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Pulse oximetry in paediatric obstructive sleep apnoea: is it used appropriately?

Published online by Cambridge University Press:  03 August 2015

H Kanona ,
S Sharma ,
K Chaidas  and
B Kotecha
H Kanona*
Affiliation:
Queen's Hospital, Havering and Redbridge University Hospitals NHS Trust, Barking
S Sharma
Affiliation:
Queen's Hospital, Havering and Redbridge University Hospitals NHS Trust, Barking
K Chaidas
Affiliation:
St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
B Kotecha
Affiliation:
Queen's Hospital, Havering and Redbridge University Hospitals NHS Trust, Barking
*
Address for correspondence: Dr H Kanona, ENT Department, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Rom Valley Way, Romford RM7 0AZ, Essex, UK Fax: +44 208 869 3098 E-mail: [email protected]
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Abstract

Objectives:

This study assessed the use of pulse oximetry testing in children with suspected obstructive sleep apnoea in a hospital setting.

Methods:

A retrospective review of patients who underwent pulse oximetry testing between April 2013 and October 2013 was performed. Primary outcome measures included positive pulse oximetry results, defined as a McGill oximetry score of 2–4.

Results:

Thirty-seven test results were usable for analysis: from 21 pre- and 16 post-operative tests. Only four patients had positive test results. There was a significant difference between pre- and post-operative quality of life outcome scores in the surgical group (p < 0.0001).

Conclusion:

Pre-operative pulse oximetry should be used as a guide to help triage patients who require specialist paediatric services, such as a paediatric intensive care unit. The use of pulse oximetry, particularly in the post-operative setting, is unlikely to change patient management and can incur unnecessary financial costs to UK National Health Service Hospital Trusts.

