Nocturnal Pulse Oximetry as an Abbreviated Testing Modality for Pediatric Obstructive Sleep Apnea

Brouillette, Robert T.; Morielli, Angela; Leimanis, Andra; Waters, Karen A.; Luciano, R; Ducharme, Francine M

doi:10.1542/peds.105.2.405

Cited by 507 publications

(412 citation statements)

References 38 publications

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“…Details of our sleep study recording systems have been published elsewhere. [9][10][11][12] Although the studies were analyzed for several variables, 5 only the OAH index and the preoperative saturation nadir (preSaO 2 nadir) are reported. The preSaO 2 nadir was defined as the minimum hemoglobin oxygen saturation regardless of duration and was validated by visual inspection of a computerized data record.…”

Section: Chart Review and Study Parameters Diagnostic Criteria For Osasmentioning

confidence: 99%

“…The preSaO 2 nadir was defined as the minimum hemoglobin oxygen saturation regardless of duration and was validated by visual inspection of a computerized data record. 10,13 POSTOPERATIVE CARE FOLLOWING ADENOTONSIL-LECTOMY It is our practice to extubate children when awake in the operating room and to administer oxygen by facemask, attached to a Jackson Rees circuit, placed in close proximity to the child's face for the initial postoperative period. We administer iv morphine, in repeated doses (0.05 mg·kg -1 ), as the opioid of choice in the postoperative care unit until the child is able to tolerate oral codeine.…”

Section: Chart Review and Study Parameters Diagnostic Criteria For Osasmentioning

confidence: 99%

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Children with severe OSAS who have adenotonsillectomy in the morning are less likely to have postoperative desaturation than those operated in the afternoon

Koomson

Morin

Brouillette

et al. 2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To determine, in a subset of children previously reported, if the time of day when adenotonsillectomy for severe obstructive sleep apnea syndrome (OSAS) was performed affected the incidence of postoperative respiratory complications.C Cl li in ni ic ca al l f fe ea at tu ur re es s: : Children having adenotonsillectomy were included if they had a polysomnographic diagnosis of severe OSAS within six months prior to operation. Patients who met the inclusion criteria were grouped by the occurrence of postoperative desaturation into a saturated (SAT) and desaturated (deSAT) group. The charts of children in group deSAT were reviewed. The clock time of the surgical procedure was recorded and categorized as morning (AM) or afternoon (PM).R Re es su ul lt ts s: : Eighty-eight patients met the inclusion criteria. There were 31 girls and 57 boys. The mean ± SD age (yr) and weight (kg) were 4.6 ± 2.9 yr and 20.8 ± 14.5 kg respectively. There were 63 children in the SAT group and 25 in the deSAT group. Differences in age, weight and gender were not significant. The preoperative oxygen saturation (SaO 2 ) nadir for the SAT and deSAT groups was 80.8 ± 10.2% and 67.6 ± 17.5% (P < 0.05) respectively. The preoperative obstructive apnea and hypopnea index was 15.8 ± 10.2 and 35.7 ± 34.6 events·hr -1 (P < 0.05), respectively. Surgery in 63 (71.6%) children was performed in the AM. Univariate logistic regression identified PM surgery [odds ratio (OR) 4.6, 95% confidence interval (CI) 1.7 to 12.6, P = 0.002] and a preoperative SaO 2 nadir < 80% (OR 3.6, 95% CI 1.4 to 9.4, P = 0.009) as risk factors predicting postadenotonsillectomy desaturation.C Co on nc cl lu us si io on n: : Children with severe OSAS whose surgery is performed in the AM are less likely to desaturate following adenotonsillectomy than children whose surgery is performed in the PM. 80,8 ± 10,2 % et de 67,6 ± 17,5 % (P < 0,05) de 15,8 ± 10,2 et de 35,7 ± 34,6 événements·h -1 (P < 0,05), respectivement. L'opération de 63 (71,6 %) Éléments cliniques : Des enfants subissant une amygdalectomie ont été inclus dans notre étude si un diagnostic polysomnographique de SAOS sévère avait été établi dans les six mois avant l'opération. Les patients admis ont été répartis selon l'occurrence de désaturation postopératoire dans un groupe de saturation (SAT) ou de désaturation (deSAT). Les dossiers des enfants du groupe deSAT ont été révisés. L'heure de l'opération a été notée sous matin (AM) ou après-midi (PM). Résultats dans les groupes SAT et deSAT respectivement. Les indices d'apnée obstructive et d'hypopnée préopératoires étaient

