Pulse oximetry in infants with Robin sequence
摘要
Infants with Robin sequence (RS) are at high risk for obstructive sleep apnea (OSA), but screening with poly(somno)graphy (P(S)G) is challenging. The aim of the study was to assess the relationships between different pulse oximetry (SpO2) parameters and the mixed obstructive apnea–hypopnea index (MOAHI) in these infants. We also compared the findings to infants having other comorbidities (OSA-III). Different SpO2 parameters were correlated with MOAHI in infants with RS and with OSA-III having similar OSA severity. The SpO2 parameters were also compared between the 2 groups. Half of the infants with RS had nap studies. Mean MOAHI did not differ significantly between the 2 groups, and the proportion of infants with MOAHI > 10 events/h or ≥ 3% oxygen desaturation index (ODI 3%) > 10 events/h was also similar. Overall, the different SpO2 parameters correlated better with MOAHI in infants with OSA-III than in those with RS. The best correlation was observed between ODI 3% and MOAHI in RS patients (r = 0.536, p < 0.001), and between the total hypoxic burden and MOAHI in OSA-III patients (r = 0.720, p < 0.0001). Mean ODI 3% was significantly lower in infants with RS (15.8 ± 22.3 (range 0.0–137.0) vs. 21.5 ± 18.3 (range 0.4–93.6) events/h for OSA-III, p = 0.024). Moreover, infants with OSA-III presented deeper desaturations and greater hypoxemic burdens.
Conclusion: SpO2 parameters correlated better with MOAHI in infants with OSA-III compared to RS. These findings question the presence of a different OSA phenotype in infants with RS. Future studies should further investigate the potential role of the different SpO2 parameters to screen for OSA in infants.