Nocturnal oximetry in pediatric respiratory disease: Urgent need for developing standardized interpretation rules

Kaditis, Athanasios G.; Dallaire, Frédéric; Praud, Jean‐Paul

doi:10.1002/ppul.23970

Cited by 2 publications

(3 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Parameters such as mean SpO 2 < 93% or ≤5% of study time with SpO 2 ≤ 93% lack the sensitivity to discriminate infants who require oxygen therapy for ongoing central apnoeas and periodic breathing. Further work in this area is required to improve our utility of overnight oximetry . Until the management of home oxygen therapy in CNLD is standardised, it will be difficult to conduct prospective research assessing the effects of various oxygen weaning practices on long‐term outcomes in these infants …”

Section: Discussionmentioning

confidence: 99%

“…Further work in this area is required to improve our utility of overnight oximetry. 46 Until the management of home oxygen therapy in CNLD is standardised, it will be difficult to conduct prospective research assessing the effects of various oxygen weaning practices on long-term outcomes in these infants. 47 This study is not without limitations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Using continuous overnight pulse oximetry to guide home oxygen therapy in chronic neonatal lung disease

Wong

Chung

Chawla

2019

J Paediatrics Child Health

View full text Add to dashboard Cite

Aim The aims of this study are: (i) to survey the knowledge of paediatric clinicians using overnight continuous pulse oximetry data to guide management of infants with chronic neonatal lung disease (CNLD); (ii) to assess the ability of paediatric clinicians to interpret overnight continuous pulse oximetry data; and (iii) to describe the overnight oximetry interpretation practices of paediatric respiratory specialists. Methods Paediatric clinicians from three tertiary teaching hospitals completed an anonymous survey regarding overnight continuous pulse oximetry in chronic neonatal lung disease. Using a modified Delphi technique, paediatric respiratory specialists participated in a concordance exercise and discussions to establish consensus interpretations for 25 oximetry studies. Paediatric clinicians were invited to complete the same exercise as a comparison. Results Self‐rated knowledge from 74 surveyed clinicians was proportional to clinical experience. Twenty paediatric clinicians and nine paediatric respiratory specialists completed the oximetry exercise with scores of 64% (κ = 0.25) and 80% (κ = 0.45), respectively. Individual parameters like a mean peripheral arterial haemoglobin saturation (SpO2) below 93% and percentage time spent below SpO2 93% correlated poorly with the consensus interpretations. Paediatric respiratory specialists instead relied on visual analysis of SpO2 waveforms, utilising the frequency and depth of desaturations to guide management. Conclusion Interpretation of overnight oximetry data is variable amongst both paediatric clinicians and respiratory specialists. This likely reflects inadequate evidence defining clinically significant intermittent hypoxaemia, whether in terms of desaturation duration, frequency or nadir.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Using continuous overnight pulse oximetry to guide home oxygen therapy in chronic neonatal lung disease

Wong

Chung

Chawla

2019

J Paediatrics Child Health

View full text Add to dashboard Cite

show abstract

“…Progress has been made in the standardized interpretation of nocturnal oximetry in children with clinical manifestations of obstructive SDB . Severity of SDB can be expressed by two oximetry measures: (i) the oxygen desaturation (≥3%) of hemoglobin index (ODI3) which is defined as the frequency of SpO 2 drops ≥3% per hour of recording and (ii) the McGill oximetry score (MOS), which ranges from 1 to 4 as determined by the presence of clusters of desaturation events and by the depth of desaturations in the tracing.…”

Section: Introductionmentioning

confidence: 99%

Nocturnal oximetry in children with obstructive lung disease or sleep‐disordered breathing

Katsouli

Polytarchou

Tsaoussoglou

et al. 2019

Pediatric Pulmonology

Self Cite

View full text Add to dashboard Cite

Objectives: Although progress has been made in the standardized interpretation of nocturnal oximetry in children with obstructive sleep-disordered breathing (SDB), no evidence exists on oximetry abnormalities in other respiratory disorders. We aimed to compare obstructive lung disease (OLD) and SDB regarding nocturnal oximetry parameters. Methods:We analyzed oximetry recordings from children with (i) OLD (obliterative bronchiolitis; cystic fibrosis); (ii) snoring and adenotonsillar hypertrophy (SDB); and (iii) no respiratory disorder (controls). The three groups were compared regarding:(i) oxygen desaturation of hemoglobin index (SpO 2 drops ≥3%/h-ODI3) and (ii) basal SpO 2 (average SpO 2 between SpO 2 drops). The associations of oximetry parameters (natural logarithm) with study group were tested using linear regression including age as covariate.Results: Data of 16 subjects with OLD (median age: 7.3 years; Q25, Q75: 5.4, 12), 22 children with SDB (6.3 years; 4, 9) and 22 controls (6.8 years; 5.6, 10.3) were analyzed.Children with OLD or SDB had significantly lower basal SpO 2 than controls (91.9% [90.8, 93.4] vs 96.3% [96, 97.4] vs 97.6% [97.1, 97.9]; P < 0.01). No subjects in the SDB or control groups had basal SpO 2 < 95%. Children with SDB had significantly higher ODI3 than children with OLD or controls [8.4 episodes/h (6.2, 16.6) vs 4.4 episodes/h(3.6, 6.6) vs 2 episodes/h (1.3, 2.7); P < 0.01]. OLD had the greatest negative effect on basal SpO 2 (R 2 = 0.62; P < 0.001) and SDB the greatest positive effect on ODI3 (R 2 = 0.34; P < 0.001).Conclusion: OLD is associated mostly with reduced basal SpO 2 , whereas SDB is characterized by elevated ODI3. K E Y W O R D S adenotonsillar hypertrophy, cystic fibrosis, obliterative bronchiolitis, obstructive sleep apnea, sleep hypopnea

show abstract

Nocturnal oximetry in pediatric respiratory disease: Urgent need for developing standardized interpretation rules

Cited by 2 publications

References 29 publications

Using continuous overnight pulse oximetry to guide home oxygen therapy in chronic neonatal lung disease

Using continuous overnight pulse oximetry to guide home oxygen therapy in chronic neonatal lung disease

Nocturnal oximetry in children with obstructive lung disease or sleep‐disordered breathing

Contact Info

Product

Resources

About