Caroline M Fields, Nicolas S Poupore, Jenna H Barengo, Hussein Smaily, Shaun A Nguyen, Jacqueline Angles, Clarice S Clemmens, Phayvanh P Pecha, William W Carroll
{"title":"REM AHI 是否能预测小儿腺扁桃体切除术后的持续性 OSA?","authors":"Caroline M Fields, Nicolas S Poupore, Jenna H Barengo, Hussein Smaily, Shaun A Nguyen, Jacqueline Angles, Clarice S Clemmens, Phayvanh P Pecha, William W Carroll","doi":"10.1177/00034894241227030","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The utility of REM AHI in managing pediatric obstructive sleep apnea (OSA) is not fully understood. This study aimed to evaluate the relationship of preoperative REM AHI to postoperative persistence of OSA in children who underwent adenotonsillectomy.</p><p><strong>Methods: </strong>This retrospective chart review identified children under the age of 18 years that received an adenotonsillectomy for OSA and a preoperative and postoperative polysomnogram. Children with craniofacial or neuromuscular disorders or a tracheostomy were excluded. The primary outcome was the postoperative persistence of OSA, defined as a postoperative obstructive apnea-hypopnea index (oAHI) ≥ 1.5 events/hour. REM-predominant OSA was defined as a ratio of REM/NREM AHI ≥ 2. REM AHI minus NREM AHI and REM AHI minus oAHI helped to identify patients with a larger distribution of REM AHI.</p><p><strong>Results: </strong>A total of 353 patients were included. Postoperative persistent OSA was seen in 232 (65.7%) children. The preoperative REM AHI, REM AHI minus NREM AHI, and REM AHI minus oAHI of children with persistent OSA did not differ significantly from children with resolution of OSA. Rates of persistence were not different between those with REM-predominant OSA and REM-independent OSA (63.8% vs 70.7%, <i>P</i> = .218).</p><p><strong>Conclusion: </strong>This study suggests that preoperative REM AHI may be a poor predictor of OSA persistence after adenotonsillectomy. Further study is needed to help characterize how pre-operative REM AHI should impact clinicians' decision making, family counseling and recommendations.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Does REM AHI Predict Persistent OSA After Pediatric Adenotonsillectomy?\",\"authors\":\"Caroline M Fields, Nicolas S Poupore, Jenna H Barengo, Hussein Smaily, Shaun A Nguyen, Jacqueline Angles, Clarice S Clemmens, Phayvanh P Pecha, William W Carroll\",\"doi\":\"10.1177/00034894241227030\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The utility of REM AHI in managing pediatric obstructive sleep apnea (OSA) is not fully understood. This study aimed to evaluate the relationship of preoperative REM AHI to postoperative persistence of OSA in children who underwent adenotonsillectomy.</p><p><strong>Methods: </strong>This retrospective chart review identified children under the age of 18 years that received an adenotonsillectomy for OSA and a preoperative and postoperative polysomnogram. Children with craniofacial or neuromuscular disorders or a tracheostomy were excluded. The primary outcome was the postoperative persistence of OSA, defined as a postoperative obstructive apnea-hypopnea index (oAHI) ≥ 1.5 events/hour. REM-predominant OSA was defined as a ratio of REM/NREM AHI ≥ 2. REM AHI minus NREM AHI and REM AHI minus oAHI helped to identify patients with a larger distribution of REM AHI.</p><p><strong>Results: </strong>A total of 353 patients were included. Postoperative persistent OSA was seen in 232 (65.7%) children. The preoperative REM AHI, REM AHI minus NREM AHI, and REM AHI minus oAHI of children with persistent OSA did not differ significantly from children with resolution of OSA. Rates of persistence were not different between those with REM-predominant OSA and REM-independent OSA (63.8% vs 70.7%, <i>P</i> = .218).</p><p><strong>Conclusion: </strong>This study suggests that preoperative REM AHI may be a poor predictor of OSA persistence after adenotonsillectomy. Further study is needed to help characterize how pre-operative REM AHI should impact clinicians' decision making, family counseling and recommendations.</p>\",\"PeriodicalId\":50975,\"journal\":{\"name\":\"Annals of Otology Rhinology and Laryngology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Otology Rhinology and Laryngology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/00034894241227030\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"OTORHINOLARYNGOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Otology Rhinology and Laryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/00034894241227030","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/23 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:目前尚不完全清楚快速眼动AHI在管理小儿阻塞性睡眠呼吸暂停(OSA)方面的作用。本研究旨在评估接受腺样体切除术的儿童术前 REM AHI 与术后 OSA 持续存在的关系:这项回顾性病历审查确定了因 OSA 而接受腺扁桃体切除术的 18 岁以下儿童,并进行了术前和术后多导睡眠图检查。不包括患有颅面或神经肌肉疾病或气管造口术的儿童。主要结果是术后OSA持续存在,即术后阻塞性呼吸暂停-低通气指数(oAHI)≥1.5次/小时。快速动眼期为主的 OSA 定义为快速动眼期/快速动眼期 AHI 比值≥ 2。REM AHI减去NREM AHI和REM AHI减去oAHI有助于识别REM AHI分布较大的患者:共纳入 353 名患者。232名(65.7%)患儿术后出现持续性 OSA。持续性 OSA 患儿的术前 REM AHI、REM AHI 减去 NREM AHI 以及 REM AHI 减去 oAHI 与 OSA 缓解的患儿没有显著差异。持续性 OSA 的比率在 REM 主导型 OSA 和 REM 依赖型 OSA 之间没有差异(63.8% vs 70.7%,P = .218):本研究表明,术前 REM AHI 可能无法预测腺样体切除术后 OSA 的持续情况。还需要进一步研究,以帮助确定术前 REM AHI 对临床医生的决策、家属咨询和建议有何影响。
Does REM AHI Predict Persistent OSA After Pediatric Adenotonsillectomy?
Objective: The utility of REM AHI in managing pediatric obstructive sleep apnea (OSA) is not fully understood. This study aimed to evaluate the relationship of preoperative REM AHI to postoperative persistence of OSA in children who underwent adenotonsillectomy.
Methods: This retrospective chart review identified children under the age of 18 years that received an adenotonsillectomy for OSA and a preoperative and postoperative polysomnogram. Children with craniofacial or neuromuscular disorders or a tracheostomy were excluded. The primary outcome was the postoperative persistence of OSA, defined as a postoperative obstructive apnea-hypopnea index (oAHI) ≥ 1.5 events/hour. REM-predominant OSA was defined as a ratio of REM/NREM AHI ≥ 2. REM AHI minus NREM AHI and REM AHI minus oAHI helped to identify patients with a larger distribution of REM AHI.
Results: A total of 353 patients were included. Postoperative persistent OSA was seen in 232 (65.7%) children. The preoperative REM AHI, REM AHI minus NREM AHI, and REM AHI minus oAHI of children with persistent OSA did not differ significantly from children with resolution of OSA. Rates of persistence were not different between those with REM-predominant OSA and REM-independent OSA (63.8% vs 70.7%, P = .218).
Conclusion: This study suggests that preoperative REM AHI may be a poor predictor of OSA persistence after adenotonsillectomy. Further study is needed to help characterize how pre-operative REM AHI should impact clinicians' decision making, family counseling and recommendations.
期刊介绍:
The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.