Details

Autor(en) / Beteiligte

• Frohlich, Megan
• Widger, John
• Thambipillay, Ganesh
• Teng, Arthur
• Farrar, Michelle
• Chuang, Sandra

Titel

Daytime predictors of nocturnal hypercapnic hypoventilation in children with neuromuscular disorders

Ist Teil von

• Pediatric pulmonology, 2022-06, Vol.57 (6), p.1497-1504

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2022

Quelle

Wiley Online Library All Journals

Beschreibungen/Notizen

• Objectives To examine objective daytime predictors of nocturnal hypercapnic hypoventilation (NHH) and identify a forced vital capacity (FVC) z‐score cut off that predicts NHH using the 2012 Global Lung Function Initiative (GLI) reference equations in pediatric neuromuscular patients. Design Single‐centre retrospective medical record review. Setting Tertiary pediatric hospital in Australia. Patients Children (<18 years old) with a neuromuscular disorder (NMD) who had a diagnostic sleep study over a 5‐year period. Results Fifty children were included, median age 11.9 years (interquartile range [IQR]: 4.5–14.3). The majority of children had a diagnosis of Duchenne Muscular Dystrophy (32%). NHH was diagnosed in 18 children (36%). Multivariate logistic regression analysis performed for the entire cohort confirmed a statistically significant association between NHH and scoliosis (odds ratio [OR]: 3.3, p = 0.03), but not age (OR: 1.01, p = 0.26), body mass index z‐score (OR: 0.86, p = 0.26) or use of a wheelchair for mobility (OR: 1.25, p = 0.72). For the subset of 29 children who had spirometry testing (median age 12.9 years [IQR: 10.2–14.3]), FVC z‐score was the only statistically significant predictor of NHH (OR: 0.45, p = 0.02). NHH was predicted by an FVC z‐score <−3.24 (sensitivity 78%, specificity 73%), or FVC <60% predicted (sensitivity 78%, specificity 73%). There was a strong positive correlation between FVC and forced expiratory volume in 1 s z‐scores (rp = 0.98, p = 0.00) and FVC and peak expiratory flow  z‐scores (rp = 0.72, p = 0.00). Conclusion Children with a NMD and scoliosis or a lower FVC z‐score have increased odds of having NHH.