Silke Anna Theresa Weber1, Raíssa Pierri Carvalho2, Greta Ridley3, Katrina Williams4, Regina El Dib5. 1. Otolaryngology, Botucatu Medical School, Univ Estadual Paulista-UNESP, Botucatu, SP, Brazil. 2. Botucatu Medical School, Univ Estadual Paulista-UNESP, Botucatu, SP, Brazil. 3. Cochrane Prognosis Group, Sydney Children's Hospital Network, Sydney, NSW, Australia. 4. Cochrane Prognosis Group, University of Melbourne, Parkville, VIC, Australia; Royal Children's Hospital Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia. 5. Evidence-Based Medicine Unit, Anaesthesiology Department, Botucatu Medical School, Univ Estadual Paulista-UNESP, Sao Paulo, SP, Brazil; McMaster Institute of Urology, McMaster University, Hamilton, Canada. Electronic address: eldib@fmb.unesp.br.
Abstract
CONTEXT: There is evidence that OSA in children can be associated with acute and chronic effects on the cardiovascular system due to repetitive episodes of apnea and hypoxemia. OBJECTIVE: To assess whether there is an association between OSA and echocardiographic findings in children and whether that association persists after adenotonsillectomy. DATA SOURCES: A literature search was conducted based on PUBMED, EMBASE and LILACS. STUDY SELECTION: Children with OSA and children who did not have OSA, who were aged ≤12 years. DATA EXTRACTION: Two reviewers extracted data independently; the risk of bias was assessed by examining the selected sample, the recruitment method, completeness of follow up, and blinding. RESULTS: Seven studies met all the inclusion criteria and methodological requirements. There was a significant difference with elevated mean pulmonary arterial pressure levels in OSA participants compared to those without OSA at preoperative assessment [mean difference (MD) 8.67; confidential interval (CI) 95% 6.09, 11.25]. OSA participants showed a statistically significant increased interventricular septum (IVS) thickness (mm) [MD 0.60; CI 95% 0.09, 1.11]; and right ventricular (RV) dimension (cm/m) [MD 0.19; CI 95% 0.10, 0.28]. There was also a significant increase in right ventricular (RV) dimension (cm/m) [MD 0.10; CI 95% 0.05, 0.14] in OSA children. CONCLUSION: There is moderate quality evidence regarding possible association between OSA and right heart repercussions. More prognosis studies are needed, to allow the combination of results in a meta-analysis.
CONTEXT: There is evidence that OSA in children can be associated with acute and chronic effects on the cardiovascular system due to repetitive episodes of apnea and hypoxemia. OBJECTIVE: To assess whether there is an association between OSA and echocardiographic findings in children and whether that association persists after adenotonsillectomy. DATA SOURCES: A literature search was conducted based on PUBMED, EMBASE and LILACS. STUDY SELECTION: Children with OSA and children who did not have OSA, who were aged ≤12 years. DATA EXTRACTION: Two reviewers extracted data independently; the risk of bias was assessed by examining the selected sample, the recruitment method, completeness of follow up, and blinding. RESULTS: Seven studies met all the inclusion criteria and methodological requirements. There was a significant difference with elevated mean pulmonary arterial pressure levels in OSA participants compared to those without OSA at preoperative assessment [mean difference (MD) 8.67; confidential interval (CI) 95% 6.09, 11.25]. OSA participants showed a statistically significant increased interventricular septum (IVS) thickness (mm) [MD 0.60; CI 95% 0.09, 1.11]; and right ventricular (RV) dimension (cm/m) [MD 0.19; CI 95% 0.10, 0.28]. There was also a significant increase in right ventricular (RV) dimension (cm/m) [MD 0.10; CI 95% 0.05, 0.14] in OSA children. CONCLUSION: There is moderate quality evidence regarding possible association between OSA and right heart repercussions. More prognosis studies are needed, to allow the combination of results in a meta-analysis.
Authors: Antoinette T Burns; Shana L Hansen; Zachary S Turner; James K Aden; Alexander B Black; Daniel P Hsu Journal: J Clin Sleep Med Date: 2019-08-15 Impact factor: 4.062
Authors: Daniel Combs; Grant Skrepnek; Michael D Seckeler; Brent J Barber; Wayne J Morgan; Sairam Parthasarathy Journal: J Clin Sleep Med Date: 2018-09-15 Impact factor: 4.062
Authors: Colleen E Hanlon; Edem Binka; Jeffrey S Garofano; Laura M Sterni; Tammy M Brady Journal: J Clin Hypertens (Greenwich) Date: 2019-06-21 Impact factor: 3.738