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European Journal of Pediatrics

, Volume 148, Issue 4, pp 353–359 | Cite as

Detection of sleep associated dysfunctional pharyngeal obstruction in infants

  • D. P. Southall
  • C. B. Croft
  • V. A. Stebbens
  • H. Ibrahim
  • A. Gurney
  • R. Buchdahl
  • J. O. Warner
Neonatology

Abstract

Six infants were referred with symptoms and clinical signs suggesting airway obstruction during sleep. In each case, overnight recordings of arterial oxygen saturation, respiratory movements and end tidal expired carbon dioxide (ETCO2) showed the presence of abnormal episodes of hypoxaemia related to partial or complete airway obstruction and associated with a specific pattern of the inspiratory movement waveforms. These events and patterns were not found on recordings from 20 age-matched healthy infants and young children. ETCO2 levels were also abnormally elevated in all six patients when asleep. Fiber-optic upper airway endoscopy excluded structural abnormalities, including significant tonsillar or adenoidal enlargement, but showed an intermittent dysfunctional inspiratory obstruction in the pharynx. Continuous positive airways pressure and tracheostomy were effective in treating this obstruction.

Key words

Sleep apnoea syndromes Failure to thrive 

Abbreviations

CPAP

continuous positive airways pressure

ETCO2

end tidal carbon dioxide

SaO2

arterial oxygen saturation

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Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • D. P. Southall
    • 1
  • C. B. Croft
    • 1
  • V. A. Stebbens
    • 1
  • H. Ibrahim
    • 1
  • A. Gurney
    • 1
  • R. Buchdahl
    • 1
  • J. O. Warner
    • 1
  1. 1.Department of Paediatrics, Cardiothoracic InstituteBrompton HospitalLondonUK

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