Can postural changes in spirometry in children with Duchenne muscular dystrophy predict sleep hypoventilation?

IF 4.7 3区医学 Q1 PEDIATRICS Paediatric Respiratory Reviews Pub Date : 2024-03-01 DOI:10.1016/j.prrv.2023.08.002

C. Pandit , B. Kennedy , K. Waters , H. Young , K. Jones , D.A. Fitzgerald

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Abstract

Aim

To explore the relationship between postural changes in lung function and polysomnography (PSG) in children with Duchenne muscular dystrophy (DMD).

Methods

In this prospective cross-sectional study, children with DMD performed spirometry in sitting and supine positions. A control group of age and gender matched healthy children also underwent postural lung function testing. PSG was performed within six months of spirometry.

Results

Seventeen children with DMD, aged 12.3 ± 3 years performed sitting spirometry. 14 (84%) performed acceptable spirometry in the supine position. Mean FEV₁_sit and FVC_sit were 77% (SD ± 22) and 74% (SD ± 20.4) respectively, with mean% ΔFVC₍_sit–sup₎ 9% (SD ± 11) (range 2% to 20%), and was significantly greater than healthy controls 4% (n = 30, SD ± 3, P < 0.001). PSG data on the 14 DMD children with acceptable supine spirometry showed total AHI 6.9 ± 5.9/hour (0.3 to 29), obstructive AHI 5.2 ± 4.0/hour (0.2 to 10), and REM AHI 14.1 ± -5.3/hour (0.1 to 34.7). ΔFVC(sit–sup) had poor correlation with hypoventilation on polysomnography.

Conclusion

Children with DMD and mild restrictive lung disease showed greater postural changes in spirometry than healthy controls but lower supine spirometry was not predictive of sleep hypoventilation.

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杜氏肌营养不良症儿童肺活量的姿势变化能否预测睡眠通气不足？

目的探讨杜氏肌营养不良症（DMD）患儿肺功能体位变化与多导睡眠图（PSG）之间的关系。方法在这项前瞻性横断面研究中，DMD 患儿在坐位和仰卧位进行了肺功能测试。由年龄和性别匹配的健康儿童组成的对照组也进行了体位肺功能测试。结果17名年龄为（12.3 ± 3）岁的 DMD 患儿进行了坐位肺活量测定。14名儿童（84%）在仰卧位进行了可接受的肺活量测定。平均 FEV1sit 和 FVCsit 分别为 77% (SD ± 22) 和 74% (SD ± 20.4)，平均 ΔFVC(sit-sup) 为 9% (SD ± 11)（范围为 2% 至 20%），明显高于健康对照组的 4% (n = 30, SD ± 3, P < 0.001)。14 名 DMD 儿童的 PSG 数据显示，总 AHI 为 6.9 ± 5.9/小时（0.3 至 29），阻塞性 AHI 为 5.2 ± 4.0/小时（0.2 至 10），快速动眼期 AHI 为 14.1 ± -5.3/小时（0.1 至 34.7）。结论与健康对照组相比，患有 DMD 和轻度限制性肺部疾病的儿童在肺活量方面表现出更大的体位变化，但较低的仰卧肺活量并不能预测睡眠通气不足。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Paediatric Respiratory Reviews 医学-呼吸系统

CiteScore

12.50

自引率

0.00%

发文量

审稿时长

23 days

期刊介绍： Paediatric Respiratory Reviews offers authors the opportunity to submit their own editorials, educational reviews and short communications on topics relevant to paediatric respiratory medicine. These peer reviewed contributions will complement the commissioned reviews which will continue to form an integral part of the journal. Subjects covered include: • Epidemiology • Immunology and cell biology • Physiology • Occupational disorders • The role of allergens and pollutants A particular emphasis is given to the recommendation of "best practice" for primary care physicians and paediatricians. Paediatric Respiratory Reviews is aimed at general paediatricians but it should also be read by specialist paediatric physicians and nurses, respiratory physicians and general practitioners. It is a journal for those who are busy and do not have time to read systematically through literature, but who need to stay up to date in the field of paediatric respiratory and sleep medicine.