Oropharyngeal airway diameter during sedation in children with and without developmental delay.
OBJECTIVE
To determine whether children with developmental delay would have closer apposition of upper airway tissues during sedation, perhaps because of poor coordination of upper airway musculature.


METHODS
Case-control and retrospective chart review.


METHODS
Tertiary-care pediatric teaching hospital.


METHODS
40 children 3 to 6 years of age, with and without a diagnosis of developmental delay.


METHODS
Subjects received only pentobarbital sedation by a protocol. Magnetic resonance imaging (MRI) scans of the head were reviewed, and transverse airway diameters at the soft palate and tongue were determined from midline sagittal images.


RESULTS
Age, weight, sedative dose, MRI window level, and window width were not different between patients with and without developmental delay. We found the airway diameter at the level of the soft palate was decreased 40% in children with developmental delay compared with those children without delay, 3 mm (1.4, 5.5 interquartile range) versus 5 mm (3, 8); p = 0.035, power 76%.


CONCLUSIONS
The anteroposterior oropharyngeal airway diameter was smaller in children with developmental delay than in those without developmental delay, in static MRI images. It is possible that children with developmental delay are at higher risk for airway obstruction during sedation.
Elwood
T
T
Department of Anesthesia, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Seattle, WA 98112, USA. telwoo@chmc.org
Hansen
L D
LD
Seely
J M
JM
D000402:Airway Obstruction / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000473:pathology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D009960:Oropharynx / Q000473:pathology*; D010424:Pentobarbital / Q000009:adverse effects*; D012189:Retrospective Studies
D006993:Hypnotics and Sedatives; D010424:Pentobarbital