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Section: Chart Review and Study Parameters Diagnostic Criteria For Osasmentioning

confidence: 99%

Section: Chart Review and Study Parameters Diagnostic Criteria For Osasmentioning

confidence: 99%

Children with severe OSAS who have adenotonsillectomy in the morning are less likely to have postoperative desaturation than those operated in the afternoon

Koomson

Morin

Brouillette

et al. 2004

Can J Anesth/J Can Anesth

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“…Pulse oximetry has been validated to be a reliable modality for monitoring oxygen saturation in children. [10,11] There is a strong parental satisfaction after adenotonsillectomy owing to the resolution of symptoms of their children/wards. [19] This further gives credence to the fact that adenotonsillectomy is the treatment of choice for adenotonsillar enlargement.…”

Section: Discussionmentioning

confidence: 99%

“…This long waiting time delays diagnosis and treatment and thus increases the anxiety of care givers. A simpler but yet effective testing modality to overcome these problems is pulse oximetry which is a tool that can determine oxygen saturation [10,11] with the added benefit of cost reduction and reduced waiting time. The device is easy to use and recording is accomplished over a shorter period of time.…”

Section: Introductionmentioning

confidence: 99%

Comparing Oxygen Saturation of Normal Children with that of Children with Adenotonsillar Hypertrophy

Mbam

Adeosun

Akinyemi

et al. 2014

Indian J Otolaryngol Head Neck Surg

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To compare the nocturnal oxygen saturation profiles of children with adenotonsillar enlargement with that of normal children. A 1 year comparative study. The study was carried out at the Otorhinolaryngology Ward of the University College Hospital Ibadan. These comprise of 60 children (1-9 years) with clinically confirmed adenotonsillar enlargement admitted for adenotonsillectomy and 60 normal children matched for age and sex. The biodata and common clinical presentations of the study group were acquired with a structured proforma. The severity of nasopharyngeal obstruction was determined by the adenoidal-nasopharyngeal ratio while the degree of tonsillar enlargement was graded by the Brodsky's classification. The nocturnal oxygen saturation of all the participants were recorded with a wrist worn pulse oximeter. Recording was for at least for 4 h. Oxygen saturation \92 % was regarded as desaturation. The oximetric values of the study and control group were compared. The mean nocturnal SPO 2 (peripheral saturation of oxygen) profiles of children with adenotonsillar enlargement were as follows: basal = 96.86 %, minimum = 84.99 %; maximum = 99 % and average SPO 2 \92 % = 87.74 % while the saturation profiles of the control group were as follows; basal = 97.88 %, minimum = 89.71 %; maximum = 99 %, average SPO 2 \92 % = 90.82 %. Normal children have better nocturnal saturation profiles than children with adenotonsillar enlargement.

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“…POX utilizes the PPG waveform to determine the oxygenation saturation levels in the blood. This is often used in situations where a patients oxygenation levels need to be monitored such as in intensive care, as well as aiding in the diagnosis of some sleep disorders such as apnea [6].…”

Section: Measurement Techniquesmentioning

confidence: 99%

A review of the state of the art in artifact removal technologies as used in an assisted living domain

Sweeney

Kelly

Ward

et al. 2011

IET Seminar on Assisted Living 2011

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There has been significant growth in the area of ubiquitous, pervasive, distributed healthcare technologies due to the increasing burden on the healthcare system and the impending demographic shift towards an aging population. The move from a hospital-centric healthcare system towards in-home health assessment is aimed to alleviate the burden on healthcare professionals, the health care system and caregivers. Advances in signal acquisition, data storage and communication channels provide for the collection of reliable and useful in-home physiological data. Artifacts, arising from environmental, experimental and physiological factors, degrade signal quality and reduce the utility of the affected part of the signal. The degrading effect of the artifacts significantly increases when data collection is moved from the clinic into the home. Advances in signal processing have brought about significant improvement in artifact removal over the last number of years. This paper reviews the most common physiological and location-indicative signals recorded in the home and documents the artifacts which occur most often. A discussion of some of the most common artifact removal techniques is then provided. An evaluation of the advantages and disadvantages of each is given with reference to the assisted living environment.

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Nocturnal Pulse Oximetry as an Abbreviated Testing Modality for Pediatric Obstructive Sleep Apnea

Cited by 507 publications

References 38 publications

Children with severe OSAS who have adenotonsillectomy in the morning are less likely to have postoperative desaturation than those operated in the afternoon

Children with severe OSAS who have adenotonsillectomy in the morning are less likely to have postoperative desaturation than those operated in the afternoon

Comparing Oxygen Saturation of Normal Children with that of Children with Adenotonsillar Hypertrophy

A review of the state of the art in artifact removal technologies as used in an assisted living domain

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