Postoperative acute respiratory insufficiency following adenotonsillectomy in children with neuropathy

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dc.contributor.authorManrique, Dayse [UNIFESP]
dc.contributor.authorSato, Juliana [UNIFESP]
dc.contributor.authorAnastacio, Erika M. [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T13:49:48Z
dc.date.available2016-01-24T13:49:48Z
dc.date.issued2008-05-01
dc.description.abstractObjective: Evaluate the incidence of acute respiratory insufficiency (ARI) in the immediate postoperative period following adenotonsillectomy in children with neurological diseases.Methods: Medical records from all pediatric adenotonsillectomies performed from January 1997 through August 2003 at the Roberto de Abreu Sodre Hospital of the Association for the Welfare of Physically Handicapped Children (AACD) in São Paulo were reviewed. Data were collected for patient age, neurological diagnosis, associated comorbidities, index of respiratory insufficiency in the immediate postoperative period and period of hospitalization.Results: One hundred and nine patients charts had sufficient documentation to be included in this study. of these, 15 (13.7%) developed ARI in the immediate postoperative period. Ages ranged from 1 to 12 years old (average of 5). of the 15 patients that presented ARI, 10 (67%) were intubated in the first 3 h following extubation. the predominant neurological diagnosis was non-progressive chronic encephalopathy, observed in 84 children (77%), and, among that, 14 (17%) presented ARI. Other neurological diagnoses present in this study were Rett syndrome, neuromuscular disease and meningomyelocele. All. of the children that developed ARI presented quadriplegia. Among children that did not develop ARI, the predominant motor pattern was: 28 with quadriplegia, 38 diplegia, 10 hemiplegia, 12 with involuntary movement (choeroathethosis) and six without motor involvement. Children presenting ARI needed mechanical ventilation for an average of 37.87 h (1.5 days) in the intensive care unit. ARI increased the period of hospitalization; these children had an average length of stay of 7 days versus 1.5 days for those that did not develop complications.Conclusion: Children with neurological disorders, especially those with quadriplegic pattern of motor involvement and severe oropharyngeal dysphagia, are at higher risk for respiratory insufficiency in immediate postoperative period of adenotonsillectomy and should be observed in intensive care unit. (C) 2008 Elsevier Ireland Ltd. All rights reserved.en
dc.description.affiliationUniversidade Federal de São Paulo, AACD, BR-04027000 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, EPM, AACD, BR-04027000 São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent587-591
dc.identifierhttp://dx.doi.org/10.1016/j.ijporl.2008.01.005
dc.identifier.citationInternational Journal of Pediatric Otorhinolaryngology. Clare: Elsevier B.V., v. 72, n. 5, p. 587-591, 2008.
dc.identifier.doi10.1016/j.ijporl.2008.01.005
dc.identifier.issn0165-5876
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/30641
dc.identifier.wosWOS:000255321200007
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofInternational Journal of Pediatric Otorhinolaryngology
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.rights.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.subjectrespiratory insufficiencyen
dc.subjecttonsillectomyen
dc.subjectadenoidectomyen
dc.subjectchilden
dc.subjectdeglutition disordersen
dc.subjectbrain diseasesen
dc.titlePostoperative acute respiratory insufficiency following adenotonsillectomy in children with neuropathyen
dc.typeinfo:eu-repo/semantics/article
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