A systematic review and meta-analysis of cohort studies of echocardiographic findings in OSA children after adenotonsilectomy

Author(s)

Weber, Silke Anna Theresa ^[1] ; Carvalho, Raissa Pierri ^[1] ; Ridley, Greta ^[2] ; Williams, Katrina ^{[3, 4, 5]} ; El Dib, Regina ^{[6, 7]}

Affiliation

^[1] Univ Estadual Paulista, UNESP, Botucatu Med Sch, Botucatu, SP - Brazil

^[2] Sydney Childrens Hosp Network, Cochrane Prognosis Grp, Sydney, NSW - Australia

^[3] Univ Melbourne, Cochrane Prognosis Grp, Parkville, Vic 3052 - Australia

^[4] Royal Childrens Hosp Melbourne, Parkville, Vic - Australia

^[5] Murdoch Childrens Res Inst, Parkville, Vic - Australia

^[6] Univ Estadual Paulista, UNESP, Botucatu Med Sch, Dept Anaesthesiol, Evidence Based Med Unit, Sao Paulo, SP - Brazil

^[7] McMaster Univ, McMaster Inst Urol, Hamilton, ON - Canada

• Document type: Review article
• Source: International Journal of Pediatric Otorhinolaryngology; v. 78, n. 10, p. 1571-1578, OCT 2014.
• Web of Science Citations: 9

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 USA and children who did not have USA, 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; Cl 95% 0.05, 0.14] in OSA children. Conclusion: There is moderate quality evidence regarding possible association between USA and right heart repercussions. More prognosis studies are needed, to allow the combination of results in a meta-analysis. (C) 2014 Elsevier Ireland Ltd. All rights reserved. (AU)

• FAPESP's process: 11/18762-9 - Association between adenotonsillar hypertrophy and cardiac alterations: systematic review of cohort studies
• Grantee: Silke Anna Theresa Weber
• Support Opportunities: Regular Research Grants