Management of Persistent, Post-adenotonsillectomy Obstructive Sleep Apnea in Children: An Official American Thoracic Society Clinical Practice Guideline.
Document Type
Article
Publication Date
2-1-2024
Identifier
DOI: 10.1164/rccm.202310-1857ST; PMCID: PMC10840779
Abstract
Background: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Although adenotonsillectomy is first-line management for pediatric OSA, up to 40% of children may have persistent OSA. This document provides an evidence-based clinical practice guideline on the management of children with persistent OSA. The target audience is clinicians, including physicians, dentists, and allied health professionals, caring for children with OSA. Methods: A multidisciplinary international panel of experts was convened to determine key unanswered questions regarding the management of persistent pediatric OSA. We conducted a systematic review of the relevant literature. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to rate the quality of evidence and the strength of the clinical recommendations. The panel members considered the strength of each recommendation and evaluated the benefits and risks of applying the intervention. In formulating the recommendations, the panel considered patient and caregiver values, the cost of care, and feasibility. Results: Recommendations were developed for six management options for persistent OSA. Conclusions: The panel developed recommendations for the management of persistent pediatric OSA based on limited evidence and expert opinion. Important areas for future research were identified for each recommendation.
Journal Title
American journal of respiratory and critical care medicine
Volume
209
Issue
3
First Page
248
Last Page
261
MeSH Keywords
Humans; Child; United States; Sleep Apnea, Obstructive; Tonsillectomy; Adenoidectomy; Sleep; Societies
Keywords
OSA; pediatrics
Recommended Citation
Ehsan Z, Ishman SL, Soghier I, et al. Management of Persistent, Post-adenotonsillectomy Obstructive Sleep Apnea in Children: An Official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2024;209(3):248-261. doi:10.1164/rccm.202310-1857ST