Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T16:17:59.807Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  04 September 2012

P Walker ,
B Whitehead  and
M Rowley
P Walker*
Affiliation:
Otolaryngology Department, John Hunter Children's Hospital, New Lambton, Australia School of Medicine, University of Newcastle, New South Wales, Australia
B Whitehead
Affiliation:
School of Medicine, University of Newcastle, New South Wales, Australia Respiratory Medicine Department, John Hunter Children's Hospital, New Lambton, Australia
M Rowley
Affiliation:
School of Medicine, University of Newcastle, New South Wales, Australia Paediatric Intensive Care Unit, John Hunter Children's Hospital, New Lambton, Australia
*
Address for correspondence: Conjoint Assoc Professor Paul Walker, Paediatric Otolaryngologist, PO Box 293, New Lambton, NSW, Australia2305 Fax: +61 2 49572960 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Intensive CarePaediatricTonsillectomyObstructive Sleep Apnea
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Supplement S1 , January 2013 , pp. S26 - S29
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

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;32:43–6CrossRefGoogle Scholar
2Walker, P, Whitehead, B, Rowley, M. Elective admission to PICU after adenotonsillectomy for severe obstructive sleep apnoea. Anaesth Intensive Care 2007;35:453Google ScholarPubMed
3Walker, P, Gillies, D. Post-tonsillectomy hemorrhage rates: are they technique-dependent? Otolaryngol Head Neck Surg 2007;136(suppl):S27–31CrossRefGoogle ScholarPubMed
4Walker, P. Pediatric adenoidectomy under vision using suction-diathermy ablation. Laryngoscope 2001;111:2173–7CrossRefGoogle ScholarPubMed
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;139:83–6CrossRefGoogle ScholarPubMed
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]Google Scholar
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;118:940–3CrossRefGoogle ScholarPubMed
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;93:784–8CrossRefGoogle ScholarPubMed
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;75:1385–90CrossRefGoogle ScholarPubMed