Unplanned Intensive Care Unit Admission Following Cleft Palate Repair by Head and Neck Surgeons

Area of Science:

• Pediatric surgery
• Craniofacial surgery
• Otolaryngology

Background:

• Cleft palate repair is a common pediatric surgical procedure.
• Postoperative pediatric intensive care unit (PICU) admission rates after cleft palate repair can vary.
• Identifying risk factors for PICU admission is crucial for optimizing patient care.

Purpose of the Study:

• To determine the incidence of PICU admission following primary cleft palate repair performed by otolaryngologist-head and neck surgeons.
• To identify diagnoses associated with PICU admission or unexpected PICU transfer.

Main Methods:

• A multi-institutional case series with chart review was conducted.
• Data from 443 children who underwent primary cleft palate repair between 2009 and 2019 at two tertiary pediatric medical centers were analyzed.
• Demographics, comorbidities, and PICU admission requirements were reviewed.

Main Results:

• The overall PICU admission rate was 9.3% (41/443), including 7.4% planned and 1.8% unexpected transfers.
• Syndromic conditions were found to be associated with both planned and unanticipated PICU admissions.
• The study included 443 children who met inclusion criteria from a cohort of 464 patients.

Conclusions:

• Unanticipated postoperative PICU admission following cleft palate repair by experienced otolaryngologist-head and neck surgeons is infrequent.
• Risk stratification by surgeons skilled in airway management can guide postoperative care decisions for complex patients.
• The low incidence suggests current surgical and postoperative management protocols are effective for most patients.