Study of arterial blood gases and pulmonary systolic pressure of children with adeno-tonsillar hypertrophy

ABSTRACT

Fifty cases with adeno-tonsillar hypertrophy were included in this study, these patients were in the waiting list for adeno-tonsillectomy. Their ages ranged from 2 to 12 years [33 males and 17 females]. The study aimed at evaluation of changes of arterial blood gases [ABG] and pulmonary systolic pressure [PSP] of these cases. Thorough history and physical examination was done with special emphasis on cardiac and chest condition, patients proved to have cardiac or chronic chest problems were excluded. These patients were subjected to plain x-ray lateral view on the head and neck, electro-cardio-gram [ECG], colored echo-Doppler and arterial blood sample for ABG study. Ten healthy children of matched age were included as a control group, among the attendant of pediatric surgery clinic and listed for surgical intervention. The consent of parents was taken.. As regards to ABG results of the study versus control group were PH [7.33 +/- 0.05 versus 7.38 +/- 0.01], PaCO2 [38.51mmHg. +/- 1.84 versus 37.3mmHg +/- 1.73], PaO2 [77.26mmHg +/- 8.99 versus 78.9mmHg +/- 7.3] and O2 saturation [95.8% +/- 5.89 versus 96.9% +/- 1.11]. The difference of ABG between study and control group was not statistically significant [P value < 0.1, systolic pressure was more than 25mmHg in 7 cases out of 50 [14%]. A statistically significant increase in the calculated pulmonary systolic pressure was detected in the study group [23.82mmHg +/- 5.82], when compared with control group [12.59mmHg +/- 0.57] and P value < 0.001. The present study showed that children with adeno-tonsillar hypertrophy, especially those with suggestive symptoms of an obstructive sleep apnea are liable to develop pulmonary hypertension. Therefore, echo-Doppler study of PSP in these cases is recommended, which may help in the decision of surgical intervention