SLEEP-RELATED BREATHING DISORDERS IN PREMATURE INFANTS WITH BRONCHOPULMONARY DYSPLASIA AND PULMONARY HYPERTENSION

Oral Session 1
Saturday, April 28, 2018 | 2:15pm-3:45pm | Room 342B

2:30pm-2:45pm
SLEEP-RELATED BREATHING DISORDERS IN PREMATURE INFANTS WITH BRONCHOPULMONARY DYSPLASIA AND PULMONARY HYPERTENSION

Authors:
Anna Solomakha (Russian Federation)*
Natalia Petrova (Russian Federation)
Dmitry Ivanov (Russian Federation)
Yuri Sviryaev (Russian Federation)

Introduction

Secondary pulmonary hypertension (PH) is a serious complication of bronchopulmonary dysplasia (BPD). PH is associated with impaired growth and remodeling of pulmonary vessels and is supported by the presence of permanent or intermittent hypoxia/hypercapnia episodes and vasoconstriction. The aim of the study was to evaluate cardiorespiratory parameters in premature infants with BPD and PH.

Materials and methods

Cardiorespiratory monitoring was performed in 58 premature infants born on 26 0/7 – 31 0/7 weeks of gestation, with birth weight less than 1500 grams, before discharge from the hospital (35-44 weeks of postmenstrual age (PMA)). Forty-four infants had BPD (31 infants were oxygen dependant at 36 weeks of PMA and 17 were diagnosed with PH). Fourteen infants had no BPD.
Results Infants with BPD plus PH were characterized by lower average SpO2 (93.6 (89.0-96.6)%) (p=0.0003), higher desaturation index (43 (13.3-133.5/hour) (p=0.04), and more desaturation episodes ˂5% (22.5 (8.7-46.2/hour) (p=0.009) compared to infants with BPD without PH (97.2 (89.7-98.7)%, 24.6 (1.0-104.5)/hour and 14.4 (0.5-46.2)/hour, respectively), and infants without BPD (97.5 (96.3-98.7)%, 20 (1.1-58.8)/hour and 13.6 (0.7/28.5)/hour, respectively). There was no difference in the apnea/hypopnea index (AHI) (p=0.1) and apnea incidence between the groups. The groups did not differ in obstructive sleep apnea index (OA) (p=0.6). Incidence of OA >1/hour (a diagnostically significant amount of OA) in infants with BPD plus PH was higher (5 infants) compared to control group (no infants, F=0.04448, p<0.05). There was no difference in central apnea index between the groups (p=0.1). Many infants in the groups had a large number of short central apnea episodes, which is associated with the presence of episodes of periodic breathing.

Conclusions

1. Preterm infants with BPD plus PH had more significant decrease in mean SpO2, a greater desaturation index and a number of desaturation episodes of ˂5% compared to infants with BPD without PH and infants without BPD.
2. Infants with BPD plus PH more often had OA than infants with BPD without PH and «healthy» infants.
3. There was no difference in AHI and central apnea index between the groups.

Acknowledgements

Researchers thanks to doctors of somnological laboratories of Almazov National Medical Research Centre