TY - JOUR T1 - A new proposal for OSA classification in children based on cardiovascular outcome JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P1074 AU - Silke A.T. Weber AU - Victor dos Santos AU - José Maurício Lopes Neto AU - Luiz Cuadrado Martins Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P1074.abstract N2 - Introduction: Pediatric OSA is associated to cardiovascular repercussions (CVR), adenotonsillectomy(AT) is considered its treatment of choice. We hypothesized that OSA leads to early CVR as loosing of nocturnal blood pressure dipping (NBPD); OSA treatment (AT) will recover NBPD.Aim: to analyse which polysomnographic(PSG) criteria best defines OSA in children, based on the absence of NBPD before and its recovering after AT.Methods: We included children with regular snoring, observed respiratory pauses and hypertrophy of the tonsills. Children with persisting snoring after AT,diagnosis of cardiovascular, renal or neurologic disease and obesity were excluded. Children realized PSG and 24-hour blood pressure monitoring before and six months after AT. AI and AHI were calculated, the presence or absence of NBPD was described before and after AT. Three current PSG definitions for OSA (D1:AHI>1; D2:AI>1 & AHI>4; D3: AHI>5) were tested for the best correlations of OSA and CVR before and NBPD recovering after AT(McNemar, Odd's ratio).Results: 26 children, 8-12 years old, were included. AHI varied from 0,0 to 23,2. 10 children presented loosing of NBPD before, 4 persisted after AT. For D1 (AHI>1) OSA diagnosis showed no significant association to CVR neither before, nor after AT. For D3 (AHI>5) OSA diagnosis showed a significant correlation to CVR before AT, but not after surgery. For D2 (AI>1 & AHI>4) OSA diagnosis showed significant correlation to CVR before and after surgery.Conclusion: Considering NBPD and surgery outcome, we identified AI>1 & AHI>4 as the best definition for OSA in children. Larger studies focusing CVR and surgical outcome should be realized to better define PSG criteria and OSA. ER -