What are the risk factors for postoperative pulmonary edema in children with obstructive sleep apnea (OSA)?

Updated: Feb 13, 2019
  • Author: Mary E Cataletto, MD; Chief Editor: Denise Serebrisky, MD  more...
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Answer

Children with severe obstructive sleep apnea may develop postobstructive pulmonary edema within a few hours of surgery to relieve upper airway obstruction.

Risk factors for postoperative pulmonary edema include the following:

  • Age younger than 3 years

  • Craniofacial anomalies affecting the pharyngeal airway, especially midfacial hypoplasia, micrognathia, or retrognathia

  • Failure to thrive

  • Hypotonia

  • Morbid obesity

  • Previous upper airway trauma

  • Severe abnormalities on polysomnography, with a respiratory disturbance index (RDI) of more than 40 events per hour or oxygen desaturations less than 70%

  • Patients undergoing uvulopalatopharyngoplasty (UPPP) in addition to tonsillectomy or adenoidectomy

  • Complicating cardiac or pulmonary disease


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