TABLE 16

Relationship Between PSG Parameters and Postoperative Respiratory Complications

SourceLevelType of StudyNo.Study GroupAge, ySpecial Populations IncludedaFindings
Hill et al269IIIRetrospective83AHI >10≤18YesMajor respiratory complication in 5%; minor in 20%
Only age <2 y (P < .01) and AHI >24 (P < .05) significantly predicted postoperative airway complications
Complication rate only 4% if special populations were excluded
AHI >24 predicted 63% of complications
Jaryszak et al270IIIRetrospective151Any child who had a PSGNot statedYesRespiratory complication rate was 15%
Children with complications had higher AHI (32 vs 14) and lower Spo2 nadir (72% vs 84%) compared with those without complications
Koomson et al271IIIRetrospective85AHI >5Not statedYesPostoperative desaturation in 28%
More likely to desaturate postoperatively if PSG Spo2 nadir <80%
Ma et al272IIIRetrospective86Any child who had a PSG1–16YesPostoperative desaturation in 7%
No difference in AHI between those with and without postoperative desaturation (11.6 ± 4.5 vs 14.7 ± 16.6)
Sanders et al273IProspective6161 children who had OSAS vs 21 who had tonsillitis2–16NoRespiratory complication rate was 28%
Subjects with RDI ≥30 were more likely to have laryngospasm and desaturation
At an RDI ≥20, OSAS was more likely to have breath-holding on induction
Schroeder et al274IIIRetrospective53Severe OSAS (AHI >25)Not statedYes43% required oxygen or PAP
Note: an additional 17 children were electively kept intubated postoperatively
Shine et al196IIIRetrospective26Obese OSAS2–17Obese; other comorbidities not stated46% had respiratory complications
Those requiring intervention for respiratory problems had a lower Spo2 (68 ± 20% vs 87 ± 18%) but no difference in RDI (27 ± 44 vs 15 ± 28) than those who did not require intervention
By using univariate analysis, a preoperative Spo2 <70% was associated with postoperative respiratory compromise, but no threshold was found for RDI
Ye et al 127IIIRetrospective327AHI ≥54–14No11% had respiratory complications
An AHI of 26 had 74% sensitivity and 92% specificity for predicting postoperative respiratory complications
  • a Special populations include children with genetic syndromes and craniofacial abnormalities.