Allen DZ, Worobetz N, Lukens J, et al. - Researchers conducted this retrospective chart review from the years of 2009-2016 to explore factors correlated with the preoperative decision to admit patients to PICU following adenotonsillectomy (AT; most common surgical procedure for the treatment of sleep-related breathing issues in children) and co-morbidities that may justify necessity for higher level of care. Those patients who had AT at Nationwide Children's Hospital for known sleep-related breathing problems are eligible for inclusion. In non-ICU setting, 180 patients were admitted to the hospital and 158 patients with a planned stay of PICU. Patients with planned PICU stays had higher technological dependence rates, perioperative sleep studies, and more severe OSA classifications. Findings suggest that while the preoperative referral program for PICU placement is effective in identifying patients needing higher levels of care, the program places many patients in the PICU who have not used respiratory support, defined as utilizing supplementary oxygen for more than one day, positive pressure ventilation, or intubation, or have complications. Some misalignment was noted between characteristics associated with planned ICU stays and actual complications. It means that patients with specific medical experience should be prepared to receive higher levels of care, not results from their sleep studies.