Pre-operative parameters do not reliably identify post-operative respiratory risk in children undergoing adenotonsillectomy

Thavagnanam, Surendran and Cheong, Saou Yinn and Chinna, Karuthan and Nathan, Anna Marie and De Bruyne, Jessie Anne (2017) Pre-operative parameters do not reliably identify post-operative respiratory risk in children undergoing adenotonsillectomy. Journal of Paediatrics and Child Health, 54 (5). pp. 530-534. ISSN 1034-4810, DOI

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Aim: Adenotonsillectomy is performed in children with recurrent tonsillitis or obstructive sleep apnoea. Children at risk of post-operative respiratory complications are recommended to be monitored in paediatric intensive care unit (PICU). The aim of the study is to review the risk factors for post-operative complications and admissions to PICU. Methods: A review of medical records of children who underwent adenotonsillectomy between January 2011 and December 2014 was performed. Association between demographic variables and post-operative complications were examined using chi-square and Mann–Whitney tests. Results: A total of 214 children were identified, and of these, 19 (8.8%) experienced post-operative complications. Six children (2.8%) had respiratory complications: hypoxaemia in four and laryngospasm requiring reintubation in a further two. Both of the latter patients were extubated upon arrival to PICU and required no escalation of therapy. A total of 13 (6.1%) children had non-respiratory complications: 8 (3.7%) had infection and 5 (2.3%) had haemorrhage. A total of 26 (12.1%) children were electively admitted to PICU and mean stay was 19.5 (SD ± 13) h. No association between demographic characteristics, comorbid conditions or polysomnographic parameters and post-operative complications were noted. A total of 194 (90.7%) children stayed only one night in hospital (median 1 day, range 1–5 days). Conclusion: The previously identified risk factors and criteria for PICU admission need revision, and new recommendations are necessary.

Item Type: Article
Uncontrolled Keywords: Adenotonsillectomy; Complication; Obstructive sleep apnoea; Post-operative
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 25 Feb 2019 07:24
Last Modified: 25 Feb 2019 07:24

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