RT Journal Article
SR Electronic
T1 Effects of adenotonsillectomy in children with sickle cell disease
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA4353
DO 10.1183/13993003.congress-2016.PA4353
VO 48
IS suppl 60
A1 Van Geyzel, Lisa
A1 Singh, Bethany
A1 Inusa, Baba
A1 Akthar, Morium
A1 Bossley, Cara
A1 Kozlowska, Wanda
A1 Rees, David
A1 Chakravorty, Subarna
A1 Ruiz, Gary
A1 Hore, Ian
A1 Gupta, Atul
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA4353.abstract
AB Introduction: Children with Sickle cell disease (SCD) have a higher prevalence of Obstructive sleep apnea (OSA) and OSA has been identified as an important comorbidity in children with SCD. There evidence linking nocturnal desaturations with an increased rate of both vaso-occlusive episodes (VOE) and acute chest syndrome (ACS).Methods: In our centre, all children and adolescents with SCD and OSA are evaluated for adenotonsillar hypertrophy, as adenotonsillectomy may be curative in some. Retrospective review of children with SCD who underwent adenotonsillectomyfor OSA between 2004 to 2015. Sleep study data and admission rates due to VOE & ACS were compared, before & after adenotonsillectomy.Results: 37 children with SCD underwent adenotonsillectomy during this time frame. 22 children (13 male) with a median age of 7 years (range 3-12 years) had sleep study before and after adenotonsillectomy.BeforeAfterP valueNocturnal oxygen saturations (Sp02) %94.495.00.412Overnight nadir oxygen saturations (Sp02) %81.087.00.002Nocturnal 3% oxygen desaturation index (ODI)5.452.40.003Nocturnal carbon dioxide (pC02) kPa6.005.780.438ACS (admissions per year)0.590.230.254VOE (admission per year)0.450.500.922*All values median (range)TABLE 1. Comparison of sleep study results & rate of ACS and VOE in children with SCD who underwent adenotonsillectomy.Discussion: Children with SCD and OSA, who had adenotonsillectomy, appeared to have a significant increase in overnight nadir oxygen saturations, as well as a reduction in the overnight ODI; but no change in the rates of severe ACS or VOE. Further testing by a randomised controlled trial or prospective longitudinal study is needed.