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Predictors for routine admission to paediatric intensive care for post-supraglottoplasty laryngomalacia patients

Published online by Cambridge University Press:  17 May 2017

S Chan ,
G Siou ,
A Welch  and
S Powell
S Chan*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK
G Siou
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK
A Welch
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK
S Powell
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK
*
Address for correspondence: Mr Samuel Chan, Dept of Otolaryngology Head and Neck Surgery, Freeman Hospital, Freeman Rd, High Heaton, Newcastle upon Tyne NE7 7DN, UK E-mail: Samuel.chan3@nhs.net
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Abstract

Objectives:

Supraglottoplasty for the treatment of laryngomalacia has little current evidence regarding post-operative care. Our study aimed to: (1) retrospectively assess what proportion of patients required paediatric intensive care unit level of care; (2) identify pre-operative predictive factors common to these cases; and (3) report patient outcomes at six weeks’ follow up.

Methods:

A 10-year retrospective case series analysis was conducted of all patients diagnosed with laryngomalacia and subsequently treated with supraglottoplasty. Paediatric intensive care unit level of care was defined as the need for intubation or tracheostomy, positive pressure ventilation, multiple doses of nebulised adrenaline, and oxygen dependency beyond 12 hours.

Results:

Forty-two patients (19 males, 23 females) were identified; 28.5 per cent of cases met our criteria for paediatric intensive care unit level of care. A low pre-operative oxygen saturation was the only significant risk factor that predicted a future need for paediatric intensive care unit level of care (p = 0.0008).

Conclusion:

This is the first study published in the UK to suggest the importance of pre-operative oxygen saturation as a predictor of a future need for paediatric intensive care unit level of care.

Keywords

LaryngomalaciaRespiratory SoundsIntensive Care UnitsPediatricsSurgeryLaser
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 7 , July 2017 , pp. 640 - 644
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented orally at the Paediatric Otolaryngology Northern Deanery Meeting, 16 March 2016, sunderland royal hospital, sunderland, UK, and at the European Society of Paediatric Otolaryngology, 18 June 2016, Lisbon, Portugal, and as a poster at the British Association of Paediatric Otolaryngology, 16 September 2016, Liverpool, UK.

References

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