Polysomnographic Variables Predictive of Adverse Respiratory Events After Pediatric Adenotonsillectomy

Abstract

Polysomnography may be used to predict which patients are at higher risk for adverse respiratory events after adenotonsillectomy. Such knowledge is valuable for planning optimal postoperative management and intraoperative anesthesia. Predictors of increased respiratory complications include apnea-hypopnea index, hypopnea index, body mass index, and nadir oxygen saturation.

Complications of adenotonsillectomy for obstructive sleep apnea in school-aged children

“…However, the AHI eligibility threshold was quite high at 30, and thus our findings indicate that over a relatively wide range of OSAS severity in children 5 to 9 years of age, the PSG has limited value in predicting post-operative complications. This observation is in contrast to findings from other studies which have shown that the AHI and the S P O 2 nadir correlate with the presence of respiratory post-operative complications 19;20;29 . Children in the current study were older than those in earlier studies and did not have additional comorbidities, which may account for some of these differences.…”

Early Adverse Respiratory Outcomes in Obese Pediatric Tonsillectomy Patients

“…We found that among the patients that had a preoperative PSG oAHI were significantly higher, and SpO 2 nadirs significantly lower in patients that had ARE. This finding is in agreement with the work of Jaryszak and colleagues who found in a study of 151 preoperative PSGs before pediatric tonsillectomy that patients with an ARE had a significantly higher oAHI (31.8 vs 14.1) and lower nadir oxygen saturation (72% vs 84%) 15 . They also found that BMI‐ z scores were significantly higher among patients with AREs.…”

A pilot study to identify pre- and peri-operative risk factors for airway complications following adenotonsillectomy for treatment of severe pediatric OSA

“…Our results are similar to other studies of correlations between PSG findings and post-operative airway complications and interventions [18][19][20]25]. Schroeder et al noted that 43% of children with a pre-operative respiratory disturbance index >25 required supplemental oxygen, BiPAP and/or CPAP [25].…”