The nasopharyngeal prong airway: An effective post-operative adjunct after adenotonsillectomy for obstructive sleep apnoea in children
| Autor: | C.J. Skilbeck, A.R. Lloyd-Thomas, D.J. Tweedie, David M. Albert |
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| Rok vydání: | 2007 |
| Předmět: |
medicine.medical_specialty
Pediatrics Adolescent medicine.medical_treatment law.invention Adenoidectomy law Nasopharynx Intensive care medicine Humans Post operative Child Intensive care medicine Retrospective Studies Tonsillectomy Sleep Apnea Obstructive business.industry medicine.medical_device Infant General Medicine Intensive care unit Nasopharyngeal airway Treatment Outcome Otorhinolaryngology Child Preschool Pediatrics Perinatology and Child Health Breathing Sleep (system call) Intubation Respiratory Insufficiency Airway business Follow-Up Studies |
| Zdroj: | International Journal of Pediatric Otorhinolaryngology. 71:563-569 |
| ISSN: | 0165-5876 |
| DOI: | 10.1016/j.ijporl.2006.11.026 |
| Popis: | Summary Objectives Obstructive sleep apnoea is a common childhood disorder. Adenotonsillar enlargement is most commonly implicated, with adenotonsillectomy representing an effective treatment in the majority of cases. Such children may develop respiratory compromise post-operatively, sometimes necessitating admission to the intensive care unit. We describe insertion of a nasopharyngeal “prong” airway and evaluate its benefits after adenotonsillectomy for obstructive sleep apnoea and milder forms of sleep-disordered breathing. Methods The prong is easily fashioned from a paediatric endotracheal tube. It is inserted once surgery is complete, remaining in situ overnight. We retrospectively examine its elective use over an 18-month period in selected children considered to be at high risk of post-operative respiratory compromise. Existing practice over the preceding 18-month period is also examined, by way of comparison. Results Forty-three children underwent adenotonsillectomy for sleep-disordered breathing/OSAS in the 18 months prior to introduction of the prong. Ten were considered “high risk” cases: post-operative intensive care beds were pre-booked for these, but none were eventually required. During the subsequent 18 months, 60 children underwent adenotonsillectomy for the same indication. Seventeen “high risk” cases received the prong post-operatively. No intensive care beds were pre-booked and all children were managed safely on the ENT ward, with minimal intervention. Conclusions Use of a nasopharyngeal prong significantly improves the post-operative course of selected children who are at high risk of respiratory compromise after adenotonsillectomy. This largely avoids the need for medical intervention and intensive care admission. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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