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Published on: August 1, 2025
Intensive care experience with sclerotherapy for cervicofacial lymphatic malformations
Hari Ravindranathan1, Jonathan Gillis, David J E Lord
1Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Sydney, Australia.
Summary
Pediatric patients with extensive cervicofacial lymphatic malformations often require intensive care after sclerotherapy. These children may need multiple pediatric intensive care unit (PICU) admissions due to unpredictable respiratory complications.
Area of Science:
- Pediatric surgery
- Vascular anomalies
- Intensive care medicine
Background:
- Cervicofacial lymphatic malformations are congenital vascular anomalies.
- Sclerotherapy is a common treatment modality for lymphatic malformations.
- Complications following sclerotherapy can necessitate intensive care support.
Purpose of the Study:
- To describe the characteristics and outcomes of pediatric patients requiring intensive care after sclerotherapy for cervicofacial lymphatic malformations.
- To identify risk factors and management strategies for these patients.
Main Methods:
- Retrospective review of medical records from January 2004 to November 2006.
- Analysis of five patients admitted to a pediatric intensive care unit (PICU) after sclerotherapy with OK432.
- Inclusion of patients with extensive lesions involving airways, mediastinum, or floor of the mouth.
Main Results:
- Five patients required a total of 13 PICU admissions (ages 4-19 months).
- Nine admissions involved elective intubation and ventilation due to extensive lesions.
- Four urgent admissions were for respiratory distress occurring 3-18 days post-sclerotherapy.
- Mean PICU stay was 7 days, with a total of 93 days.
Conclusions:
- Extensive cervicofacial lymphatic malformations and airway involvement predict the need for multiple PICU admissions.
- Respiratory compromise following sclerotherapy can be unpredictable and life-threatening.
- Performing further sclerotherapy in the PICU for intubated patients may be a safe option.
