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Risk factors analysis and intervention of lung dysfunction in children with obstructive sleep apnea: A retrospective
Yujuan Yang1, Yu Zhang1, Yanyan Yang1
1Department of Otolaryngology, Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China.
Insights
Optimized airway management improves lung function in children with obstructive sleep apnea (OSA) before surgery. Individualized atomization therapy effectively enhanced lung function, preventing perioperative complications.
Area of Science:
- Pediatric Pulmonology
- Anesthesiology
- Sleep Medicine
Background:
- Obstructive sleep apnea (OSA) can lead to preoperative lung dysfunction in children.
- Identifying risk factors for abnormal lung function is crucial for effective airway management.
Purpose of the Study:
- To establish an optimized airway management process.
- To improve preoperative lung function in pediatric patients with OSA.
Main Methods:
- 483 children (6-14 years) with OSA undergoing adenotonsillectomy were studied.
- Lung function tests identified children with abnormal airway function.
- Individualized atomization intervention was administered based on lung function severity.
Main Results:
- 45 patients had obstructive ventilation dysfunction; chronic cough/asthma were risk factors.
- Atomization intervention improved FEV1% pre to over 80% in most mild and some moderate cases within 4 days.
- No perioperative airway complications were reported.
Conclusions:
- An optimized airway management process can improve lung function in children with OSA.
- Preoperative intervention is beneficial for children with OSA and risk factors for abnormal lung function.
- This approach potentially reduces perioperative risks.
Objectives:
To establish an optimized airway management process to improve preoperative lung dysfunction in obstructive sleep apnea (OSA).
Methods:
The study included 483 children (319 males and 164 females; 6y to14y years) with OSA who underwent an adenotonsillectomy from November 2017 to December 2018. Children with OSA and who had abnormal airway function were identified by lung function test, and the risk factors for abnormal lung function were assessed. Next, the children received individualized atomization intervention based on the severity of their abnormal lung function, and the improvement in lung function was evaluated.
Results:
Lung function tests revealed that 45 patients had obstructive ventilation dysfunction, and histories of chronic cough or asthma were identified as risk factors for perioperative abnormal lung function. The FEV1% pre exceeded 80% after 2 days of atomization intervention in 27 of 28 mild cases, 4 of 13 moderate cases, but in none of the 4 moderate-severe cases. After 4 days of atomization intervention, the FEV1%pre of the remaining 14 patients in the three groups all increased up to 80%. Other indicators of lung function (e.g., FEV1/FVC% pre, MEF50% pre, MEF25% pre, and MMEF% pre) were also greatly improved following the improvement of FEV1% pre. No perioperative airway complications occurred.
Conclusions:
Prior to performing surgery on children with OSA and who have risk factors associated with abnormal lung function, it is potentially beneficial to establish an optimized airway management process to improve lung function before adenotonsillectomy.
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