Article
Do children with obstructive sleep disorders need postoperative ICU monitoring after adenotomy, adenotonsillectomy or tonsillotomy?
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Authors
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Franziska Wagner
- Department of Otolaryngology, Head and Neck Surgery University of Leipzig, Leipzig, Germany
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Jens Kluge
- Department of Pediatrics University of Leipzig, Leipzig, Germany
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Andreas Merkenschlager
- Department of Pediatrics University of Leipzig, Leipzig, Germany
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Andreas Dietz
- Department of Otolaryngology, Head and Neck Surgery University of Leipzig, Leipzig, Germany
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Milos Fischer
- Department of Otolaryngology, Head and Neck Surgery University of Leipzig, Leipzig, Germany
| Published: | September 7, 2016 |
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Outline
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Introduction: Children with obstructive sleep disorder (OSD) due to adenotonsillar hypertrophy increasingly need surgical treatment. Prevalence of OSD in pre-school aged children is estimated as up to 10% and children suffering from OSD are predisposed to postoperative respiratory complications.
Methods: We retrospectly analysed the charts of 94 children (06/2012–09/2015), who had diagnosed or suspected OSD and underwent a therapy of either adenotomy, adenotonsillectomy or tonsillotomy with postoperative monitoring at our pediatric intensive care unit (ICU). Particularly, events of respiratory complications as well as necessity of postoperative respiratory support were observed.
Results: 83 children were scheduled for postoperative ICU observation but 11 children were refered to the pediatric ICU as unscheduled observations, respectively. 10 of 11 unscheduled transfers (91%) showed respiratory problems in the recovery room (respiratory insufficiency caused by upper airway obstruction due to swelling or unknown desaturations). 20 children presented persistent apnoeas, desaturations oder hypoxia during their postoperative course at ICU. Of them 14 children (70%) suffered from severe OSD which was proven by polysomnography preoperatively.
Conclusion: The occurrence of postoperative desaturations should not be underestimated in children with OSD. There is crucial importance of the early postoperative phase in the postoperative monitoring. We recommend a scheduled postoperative monitoring at a pediatric ICU for children suffering from moderate or severe OSD.
