Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (1): 116-119.doi: 10.6040/j.issn.1673-3770.0.2021.417

Previous Articles     Next Articles

Multidisciplinary diagnosis and treatment of a child with severe obstructive sleep apnea syndrome complicated by pulmonary hypertension

SHI Xiaoli, MU Hong   

  1. The First Department of Otolaryngology, Children's Hospital, Shandong University, Jinan 250022, Shandong, China
  • Published:2022-02-22

PDF (PC)

68

Abstract: Objective To investigate the pathogenesis, diagnosis, treatment and perioperative management of children with severe obstructive sleep apnea(OSA)complicated by pulmonary hypertension. Methods A retrospective review of one child with OSA complicated by pulmonary hypertension is analyzed. Results Pulmonary hypertension can cause by severe OSA in children. Multidisciplinary diagnosis and treatment should be conducted for children with severe OSA complicated by pulmonary hypertension to exclude other factors that may lead to pulmonary hypertension. Surgical treatment could be chosen for children with severe OSA with mild hypertrophy of tonsil and adenoid after other obstruction factors were excluded. Perioperative CPAP therapy can rapidly correct pulmonary hypertension and reduce perioperative risk. Conclusion Operation combined with perioperative CPAP therapy is an effective treatment for severe OSA complicated by pulmonary hypertension. Polysomnography monitoring is an important means to judge the severity of children's disease and evaluate the efficacy of surgery.

Key words: Obstructive sleep apnea, Children, Pulmonary arterial hypertension, Continuous positive airway pressure, Adenotonsillectomy

CLC Number: 

