HMN 2026: How Post-adenotonsillectomy respiratory volume monitoring could be feasible in obstructive sleep apnea

For children with severe obstructive sleep apnea (OSA) undergoing adenotonsillectomy, postoperative respiratory volume monitoring is feasible and can predict low minute ventilation (MV), according to a study published online Feb. 17 in Anesthesia Critical Care & Pain Medicine.

Proshad N. Efune, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues examined the feasibility of noninvasive respiratory volume monitoring in the postoperative period to predict low MV and respiratory events on the first postoperative night among children with severe OSA following adenotonsillectomy with planned postoperative admission. The primary outcome was the occurrence of low MV events on the ward measured using a noninvasive respiratory volume monitor (RVM).

Sixty children were enrolled; the overnight RVM sensor was not tolerated in five (8%). The researchers found that low MV events occurred in 33% and 62% of patients in the postanesthesia care unit (PACU) and on the ward, respectively. The likelihood of having ward events was increased for patients who had PACU events (odds ratio, 4.26). Ward events increased with increasing age (odds ratio, 1.25 per year), while a history of asthma was protective (odds ratio, 0.15).

“The RVM is simple to interrogate and could be used to identify ventilatory derangements in the PACU, which could potentially be used to determine postoperative disposition,” the authors write. “Decreasing hospital admissions for overnight observation could reduce health care costs and burdens on families.”

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