Changes in nocturnal oximetry after treatment of exacerbations in cystic fibrosis
Related Experiment Videos
M B Allen1, A F Mellon, E J Simmonds
1Department of Respiratory Medicine, St James's University Hospital, Leeds.
Insights
Nocturnal oxygen desaturation is common in children with cystic fibrosis during exacerbations. Treatment significantly improves overnight oxygen saturation levels, with overnight oximetry being a valuable diagnostic tool.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Sleep Medicine
Background:
- Nocturnal oxygen desaturation is documented in stable young adults with cystic fibrosis.
- The impact of infective exacerbations on nocturnal oxygen saturation in children is less understood.
Purpose of the Study:
- To examine the incidence and severity of nocturnal oxygen desaturation in children with cystic fibrosis during infective exacerbations.
- To assess the changes in nocturnal oxygen saturation following treatment.
Main Methods:
- Forty-five children with cystic fibrosis underwent clinical evaluation, spirometry, peak flow measurement, and nocturnal oxygen saturation monitoring.
- Measurements were taken on admission and after 10 days of treatment.
Main Results:
- A significant improvement in averaged overnight oxygen saturation from 92.7% to 94.3% was observed.
- Time spent with saturation 4% or more below clinic value decreased from 122 to 21 minutes.
- Eight children unable to perform pulmonary function tests all showed desaturation on admission.
Conclusions:
- Nocturnal hypoxemia is prevalent in young cystic fibrosis patients during exacerbations but resolves with treatment.
- Overnight oximetry is a simple, well-tolerated method for identifying patients with significant nocturnal desaturation.
Abstract:
Sleep related arterial oxygen desaturation has been described in clinically stable young adults with cystic fibrosis. The incidence and severity of nocturnal oxygen desaturation in children during infective exacerbations and the changes that occur with treatment were examined. Forty five children with proved cystic fibrosis, median age 8.9 years, admitted to the Regional Cystic Fibrosis Unit underwent clinical evaluation, spirometry, and measurement of peak flow and nocturnal oxygen saturation on admission and after 10 days' treatment. There was a significant improvement in all the above measurements, with the averaged overnight saturation changing from a mean (SD) 92.7 (2.7)% to 94.3 (2.0)%, mean (SE) difference 1.58 (0.37). The time spent with a saturation 4% or more below their clinic value showed a marked improvement from 122 (152) minutes on the first night to 21 (30.7) on the second, mean (SE) difference 101 (22.4). Eight young children could not perform pulmonary function tests, all desaturated on the admission night. Nocturnal hypoxaemia is a common finding in young cystic fibrosis patients during infective exacerbations but improves with treatment. Overnight oximetry is simple to perform, well tolerated, and identifies patients with marked nocturnal desaturation.