  • R766
[1] 无创正压通气治疗儿童阻塞性睡眠呼吸暂停综合征专家共识(草案)[J]. 中华实用儿科临床杂志, 2016, 31(19): 1451-1455. doi: 10.3760/cma.i.issn.2095-428X.2016.19.004.
[2] 中华医学会儿科学分会心血管学组, 《中华儿科杂志》编辑委员会. 儿童肺高血压诊断与治疗专家共识[J]. 中华儿科杂志, 2015, 53(1): 6-16. doi: 10.3760/cma.j.issn.0578-1310.2015.01.003.
[3] Zhang W, Si LY. Obstructive sleep apnea syndrome(OSAS)and hypertension: pathogenic mechanisms and possible therapeutic approaches[J]. Ups J Med Sci, 2012, 117(4): 370-382. doi:10.3109/03009734.2012.707253.
[4] Garvey JF, Taylor CT, McNicholas WT. Cardiovascular disease in obstructive sleep apnoea syndrome: the role of intermittent hypoxia and inflammation[J]. Eur Respir J, 2009, 33(5): 1195-1205. doi:10.1183/09031936.00111208.
[5] Gozal D, Kheirandish-Gozal L. Cardiovascular morbidity in obstructive sleep apnea: oxidative stress, inflammation, and much more[J]. Am J Respir Crit Care Med, 2008, 177(4): 369-375. doi:10.1164/rccm.200608-1190pp.
[6] 帕提古丽·依司拉木, 谢江, 李菲, 等. 阻塞性睡眠呼吸暂停与肺动脉高压相关性的研究进展[J]. 心肺血管病杂志, 2020,39(6): 740-742.
[7] Galiè N, Hoeper MM, Humbert M, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the task force for the diagnosis and treatment of pulmonary hypertension of the European society of cardiology(ESC)and the European respiratory society(ERS), endorsed by the international society of heart and lung transplantation(ISHLT)[J]. Eur Heart J, 2009, 30(20): 2493-2537. doi:10.1093/eurheartj/ehp297.
[8] Mclaughlin VV, Archer SL, Badesch DB, et al. ACCF/AHA 2009 expert consensus document on pulmonary hypertension: a report of the American college of cardiology foundation task force on expert consensus documents and the American heart association developed in collaboration with the Americancollege of chest physicians; American thoracic cociety, Inc.; and the pulmonary hypertension association[J]. J Am Coll Cardiol, 2009, 53(17): 1573-619.
[9] McNicholas WT. Comorbid obstructive sleep apnoea and chronic obstructive pulmonary disease and the risk of cardiovascular disease[J]. J Thorac Dis, 2018, 10(suppl 34): S4253-S4261. doi:10.21037/jtd.2018.10.117.
[10] 叶晓芳, 朱光发. 慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停的研究进展[J]. 心肺血管病杂志, 2018,37(10): 947-951. doi: 10.12037/YXQY.2016.09-02.
[11] 中国儿童阻塞性睡眠呼吸暂停诊断与治疗指南(2020)[J]. 中华耳鼻咽喉头颈外科杂志, 2020, 55(8): 729-47. doi: 10.7507/1672-2531.202005147.
[12] Kimura H, Ota H, Kimura Y, et al. Effects of intermittent hypoxia on pulmonary vascular and systemic diseases[J]. Int J Environ Res Public Heal, 2019, 16(17): 3101. doi:10.3390/ijerph16173101.
[13] Marin JM, Soriano JB, Carrizo SJ, et al. Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome[J]. Am J Respir Crit Care Med, 2010, 182(3): 325-331. doi:10.1164/rccm.200912-1869OC.
[14] 陈兰勤, 殷菊, 王华, 等. 阻塞性睡眠呼吸暂停综合征并重度肺动脉高压多脏器功能衰竭1例报告[J]. 中国实用儿科杂志, 2020,35(10): 816-818. doi:10.19538/j.ek2020100617. CHEN Lanqin, YIN Ju, WANG Hua, et al. One case report of obstructive sleep apnea syndrome combined with multiple organ failure of severe pulmonary hypertension[J]. Chin J Pract Pediatr, 2020, 35(10): 816-818. doi:10.19538/j.ek2020100617.
[1] YANG Yang, WANG Xiaoxu, ZHANG Jie. Progress on diagnosis and treatment of middle ear cholesteatoma in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 1-6.
[2] GAO Xinzhong, LING Zongtong, SHEN Ling, LIU Pingfang, LIN Xin,XU Yangyang. Analysis of the efficacy of balloon eustachian tuboplasty combined with adenoidectomy in the treatment of otitis media with effusion in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 7-12.
[3] HU Chunyan, DANG Panhong, ZHANG Rui, FAN Mengyun. Analysis of audiological and imaging characteristics of 149 children with unilateral sensorineural hearing loss [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 31-36.
[4] DANG Panhong, ZHANG Rui, HU Chunyan, WANG Jie, FAN Mengyun. Clinical analysis of facial nerve decompression via an external transmastoid-subtemporal labyrinth approach in eight children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 37-42.
[5] LIU Shanshan, HAN Shujing, WANG Xiaoxu, LI Yanhong, NI Xin, ZHANG Jie. Hearing loss in children after bacterial meningitis: a systematic review and meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 48-54.
[6] JIAO Xuemei, YANG Yang, LI Chunfeng, ZHANG Xiaolin. Effect of tympanic membrane insertion on the function of eustachian tube in children with secretory otitis media [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 60-63.
[7] WANG Pengpeng, GE Wentong, TANG Lixing, YANG Xiaojian, ZHANG Wei, XIAO Xiao, HAN Yang. Four cases of open rhinoplasty approach for congenital nasal dermoid and sinus cysts in children and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 64-69.
[8] LI Menghui, ZHI Lili, QI Kaiwen, WANG Shanshan, GAO Qian, BU Meiling,. Clinical research of subcutaneous immunotherapy on children with allergic asthma caused by dust mites and combined with mold allergen [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 75-80.
[9] CHEN Kun, LU Hui, HUANG Qi, LI Lei, MENG Guozhen, YANG Jun, HOU Dongming. Clinical diagnosis and treatment of congenital nasal sinus mass in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 81-85.
[10] ZHAO Xinghe, FAN Mingyue, DOU Xunwu, JIA Guangbiao. Primary large B-cell lymphoma of tonsil in children: a case report and document review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 120-124.
[11] YUAN Chenyang, LIU YanOverview,FANG ZhenshengGuidance. Advances on the effect of OSAHS on pulmonary function in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 143-148.
[12] LIU Yi, YU Mingkun, SUN Wei, SHAO Zhen, HU Yuanyuan, BI Hongsheng. The effectiveness and safety of orthokeratology on controlling myopia of children: a meta-analysis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 92-100.
[13] LI DanyangOverview,LIANG HuiGuidance. Advancements in orofacial myofunctional therapy for obstructive sleep apnea [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 108-114.
[14] FENG Chen, GUO Ruixiang, WANG Yan. Application and progress of coblation in children with obstructive sleep apnea [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 16-21.
[15] LIU Shaofeng, HUANG Guiliang, HUANG Zhenyun, SUN Changzhi, LUO Renzhong. Partial tonsillectomy for 86 cases of obstructive sleep apnea syndrome in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 50-54.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd