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Role of paediatric intensive care following adenotonsillectomy for severe obstructive sleep apnoea: criteria for elective admission

  • P Walker (a1) (a2), B Whitehead (a2) (a3) and M Rowley (a2) (a4)
Abstract
Aims:

This study aimed to critically review our criteria for elective admission to the paediatric intensive care unit following adenotonsillectomy for obstructive sleep apnoea.

Materials and methods:

We reviewed 122 children electively admitted between 1997 and 2011. During this time, our criteria for admission evolved.

Results:

In these 122 children, the respiratory disturbance index during rapid eye movement sleep ranged from 6 to 159 (mean, 83). Forty-one per cent of the children had a recognised co-morbidity. Nine children required extra intervention, i.e. in addition to re-positioning and/or supplemental oxygen. One child was an unplanned re-admission after discharge from the paediatric intensive care unit. Over the same period, five children required unplanned transfers into the paediatric intensive care unit following adenotonsillectomy for sleep-disordered breathing.

Conclusion:

Based upon these results, we describe our current criteria for elective admission to the paediatric intensive care unit following adenotonsillectomy for severe obstructive sleep apnoea.

Copyright
Corresponding author
Address for correspondence: Conjoint Assoc Professor Paul Walker, Paediatric Otolaryngologist, PO Box 293, New Lambton, NSW, Australia2305 Fax: +61 2 49572960 E-mail: walkerp@pg.com.au
References
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1Walker, P, Whitehead, B, Rowley, M. Criteria for elective admission to the paediatric intensive care unit following adentonsillectomy for severe obstructive sleep apnoea. Anaesth Intensive Care 2004;32:43–6
2Walker, P, Whitehead, B, Rowley, M. Elective admission to PICU after adenotonsillectomy for severe obstructive sleep apnoea. Anaesth Intensive Care 2007;35:453
3Walker, P, Gillies, D. Post-tonsillectomy hemorrhage rates: are they technique-dependent? Otolaryngol Head Neck Surg 2007;136(suppl):S2731
4Walker, P. Pediatric adenoidectomy under vision using suction-diathermy ablation. Laryngoscope 2001;111:2173–7
5Walker, P, Whitehead, B, Gulliver, T. Polysomnographic outcome of adenotonsillectomy for obstructive sleep apnoea in children under 5 years old. Otolaryngol Head Neck Surg 2008;139:83–6
6ASOHNS Online: Indications for Tonsillectomy and Adenotonsillectomy in Children. In: http://www.asohns.org.au/about/POSITION%20PAPER%20-%20Indications%20for%20Tonsillectomy%20and%20Adenotonsillectomy%20in%20Children.pdf/view [3 March 2012]
7McColley, S, April, M, Carroll, J, Naclerio, R, Loughlin, G. Respiratory compromise after adenotonsillectomy in children with obstructive sleep apnea. Arch Otolaryngol Head Neck Surg 1992;118:940–3
8Rosen, GM, Muckle, RP, Mahowald, MW, Goding, GS, Ullevig, C. Postoperative respiratory compromise in children with obstructive sleep apnea syndrome: can it be anticipated? Pediatrics 1994;93:784–8
9Hill, CA, Litvak, A, Canapari, C, Cummings, B, Collins, C, Keamy, DG et al. A pilot study to identify pre- and peri-operative risk factors for airway complications following adenotonsillectomy for treatment of severe pediatric OSA. Int J Pediatr Otorhinolaryngol 2011;75:1385–90
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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