Comparison of high flow nasal cannula therapy to nasal oxygen as a treatment for obstructive sleep apnea in infants.
Document Type
Article
Publication Date
10-2024
Identifier
DOI: 10.1002/ppul.27109
Abstract
INTRODUCTION: Obstructive sleep apnea (OSA) in infants is treated with low flow oxygen via nasal cannula (NC), CPAP (continous positive airway pressure), or surgery. Literature supports the use of high flow NC (HFNC) in children in the outpatient setting, however there is limited data on the use of HFNC in infants.
OBJECTIVE: The purpose of this study was to compare HFNC and low-flow oxygen as treatments for OSA in infants.
METHODS: A prospective pilot study was performed at two institutions. Infants with primarily OSA underwent a 3-4 h sleep study with HFNC titration at 6-14 lpm for OSA, followed by clinical polysomnography (PSG) for oxygen titration (1/8-1 lpm). Infants with primarily central apnea were excluded.
RESULTS: Nine infants were enrolled, with a mean age of 1.3 ± 1.7 months. Average apnea hypopnea index (AHI), average obstructive apnea hypopnea index (OAHI) and average central apnea index during the diagnostic PSG was 17.2 ± 7/h, 13.4 ± 5.4/h and 3.7 ± 4.8/h respectively. OSA improved in 44.4% of subjects with HFNC; the mean AHI and OAHI decreased from 15.6 ± 5.65/h and 12.8 ± 4.4/h on diagnostic PSG to 5.12 ± 2.5/h and 4.25 ± 2.5/h on titration PSG. OSA improved universally with low flow oxygen; the mean AHI decreased from 17.2 ± 7/h on diagnostic PSG to 4.44 ± 3.6/h on titration PSG.
CONCLUSION: HFNC reduced OSA in some infants, though low flow oxygen reduced OSA in all subjects. Respiratory instability (high loop gain) in infants may explain why infants responded to low flow oxygen. More studies are needed to determine if HFNC is beneficial in selected groups of infants with OSA.
Journal Title
Pediatric pulmonology
Volume
59
Issue
10
First Page
2635
Last Page
2640
MeSH Keywords
Humans; Sleep Apnea, Obstructive; Infant; Pilot Projects; Male; Prospective Studies; Oxygen Inhalation Therapy; Cannula; Female; Polysomnography; Treatment Outcome; Oxygen; Continuous Positive Airway Pressure
Keywords
high flow nasal cannula; infants; obstructive sleep apnea; polysomnography
Recommended Citation
Gurbani N, Ehsan Z, Boh M, Schuler CL, Simakajornboon N. Comparison of high flow nasal cannula therapy to nasal oxygen as a treatment for obstructive sleep apnea in infants. Pediatr Pulmonol. 2024;59(10):2635-2640. doi:10.1002/ppul.27109
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Comments
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