Sleep apnea • airway obstruction • control of breathing • tonsils • adenoids
My research focuses on sleep disorders in children, particularly obstructive sleep apnea (OSA). Recent work is on the diagnosis of OSA using questionnaire data and nocturnal pulse oximetry. I have developed the McGill Oximetry Score, a practical method for detecting severe OSA in children being considered for adenotonsillectomy. The score not only diagnoses OSA but also quantifies the severity, predicts perioperative respiratory adverse events, helps to determine narcotic dosage for pain control, prioritizes more severe OSA for prompt surgery, and identifies children who should be operated on in a children's hospital and closely monitored postoperatively. I have recently looked at cost savings associated with this diagnostic strategy and coauthored a major pan-Canadian consensus statement on sleep disorders in children. Current and planned projects include innovative studies of biomarkers for diagnosis of severe OSA and the use of pulse rate/pulse rate variability to detect milder OSA not associated with repetitive hemoglobin saturation.
Brown KA, Brouillette RT. The elephant in the room: lethal apnea at home after adenotonsillectomy. Anesthesia & Analgesia, in press.
Brouillette RT. Let's CHAT about adenotonsillectomy. N Engl J Med. N Engl J Med.368(25):2428-9, 2013 Jun 20.
Pavone M, Cutrera R, Verrillo E, Salerno T, Soldini S, Brouillette RT. Night-to-night consistency of at-home nocturnal pulse oximetry testing for obstructive sleep apnea in children. Pediatr Pulmonol. 2013 Mar 26. doi: 10.1002/ppul.22685.
Simard-Tremblay E, Constantin E, Gruber R, Brouillette RT, Shevell M. Sleep in children with cerebral palsy: a review. J Child Neurol. 26(10):1303-10, 2011 Oct. Epub 2011 Jun 13.
Brouillette RT, Horwood L, Constantin E, Brown K, Ross NA. Childhood sleep apnea and neighborhood disadvantage. J Pediatr. 158(5):789-795.e1, 2011 May. Epub 2010 Dec 10.