Adenotonsillectomy for Treatment of Obstructive Sleep Apnea in Children

Suen, John S.; Arnold, James E.; Brooks, Lee J.

doi:10.1001/archotol.1995.01890050023005

Cited by 428 publications

(335 citation statements)

References 35 publications

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“…In this regard, there is an emerging consensus that OSAS severity is an independent risk factor for respiratory morbidity. 3,4,18,19 Furthermore the criteria for stratification of OSAS disease severity for diagnosis and prediction of postoperative respiratory morbidity probably differ. As an example, the criterion for a diagnosis of severe OSAS is an OAH index > 5 events·hr, -1 20 whereas that for prediction of postadenotonsillectomy respiratory morbidity is an OAH index > 10 events·hr -1 .…”

Section: Osas Severitymentioning

confidence: 99%

Children with severe OSAS who have adenotonsillectomy in the morning are less likely to have postoperative desaturation than those operated in the afternoon

Koomson

Morin

Brouillette

et al. 2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To determine, in a subset of children previously reported, if the time of day when adenotonsillectomy for severe obstructive sleep apnea syndrome (OSAS) was performed affected the incidence of postoperative respiratory complications.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : Children having adenotonsillectomy were included if they had a polysomnographic diagnosis of severe OSAS within six months prior to operation. Patients who met the inclusion criteria were grouped by the occurrence of postoperative desaturation into a saturated (SAT) and desaturated (deSAT) group. The charts of children in group deSAT were reviewed. The clock time of the surgical procedure was recorded and categorized as morning (AM) or afternoon (PM).R Re es su ul lt ts s: : Eighty-eight patients met the inclusion criteria. There were 31 girls and 57 boys. The mean ± SD age (yr) and weight (kg) were 4.6 ± 2.9 yr and 20.8 ± 14.5 kg respectively. There were 63 children in the SAT group and 25 in the deSAT group. Differences in age, weight and gender were not significant. The preoperative oxygen saturation (SaO 2 ) nadir for the SAT and deSAT groups was 80.8 ± 10.2% and 67.6 ± 17.5% (P < 0.05) respectively. The preoperative obstructive apnea and hypopnea index was 15.8 ± 10.2 and 35.7 ± 34.6 events·hr -1 (P < 0.05), respectively. Surgery in 63 (71.6%) children was performed in the AM. Univariate logistic regression identified PM surgery [odds ratio (OR) 4.6, 95% confidence interval (CI) 1.7 to 12.6, P = 0.002] and a preoperative SaO 2 nadir < 80% (OR 3.6, 95% CI 1.4 to 9.4, P = 0.009) as risk factors predicting postadenotonsillectomy desaturation.C Co on nc cl lu us si io on n: : Children with severe OSAS whose surgery is performed in the AM are less likely to desaturate following adenotonsillectomy than children whose surgery is performed in the PM. 80,8 ± 10,2 % et de 67,6 ± 17,5 % (P < 0,05) de 15,8 ± 10,2 et de 35,7 ± 34,6 événements·h -1 (P < 0,05), respectivement. L'opération de 63 (71,6 %) Éléments cliniques : Des enfants subissant une amygdalectomie ont été inclus dans notre étude si un diagnostic polysomnographique de SAOS sévère avait été établi dans les six mois avant l'opération. Les patients admis ont été répartis selon l'occurrence de désaturation postopératoire dans un groupe de saturation (SAT) ou de désaturation (deSAT). Les dossiers des enfants du groupe deSAT ont été révisés. L'heure de l'opération a été notée sous matin (AM) ou après-midi (PM). Résultats dans les groupes SAT et deSAT respectivement. Les indices d'apnée obstructive et d'hypopnée préopératoires étaient

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Section: Osas Severitymentioning

confidence: 99%

Children with severe OSAS who have adenotonsillectomy in the morning are less likely to have postoperative desaturation than those operated in the afternoon

Koomson

Morin

Brouillette

et al. 2004

Can J Anesth/J Can Anesth

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“…20 In our study, despite the wide age range, there was also a predominance of preschool children, in group I, representing the target population of OSAHS in children.…”

Section: Discussionmentioning

confidence: 50%

Alterações ecocardiográficas em crianças com distúrbios respiratórios obstrutivos no sono

Weber¹,

Montovani²,

Matsubara³

et al. 2007

J. Pediatr. (Rio J.)

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Objectives: To assess cardiac morphology and function by means of echocardiograms of children with obstructed breathing while asleep. Methods:The study enrolled 40 children of both sexes, aged from 3 to 11 years; 30 of them had obstructed breathing during sleep (group I) and 10 children were healthy controls (group II). The two groups were similar in terms of sex, age, weight and height. The 40 children underwent echocardiogram, viewing all four chambers during systole and diastole, paying special attention to the right ventricle (RV). These data were compared by means of Student's t test (p < 0.05). Results:In group I, increased diameter and area of the right ventricle were observed during both systole and diastole. There was less variation in RV area between systole and diastole. Reduced left ventricle (LV) diastolic diameter was also observed, together with reduced ejection fraction and reduced contraction. Conclusions:The morphological and functional cardiac abnormalities observed in the RV and LV suggest that, in children, obstructed breathing during sleep can lead to cardiovascular repercussions. These abnormalities may expose these children to increased anesthetic and surgical risks.J Pediatr (Rio J). 2007;83(6):518-522: Obstructive sleep apnea, child, echocardiography.

