ORCID Profile
0000-0001-9366-556X
Current Organisation
University of Southampton
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Publisher: Wiley
Date: 29-07-2022
DOI: 10.1002/PPUL.26072
Abstract: Ex‐preterm infants with severe bronchopulmonary dysplasia (BPD) sometimes require long‐term ventilation (LTV) to facilitate weaning from respiratory support. There are however limited data characterizing this cohort. We aim to describe the background characteristics, neonatal comorbidities, characteristics at the initiation of ventilation, and outcomes of neonatal unit graduates with BPD established on LTV. A retrospective cohort study of infants born weeks gestation with BPD referred to a regional LTV service between January 2015 and December 2020. Twenty‐five infants were referred during the study period. Median birth gestation was 26 + 1 weeks (24 + 0–30 + 4) and birth weight 645 g (430–1485). At 36 weeks postmenstrual age (PMA), median FiO 2 was 0.45 (0.24–0.80) and one‐quarter of infants remained on invasive ventilation. Twenty (80%) infants were established on noninvasive ventilation (NIV), with the smallest weighing 2085 g, and five (20%) required tracheostomy invasive ventilation (TIV). At initiation of NIV/TIV, median PMA was 41 + 1 weeks and median FiO 2 0.40 (0.29–0.80). Infants established on TIV spent almost five times longer in hospital before discharge compared to those on NIV ( p = 0.003). By March 2022, 18 (72%) infants had discontinued ventilation, spending a median total time of 113 days (18–1792) on ventilation. Due to advances in interfaces, headgear, and ventilator technology, NIV is an attractive and practically achievable option for infants with severe BPD as small as 2 kg. Initiation and weaning should take place in a facility with the required multidisciplinary expertize.
Publisher: BMJ
Date: 20-10-2020
DOI: 10.1136/ARCHDISCHILD-2020-320066
Abstract: To define reference ranges for the 3% oxygen desaturation index (DI3) in healthy children under 12 years old during sleep. Observational. Home. Healthy children aged 6 months to 12 years of age. Nocturnal pulse oximetry at home. Parents documented sleep times. Visi-Download software (Stowood Scientific) analysed data with artefact and wake periods removed. The following oximetry parameters used in the assessment of sleep-disordered breathing conditions were measured: 3% (DI3) and 4% (DI4) oxygen desaturation indices—the number of times per hour where the oxygen saturation falls by at least 3% or 4% from baseline, mean saturations (SAT50), minimum saturations (SATmin), delta index 12 s (DI12s), and percentage time with saturations below 92% and 90%. Seventy-nine children underwent nocturnal home pulse oximetry, from which there were 66 studies suitable for analysis. The median values for DI3 and DI4 were 2.58 (95% CI 1.96 to 3.10) and 0.92 (95% CI 0.73 to 1.15), respectively. The 95th and 97.5th centiles for DI3 were 6.43 and 7.06, respectively, which inform our cut-off value for normality. The mean values for SAT50 and SATmin were 97.57% (95% CI 97.38% to 97.76%) and 91.09% (95% CI 90.32% to 91.86%), respectively. In children aged 6 months to 12 years, we define normality of the 3% oxygen desaturation index as using standalone, motion-resistant pulse oximeters with short averaging times.
Publisher: Informa UK Limited
Date: 16-07-2019
DOI: 10.1080/15402002.2019.1641501
Abstract: Children with Down syndrome (DS) commonly experience difficulties with executive function (EF). They are also vulnerable to obstructive sleep apnoea (OSA). OSA is associated with EF deficits in typically developing children. A recent study reported an association between OSA and cognitive deficits in 38 school-aged children with DS. We experimentally investigated EF behaviours in young children with DS, and their association with OSA. Children with DS were recruited to take part in a larger study of OSA (N = 202). Parents of 80 children (50 male) aged 36 to 71 months ( Obstructive apnoea/hypopnoea index was in the normal range (0-1.49/h) for 28 children but indicated OSA (≥1.5/h) in 41 children. Consistent with previous research, we found a large effect for children experiencing particular weaknesses in working memory, planning and organising, whilst emotional control was a relative strength. OSA was associated with poorer working memory (β = .23, R2 = .05, Findings suggest that known EF difficulties in DS are already evident at this young age. Children with DS already have limited cognitive reserve and can ill afford additional EF deficit associated with OSA. OSA is amenable to treatment and should be actively treated in these children to promote optimal cognitive development.
Publisher: BMJ
Date: 06-2023
Publisher: BMJ
Date: 08-08-2023
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Hazel Evans.