Is one night of screening oximetry sufficient for OSA?

Galway, Niamh; Maxwell, Barbara; O’Donoghue, Dara; Shields, Michael

doi:10.1183/1393003.congress-2017.pa1306

Cited by 2 publications

(2 citation statements)

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“…In these situations, oximetry may be considered although the success of pediatric decannulation using oximetry as a substitute for PSG requires additional study. 42,43 The length of observation periods after decannulation also varied among the included protocols. No specific recommendations are made by the ATS; however, they note that most children are typically monitored for 24-48 h. 36 In our review, 76% of children were observed for 48 h or less.…”

Section: Discussionmentioning

confidence: 99%

“…The utility of a PSG may also be limited based on the relative size of the tracheostomy tube compared with a child's airway lumen, with children under 2 years less likely to tolerate a capped PSG study. In these situations, oximetry may be considered although the success of pediatric decannulation using oximetry as a substitute for PSG requires additional study 42,43 …”

Section: Discussionmentioning

confidence: 99%

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Decannulation following tracheostomy in children: A systematic review of decannulation protocols

Verma

Mocanu

Shi

et al. 2021

Pediatric Pulmonology

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Objective: To provide a systematic review of the existing pediatric decannulation protocols, including the role of polysomnography, and their clinical outcomes.Methods: Five online databases were searched from database inception to May 29, 2020. Study inclusion was limited to publications that evaluated tracheostomy decannulation in children 18 years of age and younger. Data extracted included patient demographics and primary indication for tracheostomy. Methods used to assess readiness for decannulation were noted including the use of bronchoscopy, tracheostomy tube modifications, and gas exchange measurements. After decannulation, details regarding mode of ventilation, location, and length of observation period, and clinical outcomes were also collected. Descriptive statistical analyses were performed.Results: A total of 24 studies including 1395 children were reviewed.Tracheostomy indications included upper airway obstruction at a well-defined anatomic site (35%), upper airway obstruction not at a well-defined site (12%) and need for long-term ventilation and pulmonary care (53%). Bronchoscopy was routinely used in 23 of 24 (96%) protocols. Tracheostomy tube modifications in the protocols included capping (n = 20, 83%), downsizing (n = 14, 58%), and fenestrations (n = 2, 8%). Measurements of gas exchange included polysomnography (n = 13/18, 72%), oximetry (n = 10/18, 56%), blood gases (n = 3,17%), and capnography (n = 3, 17%). After decannulation, children in 92% of protocols were transitioned to room air. Observation period of 48 h or less was used in 76% of children.Conclusions: There exists large variability in pediatric decannulation protocols.Polysomnography plays an integral role in assessing most children for tracheostomy removal. Evidence-based guidelines to standardize pediatric tracheostomy care remain an urgent priority.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%