Objective:

To evaluate the causes of sedation-related incidents in a pediatric patient using drug-induced sleep endoscopy (DISE) as a diagnostic tool.

Key Findings:

• The patient exhibited multilevel airway obstruction due to tonsillar hypertrophy and dynamic tracheomalacia.
• Sedation exacerbated the airway collapse, leading to significant hypoxemia.
• Home non-invasive ventilation maintained nocturnal oxygen saturation above 95%, preventing cyanosis and bradycardia.

Interpretation:

Multilevel airway obstruction is a critical factor in pediatric sedation emergencies, and DISE is a valuable tool for diagnosis and management, aiding in risk stratification.

Limitations:

• The case is based on a single patient experience, limiting generalizability.
• Further studies are needed to establish broader applicability of DISE in similar cases.
• Lack of long-term follow-up data on patient outcomes post-DISE.

Conclusion:

This case highlights the importance of considering anatomical and dynamic airway issues in pediatric sedation crises, with DISE serving as an effective diagnostic method.