Poligrafija je še vedno zlati standard za ocenjevanje obstruktivnih dihalnih premorov v spanju pri otrocih vseh starostnih skupin. Vendar je podatkov za skupino donošenih, zdravih novorojenčkov malo. Možna koristna uporaba poligrafije se kaže v oceni srčno-dihalnih vzorcev v različnih položajih telesa dojenčka, kot na primer pri preverjanju varnosti otroka v avtomobilskem varnostnem sedežu. Številne raziskave so pokazale, da namestitev dojenčka, še zlasti nedonošenčka, v ta položaj lahko privede do motenj v dihanju. Da bi ugotovili, ali pride do desaturacij tudi ob namestitvi zdravega, donošenega novorojenčka v avtomobilski varnostni sedež (lupinico) ali posteljico, smo v letih 2006 in 2007 izvedli dve veliki prospektivni randomizirani raziskavi v Porodnišnici UKC Ljubljana, Slovenija. Čeprav sta bili raziskavi omejeni, ker so manjkali podatki o fazi spanja med meritvami, smo v primerjavi s položajem v bolnišnični posteljici potrdili pomembne desaturacije tako v varnostnem sedežu kot v posteljici. Desaturacije pri dojenčkih so zaskrbljujoče v luči podatkov, ki kažejo vedenjske težave in kognitivni primanjkljaj tudi po blagih hipoksičnih dogodkih. Ker se avtomobilski sedeži pogosto uporabljajo tudi za druge namene kot za prevoz, so majhni dojenčki, ki so vanje nameščeni dlje časa, izpostavljeni povečanemu tveganju za ponavljajoče se desaturacije ali celo nepričakovano nenadno smrt dojenčka.
Polygraphy in Healthy Term Neonates in Maternity Hospital – Practical Implications in Car Seat Safety Testing
Polygraphy is still the gold standard for the evaluation of obstructive respiratory apnoeas during sleep in children of all ages. However, there are limited data in healthy term infants. A possible beneficial use of polygraphy is the assessment of the cardiorespiratory patterns in different positions of the infant’s body, such as in car safety seat testing. As shown in several studies, placement in the upright position, particularly in infant born preterm, may cause respiratory compromise. We conducted two large prospective randomized studies at the UMC Ljubljana’s Maternity Hospital, in Slovenia in 2006 and 2007 in order to ascertain whether oxygen desaturations also occur when healthy, term infants are positioned in car seats and car beds. Although the studies were limited by a lack of documentation of sleep stage, significant desaturations were observed in both car seats and car beds as compared with hospital cribs. Desaturations in infants are concerning in light of data demonstrating behavioural problems and IQ deficits even after mild hypoxic events. As car safety seats are often used for reasons other than transport, young infants placed in them for prolonged periods of time are at increased risk for recurrent desaturations or even unexpected sudden infant death.