Related Experiment Video

Updated: Oct 18, 2025

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

20.0K

Management and outcome of extreme pediatric obstructive sleep apnea

Tatyana G Mills1, Rakesh Bhattacharjee2, Javan Nation3

  • 1Department of Pediatrics, University of California San Diego, Rady Children's Hospital San Diego, 3030 Children's Way, San Diego, CA, 92123, USA.

Sleep Medicine
|October 4, 2021
PubMed

Insights

Children with extreme obstructive sleep apnea (OSA) undergoing adenotonsillectomy (AT) may require respiratory support post-surgery. However, AT is safe and effective, with no serious harm reported, making it a viable first-line treatment for extreme OSA.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Respiratory Physiology

Background:

  • Extreme obstructive sleep apnea (OSA) presents unique challenges in pediatric surgical management.
  • Adenotonsillectomy (AT) is a common treatment for OSA, but risks in severe cases require careful evaluation.

Purpose of the Study:

  • To classify the need for post-adenotonsillectomy (AT) respiratory support in children with extreme obstructive sleep apnea (OSA).
  • To identify predictors for respiratory interventions after AT in this population.
  • To evaluate the outcomes of AT in children diagnosed with extreme OSA.

Main Methods:

  • Retrospective chart analysis of pediatric patients with an apnea/hypopnea index (AHI) > 100 events/h.
  • Exclusion of patients with chronic diseases other than obesity.
  • Analysis of demographic, polysomnographic (PSG), and postoperative data.

Main Results:

  • Twenty-eight of 41 subjects (68.3%) underwent AT; 39.3% required postoperative respiratory support.
  • Factors predicting respiratory support included longer time with SpO2 <90% and lower SpO2 nadir during PSG.
  • No mortality, reintubation, or readmission occurred; 57.9% had residual OSA post-AT, but significant AHI improvement was noted.

Conclusions:

  • Postoperative observation is crucial for children with extreme OSA undergoing AT.
  • Despite a higher risk of respiratory support needs, AT is safe, with no severe adverse events.
  • Adenotonsillectomy can be considered a primary treatment for selected children with extreme OSA.
Abstract

Keywords:
AdenotonsillectomyAdherenceObesityObstructive sleep apneaResidual OSA

More Related Videos

Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD &#8212; A Safe, Cost-Effective Approach04:53

Author Spotlight: Traditional Chinese Medicine for Sleep Disorders in Acute COPD — A Safe, Cost-Effective Approach

Published on: October 18, 2024

991
Image Acquisition using Portable Sonography for Emergency Airway Management07:31

Image Acquisition using Portable Sonography for Emergency Airway Management

Published on: September 28, 2022

2.6K

Related Concept Videos

Sleep Apnea01:21

Sleep Apnea

Sleep apnea is a condition where breathing stops intermittently during sleep, often leading to significant health issues. Each episode can last from 10 to 20 seconds or more and is frequently accompanied by a brief arousal from sleep. This disturbance, largely unnoticed by the individual, can lead to severe daytime fatigue. Commonly, individuals seek help after being informed by their partners about loud snoring and noticeable breathing pauses during sleep.
The condition is more prevalent among...
241
Chronic Obstructive Pulmonary Disease-V: Management01:29

Chronic Obstructive Pulmonary Disease-V: Management

Managing Chronic Obstructive Pulmonary Disease (COPD) involves a multifaceted approach to reduce symptoms, prevent exacerbations, improve overall health status, and slow disease progression. Key strategies include lifestyle modifications, pharmacotherapy, supportive therapies, and, in some cases, surgery. Here is an overview of the primary COPD management strategies:
Smoking Cessation
2.8K
Cardiopulmonary Resuscitation II: ACLS Airway Management01:22

Cardiopulmonary 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...
198
Chronic Obstructive Pulmonary Disease-V: Nursing Management01:30

Chronic Obstructive Pulmonary Disease-V: Nursing Management

Nursing management of Chronic Obstructive Pulmonary Disease (COPD) is crucial for providing thorough care and support to patients. Nurses play an integral role in this process through detailed assessment, careful planning, targeted interventions, and ongoing evaluation. Here's an overview of the critical steps in nursing management for COPD.
Assessment
4.4K
Acute Respiratory Failure-III01:30

Acute 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...
390
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
236