Current opinion in pediatrics · 2008
The multiple challenges of obstructive sleep apnea in children: morbidity and treatment.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gozal David, Kheirandish-Gozal Leila
Аннотация
PURPOSE OF REVIEW: To delineate some of the major morbid phenotypes that have emerged in pediatric obstructive sleep apnea (OSA), address new concepts in our understanding of OSA-associated morbidities, and elaborate on innovative therapeutic schemes that may improve outcomes for this condition. In addition, the conceptual framework whereby a childhood condition such as OSA can be linked to specific adult diseases will be presented.
RECENT FINDINGS: OSA in children is a frequent condition that affects up to 3% of nonobese, otherwise healthy children. In recent years, increased awareness of OSA and changes in obesity rates in children have contributed to significant changes in disease prevalence and clinical presentation, such that distinct morbidity-related phenotypes have become apparent. Furthermore, oxidative stress and systemic inflammatory pathways are mechanistically involved in the pathophysiology of OSA-associated morbidity. Adenotonsillectomy, the treatment of choice for pediatric OSA, may not be as efficacious as previously thought. Alternative nonsurgical therapies have started to emerge and may become an essential component of treatment.
SUMMARY: Pediatric OSA, particularly when obesity is concurrently present, is associated with substantial end-organ morbidities that primarily but not exclusively affect central nervous and cardiovascular systems. These morbidities are pathophysiologically mediated by inflammatory and free radical mediators. Although adenotonsillectomy remains the first line of treatment, more critical assessment of its role is needed, and incorporation of nonsurgical approaches to pediatric OSA seems warranted.
RECENT FINDINGS: OSA in children is a frequent condition that affects up to 3% of nonobese, otherwise healthy children. In recent years, increased awareness of OSA and changes in obesity rates in children have contributed to significant changes in disease prevalence and clinical presentation, such that distinct morbidity-related phenotypes have become apparent. Furthermore, oxidative stress and systemic inflammatory pathways are mechanistically involved in the pathophysiology of OSA-associated morbidity. Adenotonsillectomy, the treatment of choice for pediatric OSA, may not be as efficacious as previously thought. Alternative nonsurgical therapies have started to emerge and may become an essential component of treatment.
SUMMARY: Pediatric OSA, particularly when obesity is concurrently present, is associated with substantial end-organ morbidities that primarily but not exclusively affect central nervous and cardiovascular systems. These morbidities are pathophysiologically mediated by inflammatory and free radical mediators. Although adenotonsillectomy remains the first line of treatment, more critical assessment of its role is needed, and incorporation of nonsurgical approaches to pediatric OSA seems warranted.