Arambula AM, et al. - Physicians designed this study to identify postoperative respiratory complications following adenotonsillectomy (AT) in children with obstructive sleep apnea (OSA). Furthermore, they characterized variables associated with pediatric intensive care unit (PICU) admission. As per the outcomes, pediatric patients who needed post-AT PICU care had more risk factors for respiratory compromise. Total post-anesthesia care unit (PACU) time and total PACU time requiring supplemental oxygen possibly pointed towards the patient risk for postoperative respiratory complications and requirement of intensive care.

Methods

• The physicians performed this retrospective analysis in 133 pediatric OSA patients with prior AT.
• During this study, assessment of the postoperative hospital course informed patient stratification based on respiratory event severity, PICU admission status, and unscheduled escalation of care.

Results

• The physicians admitted 36 (26.8%) patients to the PICU.
• These patients were significantly younger and with greater preoperative apnea-hypopnea indices, comorbidities, and percentage of post-anesthesia care unit (PACU) time requiring supplemental oxygen compared to non-PICU admissions.
• They noted 71 respiratory events in 59 patients, with 60.6% affecting PICU patients.
• In this study, 15 severe events occurred, affecting 31% of PICU patients.
• They identified 14 unscheduled escalations of care.
• Out of them, 7 were PICU admissions who spent significantly more time in the PACU and exhibited a trend towards greater PACU time on supplemental oxygen compared to planned PICU admissions.