Treatment of sleep-disordered breathing in children with myelomeningocele.

摘要: The prevalence of moderate to severe sleep-disordered breathing (SDB) in patients with myelomeningocele may be as high 20%, but little information is available regarding treatment these patients. To assess the efficacy and complications treatments for children, we collected data on 73 from seven pediatric sleep laboratories. Obstructive apnea (OSA, n = 30) central (n 25) occurred more frequently than hypoventilation 12). We also describe a sleep-exacerbated restrictive lung disease type SDB 6 who had hypoxemia during without or hypoventilation. For each SDB, effective were identified stepwise process, moving towards complex invasive therapies. OSA, adenotonsillectomy was often ineffective (10/14), whereas nasal continuous positive airway pressure (CPAP) usually successful (18/21). apnea, methylxanthines and/or supplemental oxygen proved sufficient 2 9 3 6, respectively, noninvasive ventilation required 7 children. hypoventilation, (alone methylxanthines), ventilation, tracheostomy 3, 2, patients, respectively. Sleep-exacerbated always treatment, cases ventilation; nutritional orthopedic procedures helpful. Posterior fossa decompression used first three types insufficient delineate specific recommendations against its use. In summary, evaluation by an experienced, multidisciplinary team can establish regime child SDB.