A comparison of pulse oximetry and cerebral oxygenation in children with severe sleep apnea–hypopnea syndrome: a pilot study

摘要

Summary Near infrared spectroscopy ( NIRS ) has been used to assess the impact of obstructive sleep apnea–hypopnea syndrome ( OSAHS ) on cerebral oxygenation. However, the relationship between the variations in the cerebral tissue oxygen saturation (Δ TOI ) and pulse oximetry (ΔSpO 2 ) has not been assessed in children with OSAHS . Consecutive clinically stable children with severe OSAHS [apnea–hypopnea index ( AHI ) 15?events?h ?1 ] diagnosed during a night‐time polygraphy with simultaneous recording of cerebral oxygenation with NIRS ( NIRO ‐200 NX , Hamamatsu Photonics KK ) were included between September 2015 and June 2016. Maximal ΔSpO 2 (SpO 2 drop from the value preceding desaturation to nadir) and concomitant variations in transcutaneous carbon dioxide (ΔPtc CO 2 ), maximal Δ TOI and maximal variations in cerebral oxygenated (O 2 Hb) and deoxygenated ( HH b) haemoglobin were reported. The relationships between ΔSpO 2 , ΔPtc CO 2 and Δ TOI , ΔO 2 Hb and Δ HH b were investigated. The data from five children (three boys, aged 9.6?±?6.7?years, AHI 16–91?events?h ?1 ) were analysed. Strong correlations were found between ΔSpO 2 and Δ TOI ( r ?=?0.887, P ??0.001), but also with ΔO 2 Hb and Δ HH b with a particular pattern in the youngest child with a dark skin pigmentation. Mean ΔSpO 2 was 20?±?17% and mean Δ TOI was 8?±?7%. Maximal ΔSpO 2 of approximately 70% were coupled with Δ TOI of no more than 35%. ΔPtc CO 2 correlated only weakly with the cerebral oxygenation indexes. This pilot study shows a strong relationship between pulse oximetry and cerebral oxygenation in children with OSAHS , with lower changes in TOI compared to SpO 2 . Future studies should address the clinical impact of respiratory events on cerebral oxygenation and its consequences.