Keywords

Pulse OximetryPediatrics, Obstructive Sleep Apnea Syndrome
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 9 , September 2015 , pp. 874 - 881
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1American Thoracic Society. Standards and indication for cardiopulmonary sleep studies in children. Am J Respir Crit Care Med 1995;153:866–78Google Scholar
2Sleep Disordered Breathing. American Thoracic Society, 2011 In: http://www.thoracic.org/patients/patient-resources/breathing-in-america/resources/chapter-23-sleep-disordered-breathing.pdf [31 October 2014]Google Scholar
3Sinha, D, Guilleminault, C. Sleep disordered breathing in children. Indian J Med Res 2010;131:311–20Google ScholarPubMed
4Gozal, D. Sleep-Disordered Breathing and School Performance in Children. Pediatrics 1998;102:616CrossRefGoogle ScholarPubMed
5Scottish Intercollegiate Guidelines Network, 2003. Management of Obstructive Sleep Apnoea/Hypopnoea Syndrome in Adults: A national clinical guideline. In: http://www.sign.ac.uk/pdf/sign73.pdf [17 May 2014]Google Scholar
6Management of people with obstructive sleep apnoea/hypopnoea syndrome, 2009. http://www.sign.ac.uk/pdf/sign73.pdf [21 June 2014]Google Scholar
7Robb, PJ, Bew, S, Kubba, H, Murphy, N, Primhak, R, Rollin, AM, Tremlett, M. Tonsillectomy and adenoidectomy in children with sleep-related breathing disorders: consensus statement of a UK multidisciplinary working party. Ann R Coll Surg Engl 2009;91:371–3CrossRefGoogle ScholarPubMed
8Marcus, CL, Brooks, LJ, Draper, KA, Gozal, D, Halbower, AC, Jones, J et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Clinical Practice Guideline. American Academy of Pediatrics. Pediatrics 2012;130:576–84CrossRefGoogle Scholar
9Nixon, GM, Brouillette, RT. Diagnostic techniques for obstructive sleep apnoea: is polysomnography necessary? Paediatr Respir Rev 2002;3:18–24Google ScholarPubMed
10Flemons, W, Buysse, D, Redline, S, Pack, A, Strohl, K, Wheatley, J et al. Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667–89Google Scholar
11Hauri, PJ, Sateia, MJ. International Classification of Sleep Disorders. 2nd edn.Westchester, Illinois: American Academy of Sleep Medicine, 2005Google Scholar
12Koo Ng, NKF, Kubba, H. Children with snoring: evaluation and management. Journal of ENT Masterclass 2013;6:8–13Google Scholar
13Brouillette, RT, Morielli, A, Leimanis, A, Waters, KA, Luciano, R, Ducharme, FM. Nocturnal pulse oximetry as an abbreviated testing modality for pediatric obstructive sleep apnea. Pediatrics 2000;105:405–12CrossRefGoogle ScholarPubMed
14Nixon, GM, Kermack, AS, Davis, GM, Manoukian, JJ, Brown, KA, Brouillette, RT. Planning adenotonsillectomy in children with obstructive sleep apnea: the role of overnight pulse oximetry. Pediatrics 2004;113:19–25CrossRefGoogle Scholar
15Oximetry, 2009. http://www.adhb.govt.nz/StarShipClinicalGuidelines/_Documents/Oximetry.pdf [30 May 2014]Google Scholar
16Ryan, PJ, Hilton, MF, Boldy, DA. Validation of British Thoracic Society guidelines for the diagnosis of sleep apnoea/hypoapnoea syndrome: can polysomnography be avoided? Thorax 1995;50:972–5CrossRefGoogle Scholar
17McNicholas, WT. Diagnosis of obstructive sleep apnea in adults. Proc Am Thorac Soc 2008;5:154–160CrossRefGoogle ScholarPubMed
18Caulfield, HM. Obstructive sleep apnoea in childhood. In: Gleeson, M et al. eds. Scott-Brown's Otorhinolaryngology: Head and Neck Surgery, 7th edn.Boca Raton, Florida: CRC Press, 2008;85:1102–11CrossRefGoogle Scholar
19Guilleminault, C, Cummiskey, J. Progressive improvement of apnea index and ventilatory response to CO2 after tracheostomy in obstructive sleep apnea syndrome. Am Rev Respir Dis 1982;126:14–20Google ScholarPubMed
20Crisalli, JA, McConnell, K, VanDyke, RD, Fenchel, MD, Somers, VK, Shamszumann, A, Chini, B, Daniels, SR, Amin, RS. Baroreflex sensitivity after adenotonsillectomy in children with obstructive sleep apnea during wakefulness and sleep. Sleep 2012;35:1335–43CrossRefGoogle ScholarPubMed
21Rosen, GM, Muckle, RP, Mahowald, MW, Goding, GS, Ullevia, C. Postoperative respiratory compromise in children with obstructive sleep apnea syndrome: can it be anticipated? Pediatrics 1994;93:784–8CrossRefGoogle ScholarPubMed
22Caufield, H. Investigations in paediatric obstructive sleep apnoea: do we need them? Int J Pediatr Otorhinolaryngol 2003;67(suppl 1):S107–10CrossRefGoogle Scholar
23Constatin, E, Tewfik, TL, Brouillette, . Can the OSA-18 quality-of-life questionnaire detect obstructive sleep apnea in children. Pediatrics 2010;125:162–8CrossRefGoogle Scholar
24Blenke, EJSM, Anderson, AR, Raja, H, Bew, S, Knight, LC. Obstructive sleep apnoea adenotonsillectomy in children: when to refer to a centre with a paediatric intensive care unit? J Laryngol Otol 2008;122:42–5CrossRefGoogle ScholarPubMed
25Pringle, MB, Natesh, BG, Buchanan, EM. National UK survey on the assessment and surgical management of suspected paediatric obstructive sleep apnoea syndrome. Int J Pediatr Otorhinolaryngol 2013;77:1689–96CrossRefGoogle ScholarPubMed
26Weatherly, RA, Mai, EF, Ruzicka, DL, Chervin, RD. Identification and evaluation of obstructive sleep apnea prior to adenotonsillectomy in children: a survey of practice patterns. Sleep Med 2003;4:297–307CrossRefGoogle ScholarPubMed
27UK Department of Health, 2004. National Service Framework for Children, Young People and Maternity Services: Executive Summary. In: http://webarchive.nationalarchives.gov.uk/20130401151715/http://www.education.gov.uk/publications/eOrderingDownload/DH-40496PDF.pdf [28 January 2015]Google Scholar