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Oximetry and carbon dioxide screening for ventilatory requirements in children with spinal muscular atrophy type 1-3.
Chacko, Archana; Sly, Peter D; Ware, Robert S; Young, Emily; Robinson, Jacob; Williams, Gordon; Gauld, Leanne M.
Afiliación
  • Chacko A; Centre for Child Health Research, University of Queensland, Brisbane, Australia. Electronic address: Archana.bodapati@Hotmail.com.
  • Sly PD; Centre for Child Health Research, University of Queensland, Brisbane, Australia; Queensland Respiratory and Sleep Department, Queensland Children's Hospital, Brisbane, Australia.
  • Ware RS; Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
  • Young E; Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
  • Robinson J; Queensland Respiratory and Sleep Department, Queensland Children's Hospital, Brisbane, Australia.
  • Williams G; Queensland Respiratory and Sleep Department, Queensland Children's Hospital, Brisbane, Australia.
  • Gauld LM; Centre for Child Health Research, University of Queensland, Brisbane, Australia; Queensland Respiratory and Sleep Department, Queensland Children's Hospital, Brisbane, Australia.
Sleep Med ; 122: 208-212, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39208519
ABSTRACT

INTRODUCTION:

Despite disease modifying treatments (DMT), assisted ventilation is commonly required in children with Spinal Muscular Atrophy (SMA). Guidelines suggest screening with oximetry and transcutaneous carbon dioxide (TcCO2) for sleep disordered breathing (SDB).

AIM:

To determine the utility of pulse oximetry and TcCO2 as a screen for SDB and the need for Non-Invasive Ventilation (NIV) in children with SMA type 1-3.

METHODS:

A prospective cohort study was conducted in Queensland, Australia. Full diagnostic PSG was completed in DMT naïve children with SMA. Pulse oximetry and TcCO2 were extracted from PSG. Apnoea-hypopnoea indices (AHI) criteria were applied to PSG results to define the need for NIV. Abnormal was defined as ≤3 months of age [mo] AHI≥10 events/hour; >3mo AHI ≥5 events/hour. Receiver operating characteristic curves were calculated for abnormal PSG and pulse oximetry/TcCO2 variables, and diagnostic statistics were calculated.

RESULTS:

Forty-seven untreated children with SMA were recruited (type 1 n = 13; 2 n = 21; 3 n = 13) ranging from 0.2 to 18.8 years old (median 4.9 years). Oxygen desaturation index ≥4 % (ODI4) ≥20events/hour had sensitivity 82.6 % (95 % CI 61.2-95.0) and specificity of 58.3 % (95 % CI 36.6-77.9). TcCO2 alone and combinations of oximetry/TcCO2 had low diagnostic ability. The same methodology was applied to 36 children who were treated (type 1 n = 7; type 2 n = 17; type n = 12) and oximetry±TcCO2 had low diagnostic ability.

CONCLUSION:

ODI4 ≥20events/hour can predict the need for NIV in untreated children with SMA. TcCO2 monitoring does not improve the PPV. If normal however, children may still require a diagnostic PSG. Neither oximetry nor TcCO2 monitoring were useful screening tests in the children treated with DMT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oximetría / Dióxido de Carbono / Atrofias Musculares Espinales de la Infancia Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Oceania Idioma: En Revista: Sleep Med Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oximetría / Dióxido de Carbono / Atrofias Musculares Espinales de la Infancia Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Oceania Idioma: En Revista: Sleep Med Asunto de la revista: NEUROLOGIA / PSICOFISIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos