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.