Related Experiment Video
Updated: May 6, 2026
Conducting Respiratory Oscillometry in an Outpatient Setting
Published on: April 8, 2022
Quantifying respiratory complications post-adenotonsillectomy in patients with normal or inconclusive overnight
Terence T N Lee, Claire E Lefebvre, Nathalie E Gans
1Department of Otolaryngology, Head and Neck Surgery, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. sam.daniel@mcgill.ca.
Insights
Children with sleep-disordered breathing (SDB) undergoing adenotonsillectomy (T&A) with normal pre-operative oximetry scores can safely have surgery at peripheral hospitals. This finding supports using oximetry as a screening tool for T&A in these patients.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Anesthesiology
Background:
- Children with sleep-disordered breathing (SDB) face increased risks of post-operative respiratory complications after adenotonsillectomy (T&A).
- Pre-operative overnight home oximetry is crucial for risk assessment, but its utility in identifying children with SDB but normal/inconclusive scores (McGill Oximetry Score [MOS] of 1) requires further investigation.
- Evaluating the safety of T&A in peripheral or outpatient settings for these specific patients is essential.
Purpose of the Study:
- To describe and quantify post-T&A respiratory complications in children with clinical SDB but normal/inconclusive pre-operative oximetry (MOS 1).
- To determine if these children can safely undergo T&A in peripheral hospitals or outpatient surgical centers.
Main Methods:
- Retrospective chart review of patients aged 3+ undergoing T&A between 2003-2010.
- Inclusion criteria: clinical SDB, normal/inconclusive overnight home oximetry (MOS 1) within 12 months of surgery, and no severe comorbidities.
- Oximetry definition: <3 episodes of desaturation <90%, stable baseline saturation >95%. Postoperative respiratory complications were the primary outcome measure.
Main Results:
- 231 out of 2708 T&A patients met inclusion criteria.
- No major postoperative respiratory complications occurred, such as re-intubation or ICU admission.
- Minor respiratory complications were observed in 5 patients (2.16%), with only one requiring ward admission.
Conclusions:
- A normal/inconclusive overnight home oximetry score (MOS 1) is a reliable screening tool for identifying pediatric patients with SDB who are suitable for T&A.
- Children with SDB and normal/inconclusive oximetry can safely undergo T&A in peripheral hospitals or outpatient surgical centers.
- This approach facilitates decentralized surgical care, improving access for patients with SDB.
Background:
Children with sleep-disordered breathing (SDB) are at risk of developing post-operative respiratory complications following adenotonsillectomy (T&A). Our goal was to describe and quantify these complications following T&A in children with clinical SDB but with a pre-operative overnight home oximetry score of "normal/inconclusive" (McGill Oximetry Score (MOS) of 1), and to determine whether these children could safely undergo surgery in peripheral hospitals or outpatient surgical centers.
Methods:
We performed a retrospective chart review of patients 3 years and older who had T&A between 2003 and 2010 at 2 of our institution's hospitals. To be included in the study, in addition to not having severe comorbidities, children had to have undergone an overnight home oximetry within 12 months of surgery that was normal or inconclusive (MOS of 1). This was defined as fewer than 3 episodes of oxygen desaturation below 90% and stable baseline saturation over 95%. Medical charts were reviewed for major and minor postoperative respiratory complications. The main outcome measure was post-T&A respiratory complications.
Results:
Out of 2708 T&A patients, 231 met the inclusion criteria. No patient had a major postoperative respiratory complication requiring re-intubation or admission to the intensive care unit. Five patients (2.16%) had minor respiratory complications but only one required admission to the ward.
Conclusions:
An overnight home oximetry that is "normal/inconclusive" (MOS of 1) can be used as a screening tool to identify patients with sleep-disordered breathing who can be safely sent to peripheral hospitals or outpatient surgical centers for T&A.
More Related Videos
07:54Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
07:52Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Related Concept Videos
01:19Special considerations while measuring oxygen saturation
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is...
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:23Acute Respiratory Failure-IV
01:20Assessment of Ventilation I: Respiratory Rate
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
01:26Respiratory Volumes and Capacities I
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...