Evolución clínica y de laboratorio en lactantes con inmadurez del centro respiratorio que presentan episodios de apnea
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Date
2004
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Abstract
Introduction: Episodes of central pauses and periodic breathing are normal in infants and decrease with age and growth. Objective: to evaluate a group of infants that had a polysomnography (PSG) performed due to an episode of apnoea, with elevated immature sleep characteristics and who required home cardiorespiratory monitoring (HCRM) and further control PSGs. Methods: 34 patients, 22 (65%) were male, mean age 27 ± 2 months (PSG 1), range 0,3-9 years, were studied between May 1997 and May 2001. Along with the first PSG (PSG 1) a second was performed (PSG 2) prior to the suspension of HCRM. Apnoea was defined as the absence of respiration for more than 20 sec (central) or more than 10 sec (obstructive and mixed); respiratory pauses as the absence of respiration for more than 6 sec and less than 20 sec (central) or more than 6 sec and less than 10 sec (obstructive). Results: The main indications for PSG were apnoea (27 pts), cyanosis (4 pts) and gastro-oesophageal reflux (GER)in 2. Respiratory events showed mean respiratory pauses of 14.1/hr, mostly central and periodic breathing during 4, 5% of the total sleep time (TST). PSG 1 was abnormal in 32 cases, with desaturation in 23, apnoea in 8, central pauses in 19, obstructive pauses in 9 and GER in 5. PSG 2 was performed at a mean age of 11,5 ± 4 months, range 6-24 months. The comparision of PSG 1 vs PSG 2 showed significant differences in the total respiratory index (p < 0.01), central pauses (p < 0.05) and periodic breathing (p < 0.05), being always lower in the PSG 2. We conclude that the majority of patients with episodes of apnoea and immature sleep patterns normalized their sleep pattern in the first year of life. In this group the correct use of HCRM is indicated.
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ALTE, Apnoea, Home monitoring, PSG