Article

Night-time postural equipment (NTPE) can prevent hip subluxation in children
with severe motor disorders (SMDs). However, it is unclear how it affects
ventilatory function. The aims of the study were to determine how NTPE use
affects ventilatory function and to compare night-to-night variability of
ventilatory function in children with SMDs and typically developing healthy
children. METHOD: Fifteen NTPE users (six males, nine females), aged 1 to 19
years (mean age 8y 7mo) alternated sleep condition between NTPE and sleeping
unsupported for 14 nights. In all but two participants, gross motor function was
classified as Gross Motor Function Classification System (GMFCS) level V; in the
other two it was level IV. Oxyhaemoglobin saturation (SpO2 ) was monitored each
night and transcutaneous CO2 (PtcCO2 ) for one night in each sleep condition. In
17 healthy children of similar age, home SpO2 only was monitored for seven
nights. RESULTS: In 13 of 15 NTPE users and 12 of the 17 typically developing
children, SpO2 monitoring was satisfactorily completed. Of the children with
SMDs, two had mean SpO2 levels below the treatment threshold for supplemental
oxygen, which was uniquely associated with use of NTPE in only one participant,
and three had nocturnal hypoventilation, which was uniquely associated with NTPE
use in only one case. Night-to-night SpO2 variability was higher in children with
SMDs than in typically developing children. INTERPRETATION: NTPE may impair or
enhance ventilatory function in a minority of children. Owing to night-to-night
variability in SpO2 , at least three nights of monitoring are recommended to
determine optimal positioning for effective ventilation before and after NTPE
introduction.
CI - (c) 2013 Mac Keith Press.

Langue : ANGLAIS