Use of noninvasive ventilation in surgical treatment of obstructive sleep apnea hypopnea syndrome in children / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the efficacy of noninvasive ventilation in the surgical treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) in children.</p><p><b>METHODS</b>Since 2002.5 - 2007.12, eleven children with adenotonsillar hypertrophy and seven children with post-adenoidtonsillectomy were enrolled in the study. All children were confirmed as OSAHS by polysomnography (PSG) or portable oximetry monitor. Male:female ratio was 17:1. The age ranged from 1 to 11 years (median 3.8 years). The noninvasive ventilation treatment was carried out in all children pre- or postoperatively. PSG was the index for therapy effect. SPSS 11.5 was used to analyse the data. The parameters, x(-) +/- s, were normal distribution, and paired t-test for significancy. A P value of < 0.05 was considered statistically significant.</p><p><b>RESULTS</b>Six children after adenotosillectomy, with AHI < 10/h, lowest pulse oxygen saturation (SpO2) > 0.85, did not need nasal continuous positive airway pressure (nCPAP). Eleven patients with preoperative nCPAP, did not have anesthesia comlications. Post-nCPAP, apnea and hypopnea index AHI (4.7 +/- 3.9)/h, the lowest SpO2 0.867 +/- 0.069, and the average time percents SpO2 < 0.90 during sleep (0.3% +/- 0.5%) improved significantly compared to pre-nasal continuous positive airway pressurecn (nCPAP), which were (77.6 +/- 39.8)/h, (0.535 +/- 0.151) and (46.9% +/- 34.5%), t value were 7.77, -11.62, 5.69, P < 0.001.</p><p><b>CONCLUSIONS</b>Noninvasive ventilation is an effective treatment for severe OSAHS children pre- or postoperation. nCPAP could be used to treat children still with OSAHS after adenotonsillectomy, and also an effective treatment to the ones who had surgical contraindication. Regular follow-up should be done for patients with nCPAP at home.</p>