Utility of Preoperative Cardiac Evaluation in Pediatric Patients Undergoing Surgery for Obstructive Sleep Apnea

Abstract

The lack of clinically relevant findings during preoperative cardiac evaluations suggests that aggressive cardiac workup in pediatric patients with OSA may not be indicated unless dictated by comorbidities. Consistent with results in prior studies, preoperative AHI can identify patients at risk for respiratory complications following TA.

Is Cardiology Evaluation Necessary in Children with Electrocardiogram Abnormalities Noted on Polysomnogram?

“…Currently, routine screening of children with OSA for cardiac disease is not recommended. 7 However, because of the relatively high incidence of cardiac pathology identified in our subjects, the authors feel that referral of children with ECG anomalies on PSG is indicated. To put this into perspective, only 1% of children referred to cardiology for chest pain are found to have cardiac pathology.…”

“…The long‐term impact of OSA on cardiovascular parameters in children is unknown. Currently, routine screening of children with OSA for cardiac disease is not recommended 7 . However, because of the relatively high incidence of cardiac pathology identified in our subjects, the authors feel that referral of children with ECG anomalies on PSG is indicated.…”

Prevalence of Pulmonary Hypertension in Pediatric Patients With Obstructive Sleep Apnea and a Cardiology Evaluation: A Retrospective Analysis

“…This result is similar to that of the only other study that used PSG to diagnose OSA in estimating the prevalence of PH. 30 In that study, the sample size was smaller (n = 55) and the prevalence was determined to be zero. Other studies that report a prevalence of PH in pediatric patients with OSA used clinical judgement or did not report the methods used to diagnose OSA.…”

Occurrence of sleep‐disordered breathing in children with pulmonary hypertension

“…This proportion of OSA diagnosis is substantially higher than previously described in children with initially diagnosed PH (6%−24%), 11,21 and is slightly higher than previously reported in children with initially diagnosed OSA (0%−85%). [22][23][24][25] Compared to a majority of these previous studies, our cohort was characterized by a comparatively more accurate diagnosis of OSA based on PSG criteria.…”