Faculty Collaboration Database

Severe hypoxemia in children with upper airway obstruction during sleep does not lead to significant changes in heart rate. Pediatr Pulmonol 1993 Dec;16(6):362-9

Date

12/01/1993

Pubmed ID

8134159

DOI

10.1002/ppul.1950160608

Scopus ID

2-s2.0-0027765946 (requires institutional sign-in at Scopus site)   14 Citations

Abstract

Life-threatening cardiac arrhythmias, including bradyarrhythmias, are well-known sequelae of obstructive sleep apnea syndrome (OSAS) in adults and are associated with apnea and severe hypoxemia. Since the clinical expression of OSAS in children is different, we questioned whether arrhythmias are a common feature of pediatric OSAS. Therefore, we analyzed R-R interval patterns from 12 subjects (age 8 months to 14 years) with OSAS in detail. The diagnosis of pediatric OSAS is based on clinical signs of loud snoring and paradoxical respiratory efforts, as well as elevated end-tidal carbon dioxide tension (PETCO2) and major phasic decreases of oxyhemoglobin saturation (SaO2). Two hundred and nine episodes of severe hypoxemia, defined as SaO2 values < or = 85% lasting > or = 30 seconds, were identified. Only 29 (14%) of these episodes were associated with obstructive apneas. The R-R intervals were analyzed before and during each desaturation. Compared to baseline, mean and minimum R-R intervals (RRmean, RRmin) decreased during the desaturation episodes (P < 0.05), while maximum R-R interval (RRmax) increased (P < 0.05). Although the absolute changes in all parameters were significantly different from baseline, the magnitude of these changes was small, with a mean of -5.3%, -12.2%, and 10.4% for RRmean, RRmin, and RRmax, respectively. No child had life-threatening arrhythmias. Although severe hypoxemia existed in these children, the magnitude of the R-R interval changes was modest, and profound bradycardia as described in adults, was rare.(ABSTRACT TRUNCATED AT 250 WORDS)

Author List

D'Andrea LA, Rosen CL, Haddad GG

Author

Lynn A. D Andrea MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Carbon Dioxide
Child
Child, Preschool
Female
Heart Rate
Humans
Hypoxia
Infant
Male
Oxyhemoglobins
Partial Pressure
Respiratory Function Tests
Severity of Illness Index
Sleep Apnea Syndromes