Impacts of disease severity on postoperative complications in children with sleep-disordered breathing

被引:29
作者
Kang, Kun-Tai [1 ,2 ]
Chang, I-Sheng [1 ]
Tseng, Chia-Chen [1 ]
Weng, Wen-Chin [3 ,4 ]
Hsiao, Tzu-Yu [1 ]
Lee, Pei-Lin [3 ,5 ]
Hsu, Wei-Chung [1 ,3 ]
机构
[1] Natl Taiwan Univ, Dept Otolaryngol, Coll Med, Taipei, Taiwan
[2] Minist Hlth & Welf, Taipei Hosp, Dept Otolaryngol, New Taipei, Taiwan
[3] Natl Taiwan Univ Hosp, Sleep Ctr, Taipei, Taiwan
[4] Natl Taiwan Univ Hosp, Dept Pediat, Taipei, Taiwan
[5] Natl Taiwan Univ Hosp, Dept Internal Med, Taipei, Taiwan
关键词
Adenoidectomy; child; polysomnography; postoperative complications; sleep apnea syndromes; tonsillectomy; POST-TONSILLECTOMY HEMORRHAGE; QUALITY-OF-LIFE; APNEA SYNDROME; RISK-FACTORS; RESPIRATORY COMPLICATIONS; BLOOD-PRESSURE; BODY-WEIGHT; ADENOTONSILLECTOMY; METAANALYSIS; POLYSOMNOGRAPHY;
D O I
10.1002/lary.26539
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives/HypothesisTo investigate the effects of diseases severity on postoperative complications following adenotonsillectomy (T&A) in children with sleep-disordered breathing (SDB). Study DesignRetrospective study. MethodsChildren aged <18 years were enrolled and underwent T&A for treating SDB. Polysomnography was used to classify the disease severity: primary snoring (apnea-hypopnea index [AHI] <1), mild (AHI = 1-5), moderate (AHI = 5-10), and severe obstructive sleep apnea [OSA] (AHI 10). Postoperative bleeding was graded using a severity scale (level I, self-reported bleeding; level II, requiring inpatient admission; level III, requiring reoperation). Primary bleeding is defined as hemorrhage occurring within the initial 24 postoperative hours. Perioperative respiratory complications are defined as oxygen saturation of less than 90%, 92%, or 95% in the recovery room. Major respiratory complications include laryngospasm, pulmonary edema, pneumonia, and intubation at recovery stage. ResultsA total of 610 children were included, of whom 42 (6.9%), eight (1.3%), and six (1.0%) children showed levels I, II, and III postoperative bleeding, respectively. Only one child had primary bleeding. The incidence and timing of postoperative bleeding did not differ significantly for children with different OSA severities. The rate of perioperative respiratory complications ranged from 1.6% to 14.3% on the basis of their definitions. The Cochran-Armitage test supported the trend that perioperative respiratory complications increase with the AHI. Six children developed major respiratory complications, which were not significantly associated with OSA severity. ConclusionsChildren with severe OSA have increased risks of perioperative respiratory complications. However, OSA severity does not influence major respiratory complications or postoperative bleeding in children. Level of Evidence4. Laryngoscope, 127:2646-2652, 2017
引用
收藏
页码:2646 / 2652
页数:7
相关论文
共 55 条
[1]  
[Anonymous], OTOLARYNG HEAD NECK
[2]   Clinical Practice Guideline: Tonsillectomy in Children [J].
Baugh, Reginald F. ;
Archer, Sanford M. ;
Mitchell, Ron B. ;
Rosenfeld, Richard M. ;
Amin, Raouf ;
Burns, James J. ;
Darrow, David H. ;
Giordano, Terri ;
Litman, Ronald S. ;
Li, Kasey K. ;
Mannix, Mary Ellen ;
Schwartz, Richard H. ;
Setzen, Gavin ;
Wald, Ellen R. ;
Wall, Eric ;
Sandberg, Gemma ;
Patel, Milesh M. .
OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2011, 144 (01) :S1-S30
[3]   Meta-analysis of the timing of haemorrhage after tonsillectomy: an important factor in determining the safety of performing tonsillectomy as a day case procedure [J].
Bennett, AMD ;
Clark, AB ;
Bath, AP ;
Montgomery, PQ .
CLINICAL OTOLARYNGOLOGY, 2005, 30 (05) :418-423
[4]   Adenotonsillectomy Outcomes in Treatment of Obstructive Sleep Apnea in Children A Multicenter Retrospective Study [J].
Bhattacharjee, Rakesh ;
Kheirandish-Gozal, Leila ;
Spruyt, Karen ;
Mitchell, Ron B. ;
Promchiarak, Jungrak ;
Simakajornboon, Narong ;
Kaditis, Athanasios G. ;
Splaingard, Deborah ;
Splaingard, Mark ;
Brooks, Lee J. ;
Marcus, Carole L. ;
Sin, Sanghun ;
Arens, Raanan ;
Verhulst, Stijn L. ;
Gozal, David .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2010, 182 (05) :676-683
[5]   A COMPARISON OF TONSILLAR SIZE AND OROPHARYNGEAL DIMENSIONS IN CHILDREN WITH OBSTRUCTIVE ADENOTONSILLAR HYPERTROPHY [J].
BRODSKY, L ;
MOORE, L ;
STANIEVICH, JF .
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 1987, 13 (02) :149-156
[6]   Adenotonsillectomy Complications: A Meta-analysis [J].
Canto, Graziela De Luca ;
Pacheco-Pereira, Camila ;
Aydinoz, Secil ;
Bhattacharjee, Rakesh ;
Tan, Hui-Leng ;
Kheirandish-Gozal, Leila ;
Flores-Mir, Carlos ;
Gozal, David .
PEDIATRICS, 2015, 136 (04) :702-718
[7]   Systematic review and meta-analysis of the use of tranexamic acid in tonsillectomy [J].
Chan, Chee Ching ;
Chan, Yee Yin ;
Tanweer, Faiz .
EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY, 2013, 270 (02) :735-748
[8]   Perioperative Ketorolac Increases Post-Tonsillectomy Hemorrhage in Adults But Not Children [J].
Chan, Dylan K. ;
Parikh, Sanjay R. .
LARYNGOSCOPE, 2014, 124 (08) :1789-1793
[9]   New Growth Charts for Taiwanese Children and Adolescents Based on World Health Organization Standards and Health-related Physical Fitness [J].
Chen, Walter ;
Chang, Mei-Hwei .
PEDIATRICS AND NEONATOLOGY, 2010, 51 (02) :69-79
[10]   Post-operative complications following adenotonsillectomy in children with severe sleep apnea-hypopnea syndrome. Do they need to be admitted to an intensive care unit? [J].
del-Rio Camacho, G. ;
Martinez Gonzalez, M. ;
Sanabria Brossart, J. ;
Gutierrez Moreno, E. ;
Gomez Garcia, T. ;
Troncoso Acevedo, F. .
ACTA OTORRINOLARINGOLOGICA ESPANOLA, 2014, 65 (05) :302-307