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Published on: April 29, 2013

Structural cardiac changes as a predictor of respiratory complications after adenotonsillectomy for obstructive

Maninder Kalra1, Thomas R Kimball, Stephen R Daniels

  • 1Department of Pulmonary Medicine, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. maninder.kalra@cchmc.org

Sleep Medicine
|April 28, 2005
PubMed

Insights

Children with obstructive sleep apnea undergoing adenotonsillectomy who develop respiratory complications often have underlying structural cardiac changes, like left ventricular hypertrophy (LVH). This suggests a cardiac origin may contribute to these post-operative issues.

Area of Science:

  • Pediatric Cardiology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Obstructive breathing during sleep in children is a common indication for adenotonsillectomy.
  • Postoperative respiratory complications can occur after adenotonsillectomy.
  • The relationship between cardiac structure and these complications is not well understood.

Purpose of the Study:

  • To investigate the association between structural cardiac changes and postoperative respiratory complications in children after adenotonsillectomy.
  • To identify potential cardiac risk factors for respiratory issues post-surgery.

Main Methods:

  • A case-control study included 48 children (ages 2-18) undergoing adenotonsillectomy.
  • Echocardiograms were used to assess cardiac structure, calculating Left Ventricular Mass (LVM) and Left Ventricular Mass Index (LVMI).
  • Left Ventricular Hypertrophy (LVH) was defined as LVMI above the 95th percentile for age.

Main Results:

  • No significant differences in age, height, gender, or race were found between groups.
  • Left Ventricular Hypertrophy (LVH) and enlarged right ventricular (RV) dimensions were significantly associated with postoperative respiratory complications.
  • These associations remained significant after controlling for BMI, age, gender, race, and blood pressure.

Conclusions:

  • A higher prevalence of structural cardiac changes, including LVH, was observed in children with postoperative respiratory complications.
  • These findings suggest that underlying cardiac abnormalities may contribute to respiratory complications following adenotonsillectomy.
  • Further cardiac evaluation may be warranted in children experiencing these complications.
Abstract

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