Objective: To evaluate the strength of respiratory muscles and to compare maximum inspiratory (MIP) and expiratory (MEP) pressure and MEP/MIP ratio between patients with chronic respiratory diseases and healthy individuals. Methods: Case-control study. Individuals with neuromuscular disease and post-infectious bronchiolitis obliterans were considered. In addition, they were also matched according to anthropometric and demographic characteristics with healthy children and adolescents. MIP, MEP in the three groups, and pulmonary function only in patients with chronic respiratory diseases were recorded. Results: A total of 52 subjects with CRD (25 with neuromuscular disease, and 27 with post-infectious bronchiolitis obliterans) and 85 healthy individuals were included, with an average age of 11.3±2.1 years. Patients with neuromuscular disease and post-infectious bronchiolitis obliterans presented lower MIP and MEP when compared with healthy individuals, although MEP/MIP ratio was lower in patients with neuromuscular disease (0.87±0.3) and higher in patients with post-infectious bronchiolitis obliterans (1.1±0.3) compared to the healthy group (0.97±0.2). Only in patients with neuromuscular disease a negative correlation was observed between MEP/MIP ratio and age (r=-0.50; p=0.01). Conclusions: Differences in the pattern of muscular weakness between patients with chronic respiratory diseases were observed. In patients with neuromuscular disease, a decrease in the MEP/MIP ratio depending on MIP was verified; and in those patients with post-infectious bronchiolitis obliterans, an increase in the MEP/MIP ratio depending on MIP was also observed.

Introduction. Pediatric pulmonary rehabilitation is relevant in the management of chronic respiratory diseases. In Chile, it is provided only at certain hospitals. Objective. To describe the outcomes of a pediatric pulmonary rehabilitation program after 3 months of rehabilitation. Methodology. Retrospective study of patients with chronic lung disease, neuromuscular disease, and other chronic conditions admitted to the program between June 2011 and June 2017. Assessments included general physical and respiratory muscle examination, and spirometry. General physical training and respiratory muscle training were planned according to facility-based, mixed and home protocols. Results. A total of 156 patients (11.45 +/- 3.55 years old) were included, 68 had chronic lung disease (11.56 +/- 4.6 years old, 43.5 %); 45, neuromuscular disease (11.4 +/- 3.7 years old, 28.8 %); and 43, various chronic conditions (11.31 +/- 3.9 years old). Out of all patients, 102 (65.4 %) followed training protocols; targeted (n = 27), mixed (n = 23), and home (n = 50); compliance was 69 %, 87.5 %, and 70 %, respectively. Peak inspiratory pressure increased by 19.3 % (p = 0.001); peak expiratory pressure, 14.5 % (p = 0.001); forced vital capacity, 12.9 % (p = 0.001); forced expiratory volume in 1 second, 11.6 % (p = 0.004); and the six-minute walk test, 17.6 meters (p = 0.036) after 3 months of rehabilitation. Conclusions. The intervention protocol improved cardiorespiratory functional capacity. Compliance was over 65 %.

IntroducciónEl diagnóstico precoz de los trastornos respiratorios del sueño permite intervenciones oportunas, mitigando consecuencias multisistémicas. El examen de elección para diagnóstico y categorización es la polisomnografía; presenta disponibilidad limitada, emergiendo alternativas como la poligrafía, más accesible y de menor costo. ObjetivoAnalizar asociación entre patologías de base y síndrome de apnea-hipoapnea obstructiva del sueño en niños con sospecha de trastornos respiratorio del sueño. Métodos. Estudio transversal retrospectivo. Se incluyeron poligrafías de niños ≥1 año hospitalizados con sospecha de trastornos respiratorios del sueño. Se recopilaron variables demográficas, clínicas y poligráficas. Se realizó un análisis de regresión logística para evaluar presencia de síndrome de apnea-hipoapnea obstructiva del sueño según patologías. ResultadosDe 1000 poligrafías se analizaron 407. Mediana de edad 8,2 años (4,1-12,2), varones 56%. Diagnósticos principales: daño neurológico (19,4%), enfermedades neuromusculares (16%), obstrucción de vía aérea superior (15,5%) y daño pulmonar crónico (15,5%). Poligrafías alteradas 56%; síndrome de apneas obstructivas del sueño leve 63%, moderado 21% y severo 16%, destacando obesidad y enfermedades neuromusculares. Se encontraron diferencias significativas en edad (p=0.001) e índice de apneas-hipoapnea (p=0,002) según diagnósticos. Los pacientes con síndrome de Down tuvieron un riesgo 5,5 veces mayor de síndrome de apnea-hipopnea obstructiva del sueño en comparación con los pacientes con daño pulmonar crónico ajustado por edad e índice de apnea-hipoapnea. ConclusionesExistió un alto porcentaje de síndrome de apnea-hipoapnea obstructiva del sueño, especialmente en obesidad y enfermedades neuromusculares. Los pacientes con síndrome de Down tienen más riesgo de síndrome de apnea-hipoapnea obstructivas del sueño respecto a daño pulmonar crónico. La poligrafía es una herramienta potencialmente implementable en centros asistenciales con características y recursos similares.

This study described and analyzed the results of cardiorespiratory polygraphic studies in infants under three months who were hospitalized and monitored due to suspected apneas. Methods: Cross-sectional study. Patients aged <3 months hospitalized from 2011 to 2023 were included. All were referred for suspected apneas, and cardiorespiratory polygraphies (PG) were conducted simultaneous to non-invasive monitoring. Demographic, PG, and diagnostic variables were recorded. PG values were obtained and compared between diagnostic groups. Association was evaluated according to diagnosis, prematurity, presence, and alteration type with Kruskal–Wallis, Wilcoxon, and Fisher tests. Association between quantitative variables was assessed with Spearman’s rho and the presence of alteration with binomial logistic regression. Analysis was performed with Jamovi v.2.3, and statistical significance was defined as p < 0.05. Results: A total of 155 studies were included. Median age was 41.0 days (IQR 22.0–59.0), median gestational age was 38 weeks (IQR 32.0–42.0), and 52.3% were premature. Diagnosis: brief resolved unexplained events (BRUE) (58.1%), apnea of prematurity (27.1%), hypotonic syndrome (7.1%), laryngomalacia (LGM) (3.9%), and craniofacial alterations (CFA) (3.9%). Altered results in 21.9% polygraphies: 44.1% with AHI ≧ 5/h and 20.6% with SpO₂ ≦ 90% in >5% of the record. CFA and LGM patients had a higher risk of an altered polygraph than those with apnea of prematurity (OR 21.3/8.5) and BRUE (OR 35.9/14.3), respectively. Conclusions: Infants under three months of age referred for apnea showed often abnormal polygraphic indices, showing significant differences between diagnostic groups. Performance of sleep studies in these groups was feasible and allowed to confirm the presence of apneas and their level of severity. Particular attention should be considered in children with CFA and LMG, since their risk is significantly higher. Age-specific apnea patterns seem to be of interest, as this may possibly lead to future consequences.