Discussion
Synopsis
The continuity that exists between the upper and lower respiratory tracts means that inflammation in those regions is rarely localized.[19] Inflammation or an obstruction in the upper airways of children with OSA can cause mucosal inflammation of the lower respiratory tract, and affect a child’s lung function.[20,21] Moreover, a meta-analysis of complications associated with adenotonsillectomy in children showed that the incidence of respiratory complications after a adenotonsillectomy in children with OSA was 5-fold higher than that in children without OSA.[22]Therefore, it is potentially beneficial to establish a standardized airway management process to reduce the incidence of perioperative airway complications in children with OSA. As the beginning of perioperative airway management, a preoperative lung function test is important for assessing the risks associated with anesthesia and the likelihood of lung complications after surgery.[23] In our study, we optimized some airway management measures and first developed an airway management process to improve preoperative lung function effectively. We found that nearly 10% of the children with OSA had abnormal lung function by lung function test. Individualized interventions were applied for these children and the results showed that FEV1% pre was greater than 80% in all patients after 2 days or 4 days of atomization inhalation which was given at different frequencies based on the severity of obstruction. Meanwhile, histories of chronic cough and asthma were identified as risk factors for perioperative abnormal lung function. We should pay attention to the patients with these risk factors and intervene with them preventively as well, even if they had normal lung function.