{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:17:30Z","timestamp":1759335450598},"reference-count":25,"publisher":"Royal College of Surgeons of England","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p> The aim of this study was to identify the proportion of children referred to a paediatric tertiary referral centre who required admission to the paediatric intensive care unit (PICU) following surgery for obstructive sleep apnoea (OSA) and to establish risk factors for these admissions. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Retrospective review of case notes and the operative database was performed for all children undergoing adenotonsillectomy for sleep disordered breathing and OSA symptoms in Great Ormond Street Hospital over a 10-year period. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Overall, 1,328 children underwent adenotonsillectomy for sleep disordered breathing and OSA. The mean age was 3.1 years (standard deviation [SD]: 1.7 years). A total of 37 (2.8%) were admitted to the PICU postoperatively (mean length of PICU stay: 1.2 days, standard deviation [SD]: 0.6 days) and 282 (21.2%) required nasopharyngeal airway (nasal prong) insertion intraoperatively. The mean length of stay on the ward following surgery was 1.4 days (SD: 0.8 days). Patients with severe OSA (apnoea\u2013hypopnoea index [AHI] &gt;10) and ASA (American Society of Anesthesiologists) grade\u00a0\u22653 were more likely to require postoperative PICU admission (22\/37 vs 381\/1,291 [p&lt;0.001] and 29\/37 vs 660\/1,291 [p=0.001] respectively). Severe OSA was also more common in children who required nasal prong insertion intraoperatively (186\/282 vs 217\/1,046, p&lt;0.001). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Very few children referred to a paediatric tertiary referral centre actually require PICU admission following surgery. This may be in part due to the use of a nasopharyngeal airway in patients where postoperative obstruction is anticipated. In children with severe OSA (AHI &gt;10) and an ASA grade of \u22653, nasopharyngeal airway insertion and potential admission to the PICU should be considered. <\/jats:p><\/jats:sec>","DOI":"10.1308\/rcsann.2017.0185","type":"journal-article","created":{"date-parts":[[2017,10,19]],"date-time":"2017-10-19T08:51:01Z","timestamp":1508403061000},"page":"67-71","source":"Crossref","is-referenced-by-count":5,"title":["Analysis of intensive care admissions among paediatric obstructive sleep apnoea referrals"],"prefix":"10.1308","volume":"100","author":[{"given":"SD","family":"Sharma","sequence":"first","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"Gupta","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Wyatt","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Albert","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Hartley","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital for Children NHS Foundation Trust, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"171","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-5231(03)00024-8"},{"key":"bib2","first-page":"866","volume":"153","year":"1995","journal-title":"Am J Respir Crit Care Med"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215115001814"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.1112"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet371"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1308\/003588415X14181254790248"},{"key":"bib7","first-page":"CD011165","volume":"10","author":"Venekamp RP","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1590\/S1806-37132015000004415"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1308\/003588409X432239"},{"key":"bib10","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1671"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12278"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.02.048"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2011.07.035"},{"key":"bib14","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200202000-00015"},{"key":"bib15","unstructured":"Royal College of Anaesthetists. 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