Related Experiment Video
Updated: Jul 19, 2026
07:54
Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Late presentation of upper airway obstruction in Pierre Robin sequence
A C Wilson1, D J Moore, M H Moore
1Department of Pulmonary Medicine, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia 5006, Australia. wilsona@mail.wch.sa.gov.au
Archives of Disease in Childhood
|October 21, 2000
Summary
Pierre Robin sequence infants often present late with severe airway obstruction, indicated by failure to thrive. Polysomnography is crucial for accurate diagnosis and monitoring treatment effectiveness.
Area of Science:
- Pediatric Pulmonology
- Clinical Genetics
- Neonatology
Background:
- Pierre Robin sequence (PRS) is a congenital condition characterized by micrognathia, glossoptosis, and cleft palate.
- Upper airway obstruction (UAO) is a significant complication in PRS, potentially leading to feeding difficulties and failure to thrive.
- Early identification and management of UAO are critical for improving outcomes in infants with PRS.
Observation:
- A retrospective review identified 11 infants with PRS over five years.
- Ten patients (91%) experienced significant UAO, with seven presenting late (24-51 days).
- Failure to thrive was observed in six of the seven late-presenting infants, correlating with UAO severity.
Findings:
- Nasopharyngeal tube placement effectively normalized growth by treating UAO.
- Clinical assessment by pediatricians/neonatologists in the first week was insufficient to predict UAO severity.
- Polysomnography significantly enhanced diagnostic accuracy for UAO and treatment monitoring.
Implications:
- Late presentation of UAO in PRS is common, necessitating proactive respiratory monitoring.
- Clinical signs alone are inadequate for assessing UAO severity in PRS infants.
- Objective measures like polysomnography are essential for timely diagnosis and management of UAO in PRS.
Related Concept Videos
01:30Acute Respiratory Failure-III
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
01:23Acute Respiratory Failure-IV
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
01:25Suctioning the Oropharyngeal Airway
In preparing for oropharyngeal airway suctioning, a nurse must gather all necessary equipment, including a suction unit with tubing, a prepackaged suction kit, sterile gloves, water or saline for irrigation, a water-soluble lubricant, and additional personal protective equipment (such as a gown, mask, and goggles) to control infections.
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned under...
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway interventions are...
01:11Pyloric Obstruction
Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...