You are here

Article Text

Article menu

Download PDFPDF

Abstracts
39 Adherence to non-invasive ventilation in obese children with obstructive sleep apnoea or obesity hypoventilation syndrome
  1. Hannah Williams1,
  2. Sakina Dastagir1,
  3. Jo Gregory1,
  4. Ruth Wakeman1,
  5. Federica Trucco1,2,
  6. Alex Thomas1,
  7. Rishi Pabary1,
  8. Hui-Leng Tan1 and
  9. Ruth O’Reilly1
  1. 1Royal Brompton Hospital, London, UK
  2. 2Dept Paediatric Neuroscience, Guy’s and St Thomas NHS trust and Department Paediatric Respiratory medicine, London, UK

Abstract

Introduction This study aimed to describe the cohort of obese children who were on respiratory support for obstructive sleep apnoea (OSA) or nocturnal hypoventilation in a tertiary respiratory centre and their adherence at 1 year.

Methods Clinical and cardiorespiratory polygraphy data were reviewed for children with a body mass index (BMI) >25kg/m2 established on NIV for OSA (AHI>1ev/Hr) or OHS (BMI>30kg/m2 and criteria for nocturnal hypoventilation)1 from 2013–21. Children with neuro-disability were excluded. Nocturnal hypoventilation was defined as transcutaneous carbon dioxide (TCO2) >6.7kPa ≥ 25% total sleep time (TST).1 Studies less than 4 hours TST were excluded. Day time hypercapnia was defined as TCO2 >5.99kPa ≥10 minutes.1 NIV compliance was >4 hours/night use for >70% of nights.2

Results Data was obtained from 16 children (9 males, 7 females) of whom 2 children had a BMI of 25-30kg/m2, and 14 > 30Kg/m2. Baseline polygraphy data was available on 13/16 children, 8 children had OSA only, 3 had OSA and nocturnal hypoventilation and 2 had and isolated OHS. 5 children (3M, 2F, age 9.0 (4.5-16) years) had nocturnal hypoventilation and also had the highest BMI of the cohort, BMI median 36.2 (28.6-47.3) kg/m2. Daytime hypercapnia was present in 4/9 children with measurements, but only 2 had nocturnal hypoventilation. No child had a TCO2 increase >10mmHg from wake to sleep. Children were established on NIV continuous (n=11) and bilevel (n=5). Only 2/14 children with adherence data were adherent to respiratory support at 1 year. (Table 1).

View this table:
Abstract 39 Table 1

Baseline characteristics of children established on respiratory support (n=13)

Discussion Assessment for complications of excess weight should include day and night-time TCO2 monitoring as OHS was evident from 5 years. Adherence to NIV is poor and intensive multi-disciplinary input may improve this.

References

  1. Masa Eur Respir Rev 2019.

  2. Schwab Am J Respir Crit Care Med 2013.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjresp-2021-bssconf.34

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.