At-home pulse oximetry in children undergoing adenotonsillectomy for obstructive sleep apnea

Research output: Contribution to journalArticlepeer-review

Abstract

Nocturnal pulse oximetry has a high positive predictive value for polysomnographically diagnosed obstructive sleep apnoea (OSA) in children. When significant adenotonsillar hypertrophy is diagnosed, adenotonsillectomy (T&A) represents a common treatment for OSA in children. We investigated the role of pulse oximetry in predicting those patients, referred for suspected OSA, who subsequently needed T&A. At-home nocturnal pulse oximetry was performed on 380 children (65.7% males), median age 4.1(IRQ 3.0–5.6) years, referred for suspected OSA, and data were retrospectively analysed. For each recording McGill Oximetry Score (MOS) was categorized. Mean pulse rate (PR) z-score and pulse rate variability (PRV)-corrected (PRSD/meanPR) were significantly higher in children with abnormal MOS. Both parameters were significantly higher in subjects who underwent T&A compared with those not surgically treated. Both DI4 and PRV corrected showed a negative correlation with the elapsed time between pulse oximetry recordings and T&A. The logistic regression model showed a strong effect of an abnormal MOS as a predicting factor for T&A (adjusted odds ratio 19.7). Conclusions: In our study, children with OSA who subsequently needed T&A showed higher PRV compared to those without surgical indication. Children with abnormal MOS were nearly 20 times more likely to undergo T&A.What is Known:• Nocturnal pulse oximetry has a high positive predictive value for polysomnographically diagnosed obstructive sleep apnoea in children.• When significant adenotonsillar hypertrophy is diagnosed, adenotonsillectomy represents a common treatment for OSA in children.What is New:• An abnormal pulse oximetry highly predict the indication for adenotonsillectomy.• We suggest the use of at-home pulse oximetry as method to predict prescription of adenotonsillectomy, and this may be useful in contexts where polysomnography is not readily available.

Original languageEnglish
Pages (from-to)493-499
Number of pages7
JournalEuropean Journal of Pediatrics
Volume176
Issue number4
DOIs
Publication statusPublished - Apr 1 2017

Keywords

  • Adenotonsillectomy
  • McGill Oximetry Score
  • Obstructive sleep apnoea
  • Pulse oximetry
  • Pulse rate variability

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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