Enurese primária nos pacientes com obstrução das vias aéreas superiores

Abstract

Introduction: Upper airway obstruction (UAO) is a common condition in all pediatric population, with a 27% prevalence; primary nocturnal enuresis (PNE) is a condition related to UAO in 8% to 47% of these children. The specific pathophysiological mechanism of this bond is not well understood. Some authors suggests a connection brain natrituretic peptide (BNP) and anti diuretic hormone (ADH) during the sleep. The aim of this study was to evaluate the hormone profile (BNP and ADH) and the “Dry Night Diary” of a sample of children before and after the surgery to treat the upper airway. Methods: This is a longitudinal prospective interventionist study in a sample of 18 children from 5 to 14 years old with UAO and PNE recruited voluntarily in a tertiary specialty outpatient from may 2018 to November 2020. Children presenting UAO and PNE were evaluated with a 30 days dry night diary and blood samples were collected to evaluate ADH and BNP prior and after surgery of the upper airway. Data were analyzed prior to surgery and 90-120 days after surgery. Results: we applied t student test in BNP, ADH and Dry Night Diary (DND) before (BS) and after surgery (AS); BNP BS mean was 92,10 (4,8 – 269,90) pg/ml and 141,36 (0,00 – 321,50) pg/ml AS (p 0,007). Mean ADH BS was 6,36 (2,7 – 12,50) pg/ml and 16,68 (1,80 – 144,80) AS (p 0,26). DND BS mean was 35,82% (0,00 – 83,3) and DND AS mean was 78,58 % (8,3 – 100,00) – p ˂ 0,001. Conclusion: airway release surgery contributed to an increase of BNP (statistically significant) ADH (not statistically significant) and DND (statistically significant). Clinically, most of children had an improvement of symptoms according to ICCS criteria