoring(22%), upper airway resistance syndrome(1%); hypoventilation(7%), obstructive sleep apnoea syndrome(53%) and both(10%). The prevalence of hypoventilation according to the definitions was: PtCO2>50mmHg[>25%] 22%, PtcCO2>55mmHg[≥10’] 17%, PtcCO2[≥10mmHg] 30%, PtcCO2>50[>2%] 44%, PtcCO2>49[peak] 51%, PtcCO2>50[mean] 12%. It did not differ for different diagnostic groups. Conclusion: SRH is common when adult definitions are applied. In the absence of validated level of SRH regarding end-organ damage in children, it may be cautious to consider less restrictive definitions. |
| Databáze: | OpenAIRE |
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