{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:01:38Z","timestamp":1790622098589,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Obstructive sleep disordered breathing (OSDB) is prevalent in children and often associated with adenotonsillar hypertrophy (ATH). This prospective study investigated the impact of adenotonsillectomy on cardiovascular parameters in children with ATH and suspected OSDB, employing a generalised estimating equation (GEE) approach to account for repeated measures and potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children (4\u201314\u2009years) with ATH and clinical OSDB undergoing adenotonsillectomy were included. Pre\u2010 and post\u2010operative resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, and estimated cardiac output (COEst) were assessed. Paired t\u2010tests and Wilcoxon signed\u2010rank tests were used for pre\u2010post comparisons, while GEE models examined the influence of time (surgery), age, gender, and their interactions on the outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 90 children (mean age: 6.86\u2009\u00b1\u20092.78\u2009years) participated. Adenotonsillectomy resulted in a significant decrease in HR (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028) and COEst (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). No significant changes were observed in SBP or DBP (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). A significant negative correlation was found between the change in COEst and age (Spearman's rho\u2009=\u2009\u22120.349,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), indicating a more pronounced reduction in COEst in younger children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adenotonsillectomy in children with ATH and clinical OSDB may lead to significant variations in resting heart rate and estimated cardiac output after surgery. This suggests a potential reduction in resting sympathetic activity following the resolution of upper airway obstruction, with a possible contribution of age\u2010related factors to the observed cardiovascular responses to adenotonsillectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.70018","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T09:14:59Z","timestamp":1754644499000},"page":"1071-1081","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Paediatric Obstructive Sleep Disordered Breathing: Cardiovascular Changes After Adenotonsillectomy"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4113-3259","authenticated-orcid":false,"given":"Francisco Alves","family":"de Sousa","sequence":"first","affiliation":[{"name":"Otorhinolaryngology and Head &amp; Neck surgery Unidade Local de Sa\u00fade de Santo Ant\u00f3nio  Porto Portugal"},{"name":"Doctoral Programme in Medical Sciences Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Rios","sequence":"additional","affiliation":[{"name":"Head of sleep Medicine laboratory, Pediatrics Department of Centro Materno Infantil do Norte Unidade Local de Sa\u00fade de Santo Ant\u00f3nio  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7831-0277","authenticated-orcid":false,"given":"Paula","family":"Branco","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology and Head &amp; Neck surgery Unidade Local de Sa\u00fade de Santo Ant\u00f3nio  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3171-3842","authenticated-orcid":false,"given":"Sara Raquel","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology and Head &amp; Neck surgery Unidade Local de Sa\u00fade de Santo Ant\u00f3nio  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7041-0994","authenticated-orcid":false,"given":"Mariline","family":"Santos","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology and Head &amp; Neck surgery Unidade Local de Sa\u00fade de Santo Ant\u00f3nio  Porto Portugal"},{"name":"Invited Assistant Professor, Otorhinolaryngology and Head &amp; Neck surgery Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9477-8822","authenticated-orcid":false,"given":"Manuel Ferreira","family":"de Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Pneumology Unit and Neonatology Unit, Pediatrics Department at Centro Materno Infantil do Norte (CMIN) Unidade Local de Sa\u00fade de Santo Ant\u00f3nio  Porto Portugal"},{"name":"Invited Assistant Professor of Pediatrics Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,8]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2023.101871"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200708-135MG"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1672"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00043.2008"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2008.03.002"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200707-111MG"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-019-1228-3"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043104"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.13926"},{"key":"e_1_2_13_11_1","first-page":"109","article-title":"Obstructive Sleep Apnea in Children: A Critical Update","volume":"5","author":"Tan H.\u2010L.","year":"2013","journal-title":"Nature and Science of Sleep"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/33.10.1279"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00385-2015"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/children11020208"},{"issue":"3","key":"e_1_2_13_15_1","first-page":"182","article-title":"Impact of Adenotonsillectomy in Pediatric Respiratory Function","volume":"74","author":"Sousa F. 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