• Martino Pavone, Nicola Ullmann, Elisabetta Verrillo, Giancarlo De Vincentiis, Emanuela Sitzia, and Renato Cutrera.
• Respiratory Unit, University Department of Pediatrics (DPUO), Bambino Gesù Children's Hospital, Piazza S.Onofrio 4, 00165, Rome, Italy. martino.pavone@opbg.net.
• Eur. J. Pediatr. 2017 Apr 1; 176 (4): 493-499.

AbstractNocturnal pulse oximetry has a high positive predictive value for polysomnographically diagnosed obstructive sleep apnoea (OSA) in children. When significant adenotonsillar hypertrophy is diagnosed, adenotonsillectomy (T&A) represents a common treatment for OSA in children. We investigated the role of pulse oximetry in predicting those patients, referred for suspected OSA, who subsequently needed T&A. At-home nocturnal pulse oximetry was performed on 380 children (65.7% males), median age 4.1(IRQ 3.0-5.6) years, referred for suspected OSA, and data were retrospectively analysed. For each recording McGill Oximetry Score (MOS) was categorized. Mean pulse rate (PR) z-score and pulse rate variability (PRV)-corrected (PRSD/meanPR) were significantly higher in children with abnormal MOS. Both parameters were significantly higher in subjects who underwent T&A compared with those not surgically treated. Both DI4 and PRV corrected showed a negative correlation with the elapsed time between pulse oximetry recordings and T&A. The logistic regression model showed a strong effect of an abnormal MOS as a predicting factor for T&A (adjusted odds ratio 19.7).

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