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Obstructive sleep apnea in Arnold‐Chiari malformation treated with acetazolamide
Author(s) -
Milerad J,
Lagercrantz H,
Johnson P
Publication year - 1992
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1992.tb12311.x
Subject(s) - acetazolamide , medicine , anesthesia , hypoventilation , apnea , periodic breathing , hypoxemia , stridor , respiratory system , airway
We studied respiratory patterns and transcutaneous gas pressures in two infants with Arnold‐Chiari type II malformation referred to us due to repeated episodes of stridor and cyanosis. During both active and quiet sleep, respiration was irregular and absent or inverse thoracic breathing movements and frequent decreases in oxygen saturation to below 80% were observed. When breathing air with 2% CO 2 or when given acetazolamide 10 mg/kg, chest wall movements normalized and oxygenation increased to near normal levels. After three months of treatment with acetazolamide 20 mg/kg/24 h no further episodes of hypoventilation or hypoxemia were observed and further treatment could be discontinued. We conclude that stimulation of respiration by CO 2 or by acetazolamide appears to recruit chest wall muscles and promote upper airway patency in Arnold‐Chiari malformation. A treatment trial with acetazolamide seems justifiable in these infants when respiratory problems are present.