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Pre-operative overnight pulse oximetry to predict high dependency unit intervention in children undergoing adenotonsillectomy for obstructive sleep apnoea

Published online by Cambridge University Press:  15 April 2014

K A Lightbody ,
A J Kinshuck  and
A J Donne
K A Lightbody*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Chester, UK
A J Kinshuck
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Alder Hey Hospital, Liverpool, UK
A J Donne
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Alder Hey Hospital, Liverpool, UK
*
Address for correspondence: Ms K A Lightbody, Apartment 26, 3 St Paul's Square, Liverpool L3 9RY, UK E-mail: kate.lightbody@gmail.com
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Abstract

Background:

Post-operative high dependency unit beds are often requested for patients undergoing adenotonsillectomy for obstructive sleep apnoea. This study evaluated the utilisation of high dependency unit beds for such cases at our institution, a paediatric tertiary referral centre.

Method:

A retrospective case note review of patients admitted to the high dependency unit following adenotonsillar surgery for obstructive sleep apnoea, over a two-year period, was performed.

Results:

Sixty-six cases were identified. Thirty-nine patients underwent pre-operative overnight pulse oximetry; of these, 30 patients had desaturations noted. Seventeen patients had significant post-operative desaturations. These were predicted in all 11 patients who had undergone pre-operative pulse oximetry. The remaining six had not undergone pre-operative pulse oximetry. Nineteen patients required high dependency unit care; eight had experienced post-operative desaturations.

Conclusion:

High dependency unit care may be required following adenotonsillectomy for obstructive sleep apnoea. In this study, pre-operative overnight pulse oximetry had 100 per cent sensitivity in predicting post-operative desaturations, and may therefore aid the appropriate utilisation of high dependency unit beds for patients undergoing adenotonsillectomy for obstructive sleep apnoea.

Keywords

Obstructive Sleep ApneaAdenoidectomyTonsillectomyMonitoring, SleepPulse OximetryIntensive Care, Surgical
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 4 , April 2014 , pp. 360 - 364
Copyright
Copyright © JLO (1984) Limited 2014 

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