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“…A hipertrofia dos tecidos linfóides da faringe é mais acentuada na idade pré-escolar, com predomínio no sexo masculino 3,4 , observando-se maior incidência de sinais obstrutivos e de intervenções cirúrgicas das tonsilas nessa faixa etária 20 .…”

Section: Discussionunclassified

Echocardiographic abnormalities in children with obstructive breathing disorders during sleep

Weber¹,

Montovani²,

Matsubara³

et al. 2007

J Pediatr (Rio J)

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ResumoObjetivos: Avaliar a morfologia e função cardíaca através do ecocardiograma em crianças com obstrução respiratória no sono. Métodos:Foram estudadas 40 crianças de ambos os sexos, com idade entre 3 e 11 anos, sendo que 30 apresentavam obstrução respiratória no sono (grupo I) e 10 crianças eram controles saudáveis (grupo II). Os dois grupos eram semelhantes quanto a gênero, idade, peso e altura. As 40 crianças realizaram ecocardiograma, visando às quatro câmaras em sístole e diástole, com atenção especial ao ventrículo direito. Os dados obtidos foram comparados através do teste t de Student (p < 0,05).Resultados: Observou-se, no grupo I, aumento do diâmetro e da área do ventrículo direito em sístole e diástole. A variação entre sístole e diástole da área do ventrículo direito era menor. Em ventrículo esquerdo, foi observada diminuição do diâmetro diastólico, uma menor fração de ejeção e um encurtamento menor. Conclusões:As alterações morfológicas e funcionais cardíacas encontradas em ventrículo direito e ventrículo esquerdo sugerem que obstrução respiratória no sono em crianças pode levar a repercussões cardiovasculares. Estas alterações podem expor as crianças a um maior risco anestésico e cirúrgico.J Pediatr (Rio J). 2007;83(6):518-522: Apnéia do sono obstrutiva, criança, ecocardiografia. AbstractObjectives: To assess cardiac morphology and function by means of echocardiograms of children with obstructed breathing while asleep. Methods:The study enrolled 40 children of both sexes, aged from 3 to 11 years; 30 of them had obstructed breathing during sleep (group I) and 10 children were healthy controls (group II). The two groups were similar in terms of sex, age, weight and height. The 40 children underwent echocardiogram, viewing all four chambers during systole and diastole, paying special attention to the right ventricle (RV). These data were compared by means of Student's t test (p < 0.05). Results:In group I, increased diameter and area of the right ventricle were observed during both systole and diastole. There was less variation in RV area between systole and diastole. Reduced left ventricle (LV) diastolic diameter was also observed, together with reduced ejection fraction and reduced contraction. Conclusions:The morphological and functional cardiac abnormalities observed in the RV and LV suggest that, in children, obstructed breathing during sleep can lead to cardiovascular repercussions. These abnormalities may expose these children to increased anesthetic and surgical risks.J Pediatr (Rio J). 2007;83(6):518-522: Obstructive sleep apnea, child, echocardiography. IntroduçãoO quadro clínico de obstrução das vias aéreas superiores (VAS) no sono varia de intensidade, desde roncos noturnos à síndrome da apnéia hipopnéia obstrutiva do sono (SAHOS) 1 .A SAHOS é caracterizada por episódios repetidos de obstrução das VAS, associados à hipóxia e hipercapnia intermitente 1,2 . Sua prevalência nas crianças varia de 0,7 a 3% nos diferentes estudos epidemiológicos [3][4][5] . O seu pico de incidên-cia é observado...

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Adenotonsillectomy for Treatment of Obstructive Sleep Apnea in Children

Cited by 428 publications

References 35 publications

Children with severe OSAS who have adenotonsillectomy in the morning are less likely to have postoperative desaturation than those operated in the afternoon

Children with severe OSAS who have adenotonsillectomy in the morning are less likely to have postoperative desaturation than those operated in the afternoon

Alterações ecocardiográficas em crianças com distúrbios respiratórios obstrutivos no sono

Echocardiographic abnormalities in children with obstructive breathing disorders during sleep

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