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The Quest for a DISE Protocol.

Kristin L Mooney1, Melissa Brooks Peterson2,3, Jonathan R Skirko4

  • 1Department of Surgery, Children's Hospital Colorado, Broomfield, Colorado, USA.

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PubMed
Summary
This summary is machine-generated.

A refined drug-induced sleep endoscopy (DISE) protocol improved obstructive sleep apnea diagnosis in children. The modified protocol enhanced surgeon and anesthesiologist satisfaction and patient comfort during the procedure.

Keywords:
DISEPS/QIchilddrug-induced sleep endoscopyobstructive sleep apneaquality improvement

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Area of Science:

  • Otolaryngology
  • Pediatric Sleep Medicine
  • Anesthesiology

Background:

  • Obstructive sleep apnea (OSA) is a common condition in children.
  • Drug-induced sleep endoscopy (DISE) is a crucial diagnostic tool for OSA.
  • Existing DISE protocols can be lengthy and cause patient discomfort.

Purpose of the Study:

  • To modify the institutional drug-induced sleep endoscopy (DISE) protocol.
  • To improve the ability to determine obstructive breathing patterns.
  • To minimize discomfort for pediatric patients undergoing DISE.

Main Methods:

  • A quality improvement initiative using the plan-do-study-act (PDSA) methodology.
  • Study conducted at a tertiary children's hospital.
  • Involved 81 children with polysomnogram-documented OSA undergoing DISE.

Main Results:

  • The DISE protocol was streamlined from 14 to 9 steps after 4 PDSA cycles.
  • Significant improvements were noted in all aspects of the DISE procedure.
  • Excellent median ratings (1) were achieved for IV placement, scope insertion, and overall satisfaction (P < .01).

Conclusions:

  • A modified DISE protocol, incorporating nasal premedication and inhalational volatile gases, enhances procedural efficiency and patient tolerance.
  • This optimized protocol allows for predictable sedation, facilitating accurate diagnosis of obstructive breathing patterns.
  • The streamlined DISE approach aids otolaryngologists in developing effective OSA treatment plans for children.