Postoperative Respiratory Compromise in Children With Obstructive Sleep Apnea Syndrome: Can It Be Anticipated?

• DOI: 10.1542/peds.93.5.784
• Publication Date: 2021-12-11T09:01:18Z
• Authors: Gerald M. Rosen; Robert P. Muckle; George S. Goding; Mark W. Mahowald; Connie Ullevig
• Keywords: Uvulopalatopharyngoplasty; Failure to Thrive

Objective. The aim of this research was to describe the postoperative respiratory complications after tonsillectomy and/or adenoidectomy (T A) in children with obstructive sleep apnea syndrome (OSAS), define which are at risk for these complications, and determine whether continuous positive airway pressure (CPAP) is an effective strategy dealing complications. Methods. data study were gathered through a retrospective chart review all 15 years age or younger polysomnographically (PSG) proven OSAS who had T A Hennepin County Medical Center between January 1985 September 1992. Particular attention paid factors that contributed OSAS, intervention strategies Results. charts 37 documented by preoperative PSG later reviewed retrospectively. Ten significant compromise secondary prolonged their hospital stay from 1 30 days caused symptoms ranging O2 desaturation <80% failure. These associated medical problems resulted addition large tonsils adenoids. included craniofacial anomalies, hypotonia, morbid obesity, previous upper trauma, cor pulmonale, failure thrive. also more severe on PSG. One child uvulopalatopharyngoplasty (UPPP) & A. Taken together, history, physical neurological examination, able identify successfully subsequently developed Nasal bilevel CPAP used manage obstruction five children. Conclusions. Based findings, overnight observation recommended monitor oximeter patients undergoing have meet any following high-risk clinical criteria: (1) <2 age, (2) anomalies affecting pharyngeal particularly midfacial hypoplasia micro/retrognathia, (3) thrive, (4) (5) (6) (7) trauma; distressindiex (RDI) >40 SaO2 nadir <70%; UPPP CPAP/bilevel can be