Clinical Characteristics and Post-Operative Outcomes in Children with Very Severe Obstructive Sleep Apnea
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Demographic and PSG Data
3.2. Perioperative Data
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Events: No. (%) | Overall Group |
---|---|
Difficult intubation | 4 (8.0) |
Post-operative desaturation | 16 (32.0) |
Supplemental oxygen | 13 (26.0) |
HFNC/CPAP administration | 4 (8.0) |
Intubation | 4 (8.0) |
ED visit/re-admission ^ | 1 (2.0) |
No. Post-Operative Respiratory Events N = 37 | Presence of Post-Operative Respiratory Events N = 13 | p Value | |
---|---|---|---|
Age in years, mean (SD) | 8.0 (5.2) | 4.4 (5.2) | 0.04 t |
Sex, No. (%) | |||
Female | 13 (35.1) | 5 (38.5) | 1.00 c |
Male | 24 (64.9) | 8 (61.5) | |
Race/Ethnicity, No. (%) | 0.66 f | ||
Asian | 5 (13.5) | 2 (15.4) | |
African-American | 7 (18.9) | 3 (23.1) | |
Caucasian | 15 (40.5) | 5 (38.5) | |
Hispanic | 8 (21.6) | 1 (7.7) | |
Other | 2 (5.4) | 2 (15.4) | |
Co-morbidities, No. (%) | 14 (37.8) | 5 (38.4) | 0.97 c |
Asthma | 8 (21.6) | 2 (15.4) | 0.71 f |
Craniofacial condition | 6 (16.2) | 4 (30.8) | 0.42 f |
Syndromic diagnosis | 6 (16.2) | 4 (30.8) | 0.42 f |
Neuromuscular disease | 0 (0) | 0 (0) | |
Pulmonary HTN * | 1 (2.6) | 1 (7.7) | 0.16 f |
Obesity | 12 (32.4) | 2 (15.4) | 0.30 f |
Prematurity | 3 (8.1) | 3 (23.1) | 0.17 f |
Z-score weight, mean (SD) | 0.66 (1.52) | −0.51 (2.07) | 0.04 t |
Intervention (%) | 0.64 f | ||
T&A alone | 33 (89.2) | 11 (84.6) | |
T&A with other intervention ^ | 4 (10.5) | 2 (15.4) | |
Opioid administration post-PACU Pre-operative sleep study data, mean (SD) | 2 (5.2) | 0 (0) | 1.00 f |
Total sleep time, min | 351.6 (87.2) | 328.2 (124.0) | 0.46 t |
Sleep efficiency, % | 79.2 (16.2) | 76.3 (17.3) | 0.36 t |
REM duration, min | 45.7 (34.0) | 49.4 (46.7) | 0.96 t |
N1 Stage duration, min | 30.6 (48.6) | 36.7 (50.8) | 0.69 t |
N2 Stage duration, min | 156.5 (71.8) | 152.6 (70.2) | 0.74 t |
N3 Stage duration, min | 107.9 (68.9) | 89.5 (58.3) | 0.28 t |
Arousal index | 31.2 (24.8) | 44.2 (33.0) | 0.07 t |
AHI, events/hr | 44.8 (24.9) | 73.6 (27.4) | <0.01 t |
SpO2 nadir, % | 83.0 (7.0) | 70.0 (13.0) | <0.01 t |
Hypoventilation, No. (%) ° | 15 (46.8) | 4 (66.7) | 0.02 f |
Length of stay >1 day, No. (%) | 0 | 10 (76.9) | <0.01 m |
Length of stay median, (IQR) | 1 (1–1) | 2 (2–3) | <0.01 m |
Opioid administration post-PACU | 2 | 0 | 1.00 f |
No. Post-PACU Desaturations N = 37 | Highest Level of Respiratory Intervention Post-PACU | p-Value | |||
---|---|---|---|---|---|
Supplemental O2 N = 8 | HFNC/CPAP N = 1 | Intubation N = 4 | |||
Age in years, mean (SD) | 8.0 (5.2) | 5.9 (6.3) | 3.2 | 1.8 (0.5) | 0.12 a |
Z-score weight mean (SD) | 0.66 (1.52) | 0.27 (1.94) | −1.70 | −1.79 (2.00) | 0.02 a |
AHI, mean (SD) | 41.0 (24.4) | 46.2 (27.1) | 94.2 | 85.2 (33.1) | <0.01 a |
O2 nadir %, (SD) | 83.0 (7.0) | 73.0 (16.0) | 70.0 | 65.0 (3.0) | <0.01 a |
Length of stay, median (IQR) | 1 (1–1) | 2 (1–2.5) | 2 (2–2) | 4 (3–9.5) | <0.01 k |
Parameter | Pre-T&A | Post-T&A | Change (95% CI) | p Value t |
---|---|---|---|---|
Total sleep time, min | 345.5 | 366.6 | +21.1 (−3.6 to 45.8) | 0.58 |
Sleep efficiency, % | 80.0 | 90.0 | +10.0 (5.8 to 14.2) | <0.01 |
REM duration, min | 48.9 | 71.0 | +22.1 (10.5 to 33.7) | 0.01 |
Stage N1 duration, min | 32.1 | 22.3 | −9.8 (−16.7 to −2.9) | 0.37 |
Stage N2 duration, min | 158.2 | 164.5 | +6.3 (−9.4 to 22.0) | 0.20 |
Stage N3 duration, min | 106.4 | 117.6 | +11.2 (−5.5 to 27.9) | 0.47 |
Arousal index | 32.7 | 14.1 | −18.6 (−21.9 to −15.3) | <0.01 |
AHI, events/hr | 46.4 | 13.7 | −32.7 (−38.3 to −26.8) | <0.01 |
SpO2 nadir, % | 79.9 | 88.5 | +8.6 (7.4 to 10.1) | <0.01 |
Hypoventilation, no. (%) ^ | 19 (50.0) | 13 (52.0) | 0.57 c |
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Saied, N.; Solis, R.N.; Funamura, J.; Chen, J.; Lammers, C.; Nandalike, K. Clinical Characteristics and Post-Operative Outcomes in Children with Very Severe Obstructive Sleep Apnea. Children 2022, 9, 1396. https://doi.org/10.3390/children9091396
Saied N, Solis RN, Funamura J, Chen J, Lammers C, Nandalike K. Clinical Characteristics and Post-Operative Outcomes in Children with Very Severe Obstructive Sleep Apnea. Children. 2022; 9(9):1396. https://doi.org/10.3390/children9091396
Chicago/Turabian StyleSaied, Nancy, Roberto Noel Solis, Jamie Funamura, Joy Chen, Cathleen Lammers, and Kiran Nandalike. 2022. "Clinical Characteristics and Post-Operative Outcomes in Children with Very Severe Obstructive Sleep Apnea" Children 9, no. 9: 1396. https://doi.org/10.3390/children9091396