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O009 Keep The Chin Up: Evidence-based standardised care pathway for infants with Pierre Robin Sequence (PRS)

BACKGROUND: Management of upper airway obstruction in neonates with Pierre Robin Sequence (PRS) is challenging given difficulties in grading severity of disease, difficulties obtaining early polysomnography (PSG) and variable practices with no widely accepted standard protocol. We aimed to develop a...

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Autores principales: Goel, D, Wilson, A, O'Donnell, A, Rao, S, Herbert, H, Pachter, N, Hamden, B, Gillett, D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10109178/
http://dx.doi.org/10.1093/sleepadvances/zpac029.008
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author Goel, D
Wilson, A
O'Donnell, A
Rao, S
Herbert, H
Pachter, N
Hamden, B
Gillett, D
author_facet Goel, D
Wilson, A
O'Donnell, A
Rao, S
Herbert, H
Pachter, N
Hamden, B
Gillett, D
author_sort Goel, D
collection PubMed
description BACKGROUND: Management of upper airway obstruction in neonates with Pierre Robin Sequence (PRS) is challenging given difficulties in grading severity of disease, difficulties obtaining early polysomnography (PSG) and variable practices with no widely accepted standard protocol. We aimed to develop a standardised care pathway for infants with PRS. METHODS: Total 190 publications were identified of which 21 were reviewed in detail. Majority were review articles or retrospective studies. Consultation was obtained from the Complex Airway Team (multidisciplinary team of neonatologist, paediatric sleep specialist, otolaryngologist, plastic surgeon, clinical nurse specialist and speech pathologist), geneticists, audiologists, the consumer group “PRS Australia” and ANZ paediatric sleep physicians. Final recommendations were based on consensus and quality of the evidence. RESULTS: We developed a pathway outlining sequential interventions to manage OSA based on functional assessment by PSG (7-14 day of life) and structural assessment by flexible nasal endoscopy “FNE” (0-7 day of life). Conduct of bedside PSG in NICU instead of sleep lab enables innovative, timely, patient-centred and cost-effective service delivery. We standardised reporting of glossoptosis (Yellon classification), laryngomalacia (Olney et.al) and airway (Seattle DISE scoring) on FNE. Early multidisciplinary involvement, structured assessment of feeding, synchronous airway lesions and associated genetic syndromes is also considered. The pathway allows for standardised management and discharge planning with clearly defined multidisciplinary follow-ups. INTENDED OUTCOME/IMPACT: This project is likely first in Australia to standardise care pathway for infants with PRS encompassing collaborative, innovative and structured care delivery principles. The project provides foundation for future clinical and research collaboration.
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spelling pubmed-101091782023-05-15 O009 Keep The Chin Up: Evidence-based standardised care pathway for infants with Pierre Robin Sequence (PRS) Goel, D Wilson, A O'Donnell, A Rao, S Herbert, H Pachter, N Hamden, B Gillett, D Sleep Adv ORAL PRESENTATIONS BACKGROUND: Management of upper airway obstruction in neonates with Pierre Robin Sequence (PRS) is challenging given difficulties in grading severity of disease, difficulties obtaining early polysomnography (PSG) and variable practices with no widely accepted standard protocol. We aimed to develop a standardised care pathway for infants with PRS. METHODS: Total 190 publications were identified of which 21 were reviewed in detail. Majority were review articles or retrospective studies. Consultation was obtained from the Complex Airway Team (multidisciplinary team of neonatologist, paediatric sleep specialist, otolaryngologist, plastic surgeon, clinical nurse specialist and speech pathologist), geneticists, audiologists, the consumer group “PRS Australia” and ANZ paediatric sleep physicians. Final recommendations were based on consensus and quality of the evidence. RESULTS: We developed a pathway outlining sequential interventions to manage OSA based on functional assessment by PSG (7-14 day of life) and structural assessment by flexible nasal endoscopy “FNE” (0-7 day of life). Conduct of bedside PSG in NICU instead of sleep lab enables innovative, timely, patient-centred and cost-effective service delivery. We standardised reporting of glossoptosis (Yellon classification), laryngomalacia (Olney et.al) and airway (Seattle DISE scoring) on FNE. Early multidisciplinary involvement, structured assessment of feeding, synchronous airway lesions and associated genetic syndromes is also considered. The pathway allows for standardised management and discharge planning with clearly defined multidisciplinary follow-ups. INTENDED OUTCOME/IMPACT: This project is likely first in Australia to standardise care pathway for infants with PRS encompassing collaborative, innovative and structured care delivery principles. The project provides foundation for future clinical and research collaboration. Oxford University Press 2022-11-09 /pmc/articles/PMC10109178/ http://dx.doi.org/10.1093/sleepadvances/zpac029.008 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Sleep Research Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle ORAL PRESENTATIONS
Goel, D
Wilson, A
O'Donnell, A
Rao, S
Herbert, H
Pachter, N
Hamden, B
Gillett, D
O009 Keep The Chin Up: Evidence-based standardised care pathway for infants with Pierre Robin Sequence (PRS)
title O009 Keep The Chin Up: Evidence-based standardised care pathway for infants with Pierre Robin Sequence (PRS)
title_full O009 Keep The Chin Up: Evidence-based standardised care pathway for infants with Pierre Robin Sequence (PRS)
title_fullStr O009 Keep The Chin Up: Evidence-based standardised care pathway for infants with Pierre Robin Sequence (PRS)
title_full_unstemmed O009 Keep The Chin Up: Evidence-based standardised care pathway for infants with Pierre Robin Sequence (PRS)
title_short O009 Keep The Chin Up: Evidence-based standardised care pathway for infants with Pierre Robin Sequence (PRS)
title_sort o009 keep the chin up: evidence-based standardised care pathway for infants with pierre robin sequence (prs)
topic ORAL PRESENTATIONS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10109178/
http://dx.doi.org/10.1093/sleepadvances/zpac029.008
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