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Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
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Management of Persistent, Post-adenotonsillectomy Obstructive Sleep Apnea in Children: An Official American Thoracic

Zarmina Ehsan, Stacey L Ishman, Israa Soghier

    American Journal of Respiratory and Critical Care Medicine
    |October 27, 2023
    PubMed

    Insights

    Persistent obstructive sleep apnea (OSA) in children requires further management after initial surgery. This guideline offers evidence-based recommendations for clinicians treating children with ongoing pediatric OSA.

    Area of Science:

    • Pediatric Pulmonology
    • Sleep Medicine
    • Clinical Practice Guidelines

    Background:

    • Obstructive sleep apnea (OSA) is a prevalent sleep disorder in children.
    • Adenotonsillectomy is the primary treatment, but up to 40% of pediatric cases persist.
    • This guideline addresses the management of persistent pediatric OSA.

    Purpose of the Study:

    • To provide an evidence-based clinical practice guideline for managing persistent pediatric obstructive sleep apnea (OSA).
    • To guide clinicians, including physicians, dentists, and allied health professionals, in treating children with persistent OSA.

    Main Methods:

    • A multidisciplinary international expert panel convened to address key questions.
    • Systematic literature review was conducted using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.
    • Recommendations considered evidence quality, benefits, risks, patient values, cost, and feasibility.

    Main Results:

    • Six distinct management options for persistent pediatric OSA were evaluated.
    • Evidence-based recommendations were formulated for each management strategy.

    Conclusions:

    • The guideline provides recommendations for persistent pediatric OSA management, acknowledging limited evidence and relying on expert consensus.
    • Future research priorities were identified for each recommendation to advance the field.

    Keywords:
    OSApediatrics

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