Clinical significance of continuous percutaneous CO 2 monitoring in severe OSA in children with NPPV
10.3760/cma.j.cn115330-20250110-00032
- VernacularTitle:经皮CO 2连续监测在NPPV治疗儿童重度OSA中的临床意义研究
- Author:
Yi WEI
1
;
Jie ZHANG
;
Ying XU
;
Yujie LIU
;
Yue LI
;
Qingchuan DUAN
Author Information
1. 郑州大学附属儿童医院 河南省儿童医院郑州儿童医院耳鼻咽喉头颈外科 河南省儿童睡眠呼吸疾病早期筛查与精准诊疗工程研究中心，郑州450018
- Publication Type:Journal Article
- Keywords:
Sleep apnea, obstructive;
Children;
Percutaneous carbon dioxide;
Non-invasive ventilator positive pressure ventilation
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(9):1141-1146
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value and clinical significance of percutaneous CO 2 monitoring in non-invasive positive pressureventilator in the treatment of severe obstructive sleep apnea (OSA) in children. Methods:Retrospective analysis was conducted on 38 children with severe OSA, who were treated in Henan Children′s Hospital from August 2023 to December 2024. All of the enrolled children were diagnosed by polysomnography(PSG), treated with non-invasive positive pressure ventilator (NPPV) according to the standard treatment plan, and continuously monitored with TcpCO 2. Arterial blood gas was analyzed before and after pressure titration and TcpCO 2 changes were compared between awake and sleep with arterial blood gas PaCO 2. The sleep parameters, parameters related to arterial blood gas, and the relationship between TcpCO 2 and alveolar hypoventilation in children were analyzed. The cut-off value of alveolar hypoventilation factors were estimated. Statistical analysis was performed using the SPSS 27.0 software. Results:(1)The difference between awake TcpCO 2 and sleep TcpCO 2 was statistically significant[(42.52±3.56)mmHg vs.(51.09±4.07)mmHg, P<0.001), and the difference between sleep TcpCO 2 and morning PaCO 2 was statistically significant[(51.09±4.07)mmHg vs. (40.83±5.34)mmHg, P<0.001]. (2) There was no significant difference in related indicators among different gender children, but the difference in BMI values between preschool and school age children was significant[(18.03±4.96)kg/m 2vs.(25.21±5.25)kg/m 2, t=-4.08, P<0.001]. (3) Obstructive apnea hypopnea index(OAHI), oxygen desaturation index (ODI), and TcpCO 2 were independent risk factors for alveolar hypopnea, but there was no correlation between BMI and whether alveolar hypoventilation.(4).OAHI, ODI, and TcpCO 2 were predictive of the presence of alveolar hypoventilation. When the OAHI exceeded 54.7events/h, ODI exceeded 72.1 events/h, and TcpCO 2 exceeded 56.5 mmHg, the children were more likely to have alveolar hypoventilation. Conclusion:Transcutaneous carbon dioxide, OAHI and ODI can effectively predict whether children have alveolar hypoventilation, which is helpful for clinical treatment.
