Abstract
Background: Neuromuscular (NMD) patients are at risk of developing respiratory failure. However, the type of the screening test is not specified by the British Thoracic Society Guidelines and it varies in different centres.
Hypothesis: Overnight oxycapnography is sufficient as a screening test for identifying NMD children with nocturnal hypoventilation (NH) who need non-invasive ventilation.
Methods: This is a retrospective review of paired cardiorespiratory (CR) polygraphy studies and oxycapnographies performed on patients with NMD between 2013-2018. NH was defined as transcutaneous carbon dioxide (TcCO2) level greater than 6.5kPa for > 25% of total sleep time (TST).
Results: Thirty-eight paired studies for 21 patients were reviewed. From the oxycapnography studies, 15 patients were identified to be in need of NIV. Fourteen patients had evidence of NH and one patient had a typical pattern of REM related NH with clusters of desaturations and elevated CO2 in active sleep (TcCO2 >6.5kPa for 17.9% TST). From CR polygraphy, 2 additional patients were identified who had raised AHI 9.2/h and 6.6/h (but did not have raised CO2). On repeat of these studies, both showed significant improvement and NIV was not started. All patients with low mean SpO2 (< 93%) or desaturation index >5/hour had evidence of NH. Nine out of 14 patients with NH had normal oximetry.
Conclusion: Oxycapnography alone is a reasonable screening tool for NH in NMD patients.
Footnotes
Cite this article as: ERJ Open Research 2019; 5 : Suppl. 3, P138.
This is an ERS Sleep and Breathing Conference abstract. No full-text version is available. Further material to accompany this conference is available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019