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The incidence of postoperative atelectasis following gastrointestinal procedures in pediatric population

Emi Yuki1,2, Sulpicio G Soriano2,3, Miho Shibamura-Fujiogi2,3

  • 1University of Michigan, Ann Arbor, MI, USA.

Perioperative Care and Operating Room Management
|September 8, 2025
PubMed

Insights

Postoperative atelectasis is common in pediatric gastrointestinal surgery patients. Inadequate reversal of neuromuscular blockade significantly increases this risk, highlighting the need for careful management.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Pulmonary Medicine

Background:

  • Postoperative pulmonary complications, such as atelectasis, are frequent after surgery.
  • The occurrence of postoperative atelectasis in pediatric surgical patients requires further delineation.

Purpose of the Study:

  • To determine the incidence of postoperative atelectasis in pediatric patients undergoing gastrointestinal surgery.
  • To identify risk factors associated with postoperative atelectasis in this population.

Main Methods:

  • Electronic medical records of pediatric patients undergoing gastrointestinal surgery (January 2016-September 2019) were reviewed.
  • Postoperative atelectasis was diagnosed via radiographic evidence (X-ray).
  • Logistic regression analysis was employed for risk factor identification.

Main Results:

  • Radiographic evidence of postoperative atelectasis was present in 25.6% of patients.
  • Identified risk factors include lower weight, higher ASA class, emergency surgery, higher peak airway pressure, and lower lung compliance.
  • Lack of neuromuscular relaxant reversal agent use was a significant risk factor (OR 0.421, P < 0.001) in patients who received muscle relaxants.

Conclusions:

  • Postoperative atelectasis is a frequent complication in pediatric gastrointestinal surgery.
  • Adequate reversal of neuromuscular blockade is critical to mitigate the risk of postoperative atelectasis in pediatric patients.
Abstract

Keywords:
AtelectasisNeuromuscular blockadePostoperativeReversal

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