Nocturnal hypoxaemia and hypercapnia in children with neuromuscular disorders
Nocturnal hypoxaemia and hypercapnia in children with neuromuscular disorders
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DOI：
10.1183/09031936.00087511
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发表时间：
2012-05-01
影响因子：
24.3
通讯作者：
Fauroux, Brigitte
中科院分区：
文献类型：
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作者：
Bersanini, Chiara;Khirani, Sonia;Fauroux, Brigitte
该研究的目的是确定患有神经肌肉疾病（NMD）和白天气体交换正常的儿童夜间气体交换异常的日间预测因子。作为常规评估的一部分，进行了肺功能测试、呼吸肌评估和夜间气体交换。我们连续纳入了 52 名患有杜氏肌营养不良症 (n = 20)、脊髓性肌萎缩症 (n = 10) 和其他 NMD (n = 22) 的儿童。 20 名患者患有夜间低氧血症，定义为通过脉搏血氧饱和度测量的最小动脉氧饱和度 (Sp,O-2) = 夜间的 2%，22 名患者患有夜间高碳酸血症，定义为夜间最大经皮二氧化碳分压 (Ptc,CO2) >50 mmHg，≥ 2% 的夜间时间。用力肺活量和氦气功能残气量与最小夜间 Sp,O-2 相关（分别为 p=0.009 和 p=0.01）。白天 pH 值与最大夜间 Ptc,CO2 (p=0.005) 呈负相关，白天动脉二氧化碳张力 (Pa,CO2) 与 Ptc,CO2 > 50 mmHg 的时间百分比相关 (p=0.02)。嗅鼻吸气压与最小夜间 Sp,02 相关 (p=0.02)。白天 Pa,CO2 是夜间高碳酸血症的弱预测因子（敏感性 80%；特异性 57%）。 NMD 儿童的日间肺功能和呼吸肌参数与夜间低氧血症和高碳酸血症以及白天气体交换正常的相关性较差，因此需要对这些儿童进行更系统的睡眠研究。
The aim of the study was to identify daytime predictors of nocturnal gas exchange anomalies in children with neuromuscular disease (NMD) and normal daytime gas exchange. Lung function tests, respiratory muscle evaluation and nocturnal gas exchange were obtained as part of routine evaluation.We included 52 consecutive children with Duchenne muscular dystrophy (n=20), spinal muscular atrophy (n=10) and other NMD (n=22). 20 patients had nocturnal hypoxaemia, defined as minimal arterial oxygen saturation measured by pulse oximetry (Sp,O-2) = 2% of night time, and 22 had nocturnal hypercapnia, defined as maximal transcutaneous carbon dioxide tension (Ptc,CO2) >50 mmHg for >= 2% of night time. Forced vital capacity and helium functional residual capacity correlated with minimal nocturnal Sp,O-2, (p=0.009 and p=0.01, respectively). Daytime pH correlated negatively with maximal nocturnal Ptc,CO2 (p=0.005) and daytime arterial carbon dioxide tension (Pa,CO2) correlated with the percentage of time with a Ptc,CO2 >50 mmHg (p=0.02). Sniff nasal inspiratory pressure correlated with minimal nocturnal Sp,02 (p=0.02).Daytime Pa,CO2, was a weak predictor of nocturnal hypercapnia (sensitivity 80%; specificity 57%). Daytime lung function and respiratory muscle parameters correlate poorly with nocturnal hypoxaemia and hypercapnia in children with NMD and normal daytime gas exchange, which necessitates more systematic sleep studies in these children.