Treatment of sleep-disordered breathing among children with myelomeningocele.

IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY Journal of neurosurgery. Pediatrics Pub Date : 2024-11-01 DOI:10.3171/2024.8.PEDS24223
Addison Stewart, Stephanie Rau, Renée A Shellhaas, Jason Woodward, Betsy Hopson, Anastasia Arynchyna-Smith, Isaac Shamblin, Jeffrey P Blount, John E Pascoe, Curtis J Rozzelle, James M Johnston, Mary Halsey Maddox, Brandon G Rocque
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Abstract

Objective: Studies have shown a high prevalence of sleep-disordered breathing (SDB) among children with myelomeningocele (MMC), but there are few published data on the longitudinal care of these patients. The objective of this study was to determine the effectiveness of standard treatments for SDB in children with MMC.

Methods: The authors analyzed records from three multidisciplinary spina bifida clinics to identify all patients with both MMC and SDB diagnosed by polysomnography (PSG). The primary outcome of this study was a change in apnea-hypopnea index (AHI; the number of apneic or hypopneic events per hour of sleep) before and after clinically recommended SDB treatments. Clinical and demographic variables were recorded and evaluated for possible association with posttreatment improvement of AHI. Analysis included change in AHI (a continuous variable) and whether SDB improved (defined as an AHI < 2.5 or decrease of AHI by ≥ 50% from baseline).

Results: Seventy-one eligible patients (aged 2 days-21 years, 52% male) had an initial AHI > 2.5 and had follow-up PSG after treatment for SDB. The mean AHI decreased from 20.5 (SD 21.6) at baseline to 11.6 (SD 15.7) after treatment (p = 0.0006). Children treated with supplemental oxygen and with continuous positive airway pressure had improvement on PSG (18 of 25 and 12 of 18, respectively). Children treated with adenotonsillectomy were less likely to improve (7 of 19). Forty-one patients (58%) improved from a baseline AHI > 2.5 to an AHI < 2.5 after treatment.

Conclusions: Children with MMC and SDB who undergo standard SDB treatments guided by pediatric sleep medicine physicians show improvement in PSG parameters after treatment.

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治疗髓母细胞瘤患儿的睡眠呼吸障碍。
目的:研究表明,在患有脊髓脊膜膨出症(MMC)的儿童中,睡眠呼吸障碍(SDB)的发病率很高,但有关这些患者的纵向护理的公开数据却很少。本研究的目的是确定针对脊髓脊膜膨出症儿童睡眠呼吸障碍的标准治疗方法的有效性:作者分析了三家多学科脊柱裂诊所的记录,以确定所有经多导睡眠图(PSG)诊断同时患有 MMC 和 SDB 的患者。本研究的主要结果是临床推荐的 SDB 治疗前后呼吸暂停-低通气指数(AHI,每小时睡眠中发生呼吸暂停或低通气的次数)的变化。对临床和人口统计学变量进行了记录,并评估了这些变量与治疗后 AHI 改善之间可能存在的关联。分析包括 AHI 的变化(连续变量)和 SDB 是否改善(定义为 AHI < 2.5 或 AHI 比基线下降≥ 50%):71名符合条件的患者(2天-21岁,52%为男性)初始AHI>2.5,在接受SDB治疗后进行了PSG随访。平均 AHI 从基线时的 20.5(标准差 21.6)降至治疗后的 11.6(标准差 15.7)(p = 0.0006)。接受补充氧气和持续气道正压治疗的患儿的 PSG 均有所改善(分别为 25 例中的 18 例和 18 例中的 12 例)。接受腺样体切除术治疗的患儿病情改善的可能性较小(19 例中有 7 例)。治疗后,41 名患者(58%)从基线 AHI > 2.5 改善到 AHI < 2.5:结论:MMC 和 SDB 患儿在儿科睡眠医师的指导下接受标准 SDB 治疗后,PSG 参数会有所改善。
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来源期刊
Journal of neurosurgery. Pediatrics
Journal of neurosurgery. Pediatrics 医学-临床神经学
CiteScore
3.40
自引率
10.50%
发文量
307
审稿时长
2 months
期刊介绍: Information not localiced
期刊最新文献
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