Hypoxia and hypercapnia in infants with mild laryngomalacia
P. B. McCray Jr, D. M. Crockett, J. S. Wagener and D. J. Thies
Department of Pediatrics, University of Iowa Hospitals, Iowa City 52242.
We evaluated 15 infants with laryngomalacia and 12 healthy infants to
determine their risk of hypoxia and hypercapnia as complications of partial
upper airway obstruction. Transcutaneous carbon dioxide pressure and oxygen
pressure were recorded continuously overnight with episodes of hypercapnia
and/or hypoxia scored for frequency, duration, and relationship to
activity. Episodes occurred in 12 infants with laryngomalacia and eight
control infants. Infants with laryngomalacia had significantly more
episodes. The greatest decrease in transcutaneous oxygen pressure was 29 mm
Hg and increase in transcutaneous carbon dioxide pressure was 31 mm Hg,
both occurring in infants with laryngomalacia. Three infants had prolonged
episodes of hypoxia and hypercapnia. History or physical examination did
not distinguish those infants with laryngomalacia who had hypercapnia
and/or hypoxia from those without episodes. Two- to 15-month follow-ups in
13 infants with laryngomalacia revealed that symptoms were unchanged or
improved. Twelve of these 13 infants had normal growth without
developmental delay or other complications. These results demonstrate that
episodes of hypoxia and hypercapnia occur more frequently in infants with
laryngomalacia than in control infants; however, their apparent risk for
complications is low.
