Clinical Pediatric Literature Updates from July 2019

P-Wave Dispersion as a Simple Tool for Screening Childhood Obstructive Sleep Apnea Syndrome

“P-wave dispersion (PWD) as defined by the difference between the duration of maximum and minimum p-waves has been used to screen for the presence of OSAS in adults. This study looks at the utility of this tool for OSAS screening in children. The authors obtained ECGs from 77 children with documented OSAS by PSG and 44 controls. A cutoff of 26.5 ms provided 89.6% sensitivity and 61.4% specificity. PWD was significantly higher in children with severe OSA even when the authors adjusted for the presence of obesity.”

 

https://www.ncbi.nlm.nih.gov/pubmed/30580188

Outcome of Drug-Induced Sleep Endoscopy-Directed Surgery for Persistent Obstructive Sleep Apnea after Adenotonsillar Surgery

“Drug-induced sleep endoscopy (DISE) can be considered in children with persistent OSAS despite adenotonsillectomy. The authors described sleep-related outcomes in 20 children a year after DISE directed surgery (e.g., turbinate reductions, pharyngoplasty, lingual tonsillectomy, and tonsillectomy revisions). All children demonstrated an improvement in their sleep breathing parameters. Five children had complete resolution of OSAS whereas 15 continue to have persistent OSAS but in the mild range”.

https://www.ncbi.nlm.nih.gov/pubmed/30776569

Prenatal, Perinatal, and Early Childhood Factors Associated with Childhood Obstructive Sleep Apnea

“In this study, the authors tested associations between pre and perinatal and early childhood factors and the risk of childhood OSAS from a cohort of 2867 mother-child pairs already enrolled in the Boston Birth Cohort Study. Children conceived by in-vitro fertilization, premature deliveries due to trauma were some of the exclusions. This secondary analysis study demonstrated strong associations between childhood OSAS and prematurity/low birth weight, maternal obesity/diabetes, childhood obesity, and elevated early childhood leptin levels. “

https://www.ncbi.nlm.nih.gov/pubmed/31253409