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Ventilatory function in children with severe motor disorders using night time postural equipment

Ventilatory function in children with severe motor disorders using night time postural equipment
Ventilatory function in children with severe motor disorders using night time postural equipment
AIM: Night-time postural equipment (NTPE) can prevent hip subluxation in children with severe motor disorders (SMDs). However, it is unclear how it affects ventilatory function. The aims of the study were to determine how NTPE use affects ventilatory function and to compare night-to-night variability of ventilatory function in children with SMDs and typically developing healthy children.

METHOD: Fifteen NTPE users (six males, nine females), aged 1 to 19 years (mean age 8y 7mo) alternated sleep condition between NTPE and sleeping unsupported for 14 nights. In all but two participants, gross motor function was classified as Gross Motor Function Classification System (GMFCS) level V; in the other two it was level IV. Oxyhaemoglobin saturation (SpO2 ) was monitored each night and transcutaneous CO2 (PtcCO2 ) for one night in each sleep condition. In 17 healthy children of similar age, home SpO2 only was monitored for seven nights.

RESULTS: In 13 of 15 NTPE users and 12 of the 17 typically developing children, SpO2 monitoring was satisfactorily completed. Of the children with SMDs, two had mean SpO2 levels below the treatment threshold for supplemental oxygen, which was uniquely associated with use of NTPE in only one participant, and three had nocturnal hypoventilation, which was uniquely associated with NTPE use in only one case. Night-to-night SpO2 variability was higher in children with SMDs than in typically developing children.

INTERPRETATION: NTPE may impair or enhance ventilatory function in a minority of children. Owing to night-to-night variability in SpO2 , at least three nights of monitoring are recommended to determine optimal positioning for effective ventilation before and after NTPE introduction.
0012-1622
Dawson, Nicola C.
250a759b-d773-41ce-8662-60198749222a
Padoa, Kathryn A.
e3108f07-94bd-4884-8d8a-5b52faf8a56a
Bucks, Romola S.
95c31da3-2a01-45e7-a648-76d84a49edc4
Allen, Penny
c543cf97-f014-4d75-942a-6a1df7a6a42f
Evans, Hazel
3207ef8b-38a9-46e4-81e3-7f1a4217c302
McCaughey, Elizabeth
b7d0bb26-de72-4364-95b0-9c6565da2ff3
Hill, Catherine M.
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d
Dawson, Nicola C.
250a759b-d773-41ce-8662-60198749222a
Padoa, Kathryn A.
e3108f07-94bd-4884-8d8a-5b52faf8a56a
Bucks, Romola S.
95c31da3-2a01-45e7-a648-76d84a49edc4
Allen, Penny
c543cf97-f014-4d75-942a-6a1df7a6a42f
Evans, Hazel
3207ef8b-38a9-46e4-81e3-7f1a4217c302
McCaughey, Elizabeth
b7d0bb26-de72-4364-95b0-9c6565da2ff3
Hill, Catherine M.
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d

Dawson, Nicola C., Padoa, Kathryn A., Bucks, Romola S., Allen, Penny, Evans, Hazel, McCaughey, Elizabeth and Hill, Catherine M. (2013) Ventilatory function in children with severe motor disorders using night time postural equipment. Developmental Medicine & Child Neurology. (doi:10.1111/dmcn.12149). (PMID:23582011)

Record type: Article

Abstract

AIM: Night-time postural equipment (NTPE) can prevent hip subluxation in children with severe motor disorders (SMDs). However, it is unclear how it affects ventilatory function. The aims of the study were to determine how NTPE use affects ventilatory function and to compare night-to-night variability of ventilatory function in children with SMDs and typically developing healthy children.

METHOD: Fifteen NTPE users (six males, nine females), aged 1 to 19 years (mean age 8y 7mo) alternated sleep condition between NTPE and sleeping unsupported for 14 nights. In all but two participants, gross motor function was classified as Gross Motor Function Classification System (GMFCS) level V; in the other two it was level IV. Oxyhaemoglobin saturation (SpO2 ) was monitored each night and transcutaneous CO2 (PtcCO2 ) for one night in each sleep condition. In 17 healthy children of similar age, home SpO2 only was monitored for seven nights.

RESULTS: In 13 of 15 NTPE users and 12 of the 17 typically developing children, SpO2 monitoring was satisfactorily completed. Of the children with SMDs, two had mean SpO2 levels below the treatment threshold for supplemental oxygen, which was uniquely associated with use of NTPE in only one participant, and three had nocturnal hypoventilation, which was uniquely associated with NTPE use in only one case. Night-to-night SpO2 variability was higher in children with SMDs than in typically developing children.

INTERPRETATION: NTPE may impair or enhance ventilatory function in a minority of children. Owing to night-to-night variability in SpO2 , at least three nights of monitoring are recommended to determine optimal positioning for effective ventilation before and after NTPE introduction.

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More information

e-pub ahead of print date: 15 April 2013
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 352000
URI: http://eprints.soton.ac.uk/id/eprint/352000
ISSN: 0012-1622
PURE UUID: 4259d991-b84c-4e82-835d-5105ff789e28
ORCID for Catherine M. Hill: ORCID iD orcid.org/0000-0003-2372-5904

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Date deposited: 30 Apr 2013 09:55
Last modified: 15 Mar 2024 03:01

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Contributors

Author: Nicola C. Dawson
Author: Kathryn A. Padoa
Author: Romola S. Bucks
Author: Penny Allen
Author: Hazel Evans
Author: Elizabeth McCaughey

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