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. 2022 Apr;42(2):162-168.
doi: 10.14639/0392-100X-N1803.

Postoperative respiratory complications in children with obstructive sleep apnoea syndrome

Pálma Benedek  1   2 , Fanni Keserü  1   2 , Gabriella Kiss  3 , Zsolt Bella  2 , László Rovó  2 , Gábor Katona  1 , András Bikov  4 , Balázs Csoma  5 , Zsófia Lázár  5
Affiliations

Postoperative respiratory complications in children with obstructive sleep apnoea syndrome

Pálma Benedek et al. Acta Otorhinolaryngol Ital. 2022 Apr.

Abstract
in English, Italian

Objective: We aimed to prospectively assess the effect of comorbidities on the occurrence of postoperative respiratory complications (PoRCs) after adenotonsillectomy in children with obstructive sleep apnoea syndrome (OSA) and whether otherwise healthy children need a higher level of postoperative monitoring.

Methods: 577 children who had OSA and underwent adenotonsillectomy were enrolled. The effects of demographics, comorbidities and OSA on PoRCs were investigated with logistic regression analysis.

Results: The PoRC rate was 4.3%. Postoperative oxygen desaturations were more marked in patients with comorbidities (p = 0.005). The presence of comorbidity increased the risk of PoRCs (odds ratio 4.234/3.226-5.241, 95% confidence intervals, p < 0.001). There was no difference in apnoea-hypopnoea index (AHI) values between comorbid patients with and without PoRCs [8.2 (3.8-50.2) vs 14.3 (11.7-23.3)]. (p = 0.37). In the group of patients without comorbidities, PoRCs were associated with a higher AHI [14.7 (3.4-51.3) vs 3.9 (2.0- 8.0), p < 0.001].

Conclusions: Comorbidities are more closely linked with PoRCs than OSA severity. In patients without comorbidity, PoRCs are associated with OSA severity and usually occur within the first 2 hours after the intervention.

Complicanze respiratorie postoperatorie nei pazienti pediatrici affetti da sindrome delle apnee ostruttive notturne.

Obiettivo: Abbiamo valutato prospetticamente l’effetto delle comorbilità sull’insorgenza di complicanze respiratorie postoperatorie (PoRC) dopo adenotonsillectomia in bambini con sindrome delle apnee ostruttive del sonno (OSA) e se tali bambini altrimenti sani necessitano di un livello più elevato di monitoraggio postoperatorio.

Metodi: Sono stati arruolati 577 bambini con OSA e sottoposti ad adenotonsillectomia. Gli effetti dei dati demografici, delle comorbilità e dell’OSA sui PoRC sono stati studiati con l’analisi di regressione logistica.

Risultati: Il tasso di PoRC è stato del 4,3%. Le desaturazioni di ossigeno postoperatorie erano più marcate nei pazienti con comorbilità (p = 0,005). La presenza di comorbilità ha aumentato il rischio di PoRC (odds ratio 4,234 /3,226-5,241, intervalli di confidenza 95%/, p < 0,001). Non c’era differenza nei valori dell’indice di apnea-ipopnea (AHI) tra i pazienti con comorbilità con e senza PoRC (8,2 (3,8-50,2) vs 14,3 (11,7-23,3) (p = 0,37), ma nel gruppo di pazienti senza comorbilità. I PoRC erano associati a un AHI più elevato (14,7 (3,4-51,3) rispetto a 3,9 (2,0-8,0), p < 0,001).

Conclusioni: Le comorbilità sono più strettamente legate ai PoRC rispetto alla gravità dell’OSA. Nei pazienti senza comorbidità le PoRC sono associati alla gravità dell’OSA e di solito si verificano entro le prime 2 ore dopo l’intervento.

Keywords: apnoea-hypopnoea index; comorbidity; obstructive sleep apnoea; postoperative monitoring; respiratory complications; sleep breathing disorders.

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Figures

Figure 1.
Figure 1.
Selection process of patients during the recruitment period. PSG: polysomnography; PoRCs: postoperative respiratory complications.
Figure 2.
Figure 2.
Postoperative oxygen desaturation in patients with PoRCs*. Data are expressed as mean ± standard deviation. *PoRCs: postoperative respiratory complications.
Figure 3.
Figure 3.
AHI* values in relation to complications and comorbidities. Data are shown as median with interquartile range. *AHI: apnoea-hypopnoea index.
See this image and copyright information in PMC

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