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Pre-operative overnight pulse oximetry to predict high dependency unit intervention in children undergoing
K A Lightbody1, A J Kinshuck2, A J Donne2
1Department of Otolaryngology, Head and Neck Surgery, Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Chester, UK.
Insights
Pre-operative overnight pulse oximetry accurately predicts post-operative desaturations in children undergoing adenotonsillectomy for obstructive sleep apnoea. This can help optimize high dependency unit bed use.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Critical Care Medicine
Background:
- Adenotonsillectomy for obstructive sleep apnoea (OSA) often leads to requests for post-operative high dependency unit (HDU) beds.
- Evaluating HDU bed utilization for these patients is crucial in pediatric tertiary care settings.
Purpose of the Study:
- To assess the utilization of HDU beds for patients undergoing adenotonsillectomy for OSA.
- To determine the predictive value of pre-operative overnight pulse oximetry for post-operative desaturations.
Main Methods:
- A retrospective review of patient case notes was conducted.
- Data from patients admitted to the HDU following adenotonsillar surgery for OSA over a two-year period were analyzed.
Main Results:
- Sixty-six cases were reviewed. Of 39 patients with pre-operative pulse oximetry, 30 showed desaturations.
- Seventeen patients experienced significant post-operative desaturations, accurately predicted by pre-operative pulse oximetry in all 11 tested cases.
- Nineteen patients required HDU care, with eight having experienced post-operative desaturations.
Conclusions:
- HDU care is sometimes necessary after adenotonsillectomy for OSA.
- Pre-operative overnight pulse oximetry demonstrated 100% sensitivity in predicting post-operative desaturations, aiding appropriate HDU bed allocation.
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.
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