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Disposition to pediatric intensive care unit post supraglottoplasty repair: a systematic review

BACKGROUND: Patients undergoing supraglottoplasty are often routinely admitted post-operatively to the pediatric intensive care unit (PICU) due to rare but potentially fatal complications such as airway compromise. A systematic review was performed to determine the rate of post-operative PICU-level...

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Autores principales: Kang, Esther ShinHyun, Turkdogan, Sena, Yeung, Jeffrey C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136380/
https://www.ncbi.nlm.nih.gov/pubmed/37106398
http://dx.doi.org/10.1186/s40463-023-00622-z
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author Kang, Esther ShinHyun
Turkdogan, Sena
Yeung, Jeffrey C.
author_facet Kang, Esther ShinHyun
Turkdogan, Sena
Yeung, Jeffrey C.
author_sort Kang, Esther ShinHyun
collection PubMed
description BACKGROUND: Patients undergoing supraglottoplasty are often routinely admitted post-operatively to the pediatric intensive care unit (PICU) due to rare but potentially fatal complications such as airway compromise. A systematic review was performed to determine the rate of post-operative PICU-level respiratory support required by pediatric patients following supraglottoplasty, to identify risk factors for patients who may benefit from post-operative PICU admission and limit unnecessary use of intensivist resources. REVIEW METHODS: Key search terms ‘supraglottoplasty’ OR ‘supraglottoplasties’ were queried on three databases: CINHAL, Medline and Embase. Inclusion criteria were pediatric patients under 18 years of age who underwent a supraglottoplasty procedure with either an admission to PICU or requirement for PICU-level respiratory support. Risk of bias was assessed by two independent reviewers using QUADAS-2. Findings were critically appraised by three independent reviewers and pooled proportions of criteria meeting PICU admission were calculated for meta-analysis. RESULTS: Nine studies met inclusion criteria, totaling 922 patients. Age at time of surgery ranged from 19 days to 15.7 years with mean age of 5.65 months. A weighted pooled estimate suggested that 19% (95% CI 14–24%) of patients who underwent supraglottoplasty required PICU-admission. The included studies revealed several patient and surgical factors have been linked to postoperative respiratory issues requiring PICU admission, including: neurological disease, perioperative oxygen saturation < 95%, prolonged surgical time and age < 2 months. CONCLUSIONS: This study found that the majority of supraglottoplasty patients do not require significant postoperative respiratory support and suggests that routine PICU admission of these patients may be avoided by careful patient selection. Given the wide heterogeneity of outcome measures, further studies are needed to determine the ideal PICU admission criteria following supraglottoplasty. GRAPHICAL ABSTRACT: [Image: see text]
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spelling pubmed-101363802023-04-28 Disposition to pediatric intensive care unit post supraglottoplasty repair: a systematic review Kang, Esther ShinHyun Turkdogan, Sena Yeung, Jeffrey C. J Otolaryngol Head Neck Surg Review BACKGROUND: Patients undergoing supraglottoplasty are often routinely admitted post-operatively to the pediatric intensive care unit (PICU) due to rare but potentially fatal complications such as airway compromise. A systematic review was performed to determine the rate of post-operative PICU-level respiratory support required by pediatric patients following supraglottoplasty, to identify risk factors for patients who may benefit from post-operative PICU admission and limit unnecessary use of intensivist resources. REVIEW METHODS: Key search terms ‘supraglottoplasty’ OR ‘supraglottoplasties’ were queried on three databases: CINHAL, Medline and Embase. Inclusion criteria were pediatric patients under 18 years of age who underwent a supraglottoplasty procedure with either an admission to PICU or requirement for PICU-level respiratory support. Risk of bias was assessed by two independent reviewers using QUADAS-2. Findings were critically appraised by three independent reviewers and pooled proportions of criteria meeting PICU admission were calculated for meta-analysis. RESULTS: Nine studies met inclusion criteria, totaling 922 patients. Age at time of surgery ranged from 19 days to 15.7 years with mean age of 5.65 months. A weighted pooled estimate suggested that 19% (95% CI 14–24%) of patients who underwent supraglottoplasty required PICU-admission. The included studies revealed several patient and surgical factors have been linked to postoperative respiratory issues requiring PICU admission, including: neurological disease, perioperative oxygen saturation < 95%, prolonged surgical time and age < 2 months. CONCLUSIONS: This study found that the majority of supraglottoplasty patients do not require significant postoperative respiratory support and suggests that routine PICU admission of these patients may be avoided by careful patient selection. Given the wide heterogeneity of outcome measures, further studies are needed to determine the ideal PICU admission criteria following supraglottoplasty. GRAPHICAL ABSTRACT: [Image: see text] BioMed Central 2023-04-27 /pmc/articles/PMC10136380/ /pubmed/37106398 http://dx.doi.org/10.1186/s40463-023-00622-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Review
Kang, Esther ShinHyun
Turkdogan, Sena
Yeung, Jeffrey C.
Disposition to pediatric intensive care unit post supraglottoplasty repair: a systematic review
title Disposition to pediatric intensive care unit post supraglottoplasty repair: a systematic review
title_full Disposition to pediatric intensive care unit post supraglottoplasty repair: a systematic review
title_fullStr Disposition to pediatric intensive care unit post supraglottoplasty repair: a systematic review
title_full_unstemmed Disposition to pediatric intensive care unit post supraglottoplasty repair: a systematic review
title_short Disposition to pediatric intensive care unit post supraglottoplasty repair: a systematic review
title_sort disposition to pediatric intensive care unit post supraglottoplasty repair: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136380/
https://www.ncbi.nlm.nih.gov/pubmed/37106398
http://dx.doi.org/10.1186/s40463-023-00622-z
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