Adverse Respiratory Events After Pediatric Endoscopic Airway Surgeries

Area of Science:

• Pediatric Otolaryngology
• Airway Surgery
• Respiratory Medicine

Background:

• Perioperative risk stratification is vital for pediatric patients undergoing airway interventions.
• Identifying patients at high risk for postoperative intensive care unit (ICU) admission is crucial.

Purpose of the Study:

• To determine the likelihood of perioperative adverse respiratory events (PAREs) requiring ICU care after pediatric endoscopic airway surgeries (EASs).
• To identify risk factors associated with PAREs in pediatric patients undergoing EASs.

Main Methods:

• Retrospective chart review of pediatric patients (<18 years) who underwent EAS between 2015 and 2021.
• Analysis of early postoperative adverse events within 24 hours of surgery.

Main Results:

• 16.2% of 99 pediatric patients experienced PAREs, with 75% occurring within 4 hours post-surgery.
• Univariate analysis indicated subglottic intervention and multi-site laryngeal intervention increased PARE risk.
• Multivariate analysis confirmed subglottic intervention as an independent predictor of PAREs (OR = 6.84).

Conclusions:

• Respiratory adverse events are common following pediatric EAS.
• The majority of PAREs manifest early in the postoperative period.
• Intervention in the subglottic area is a significant independent predictor of PAREs.