Outcomes intensive care unit placement following pediatric adenotonsillectomy

• Published in: International journal of pediatric otorhinolaryngology 2020-02, Vol.129, p.109736-109736, Article 109736
• Main Authors: Allen, David Z., Worobetz, Noah, Lukens, Jordan, Sheehan, Cameron, Onwuka, Amanda, Dopirak, Ryan M., Chiang, Tendy, Elmaraghy, Charles
• Format: Article
• Language: English
• Subjects: Adenotonsillectomy; Intensive care; Pediatric; Polysomnogram
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2019.109736

Adenotonsillectomy (AT) is the most common surgical procedure for the treatment of sleep related breathing issues in children. While overnight observation in the hospital setting is utilized frequently in children after a AT, ICU setting is commonly used for patients with sleep apnea. This objective of this study is to examine factors associated with the preoperative decision to admit patients to PICU following AT as well as co-morbidities that may justify necessity for higher level of care. This is a retrospective chart review from the years of 2009–2016. All patients who underwent AT for known sleep-related breathing issues at Nationwide Children's Hospital were eligible for inclusion. A complication was defined as an adverse event such as pulmonary edema, re-intubation, or a bleeding event. Respiratory support was defined as utilizing supplementary oxygen for more than one day, positive pressure ventilation, or intubation. Proportions and medians were used to describe the overall rate of complications/complexities in care, and bivariate statistics were used to evaluate the relationship between patient characteristics and outcomes. Similar methods were used to evaluate factors associated with preoperative referral to the PICU. There were 180 patients admitted to hospital in non-ICU setting and 158 patients with a planned PICU stay. The patients with planned PICU stays had higher rates of technological dependence (13% vs. 3%; p = 0.0006), perioperative sleep studies (80% vs. 29%; p