Obstructive Sleep Apnea in Infancy: A 7-Year Experience at a Pediatric Sleep Center
Obstructive Sleep Apnea in Infancy: A 7-Year Experience at a Pediatric Sleep Center
复制标题
DOI：
10.1002/ppul.22867
复制
发表时间：
2014-06-01
影响因子：
3.1
通讯作者：
Khatwa, Umakanth
中科院分区：
文献类型：
--
作者：
Ramgopal, Sriram;Kothare, Sanjeev V.;Khatwa, Umakanth
PurposeTo探讨多导睡眠图（PSG）相关的共病条件下，评估策略，治疗方案，并在一系列的婴儿诊断为阻塞性睡眠呼吸暂停（OSA）的PSG.MethodsRetrospective图表审查的婴儿进行了7年的时间内完成了结果的共同适应症。结果97例（男59例，平均年龄4.6个月，标准差3.3个月）经多导睡眠图诊断为阻塞性睡眠呼吸暂停综合征（AHI 1/hr）。婴儿PSG最常见的适应症是过度打鼾（53%），其次是夜间饱和度下降（24%）。相关的合并症包括胃食管反流（30%）、喉软化（24%）和颅面畸形（16%）。53%的患者存在遗传异常，其中21三体最为常见。手术治疗占36%，氧疗占15%。38例患者在中位间隔8个月（范围1-24个月）后接受重复睡眠研究随访，其中26/38例症状消退。27例患者（28%）在平均5个月的干预间隔（范围，1-34.5个月）后接受了临床随访，其中23/27例患者的症状消退。7例患者在审查时死亡。死亡原因包括癫痫持续状态，呼吸衰竭，肝功能衰竭，肾功能衰竭，或未知causes.ConclusionThe病因OSA的婴儿是不同的，相比，年龄较大的儿童。多导睡眠图是一种可行的，有价值的工具，在诊断阻塞性睡眠呼吸暂停的婴儿，并可能有助于确定及时和适当的评估和干预措施。在内科和/或外科干预后，观察到症状的临床改善和PSG参数的消退。需要进行前瞻性研究以确定诊断为OSA的婴儿的长期结局，以评估早期干预对其神经认知发育的益处。小儿肺醇。2014; 49：554-560. (c)2013 Wiley Periodicals，Inc.
PurposeTo investigate the common indications for polysomnogram (PSG) associated co-morbid conditions, evaluation strategies, treatment options, and outcomes in a series of infants diagnosed with obstructive sleep apnea (OSA) by a PSG.MethodsRetrospective chart review of infants who underwent PSG over a 7-year period was done. Infants with PSG diagnosed OSA were included in this study.ResultsA total of 97 infants (59 males, mean age 4.6 months, standard deviation 3.3 months) were diagnosed with OSA (AHI1/hr) based on PSG. The most common indication for PSG in infants were excessive snoring (53%) followed by nocturnal desaturations (24%). Associated co-morbid conditions included gastro-esophageal reflux (30%), laryngomalacia (24%), and craniofacial abnormalities (16%). Genetic abnormalities were found in 53%, of which trisomy 21 was the most common. Surgical treatments were employed in 36% and oxygen therapy in 15%. Thirty-eight patients were followed up with a repeat sleep study after a median interval of 8 months (range 1-24 months), of whom 26/38 had resolution of symptoms. Twenty-seven patients (28%) were followed clinically after a mean interval of 5 months of intervention (range, 1-34.5 months), in whom the symptoms resolved in 23/27 patients. Seven patients were deceased at review. Causes of death included status epilepticus, respiratory failure, hepatic failure, kidney failure, or unknown causes.ConclusionThe etiologies of OSA in infants are different when compared to older children. PSG is feasible and a valuable tool in the diagnosis of OSA in infants and may help determine timely and appropriate evaluation and interventions. Clinical improvement in symptoms and resolution of PSG parameters were noted following medical and/or surgical interventions. Prospective studies need to be done to ascertain the long-term outcome of infants diagnosed with OSA to assess the benefits of early intervention on their neurocognitive development. Pediatr Pulmonol. 2014; 49:554-560. (c) 2013 Wiley Periodicals, Inc.