Home management of upper airway obstruction in Pierre Robin sequence using a nasopharyngeal airway.
OBJECTIVE
This unit has reported management of infants with Pierre Robin Sequence (PRS) and upper airway obstruction using nasopharyngeal airways and nutritional support until enough growth takes place for the infant to thrive. There was a mean hospital stay of 60 days. This long in-patient stay prompted review of our management protocols and consideration of treatment at home. This paper reports our experience of managing infants with PRS at home using a nasopharyngeal airway and nasogastric feeding tube and reviews whether such management reduces in-patient stay while remaining safe and effective.


METHODS
Retrospective review of cases referred over a 3.5-year period. Comparison is made with the unit's previously published results.


METHODS
Thirteen PRS infants were referred to the West Midlands Regional Cleft service and required transfer to Birmingham Children's Hospital for specialist assessment and airway control.


METHODS
The parents of 12 infants underwent training to manage the airway and feeding tube. Treatment then continued at home.


METHODS
In-patient episode, rate of weight gain, and complication rate were used.


RESULTS
The median hospital stay was 19.5 days compared to 54 days previously. The median rate of weight gain was 34 g/d. There were no complications or readmissions.


CONCLUSIONS
This series demonstrates the revised management protocol followed has reduced in-patient stays and remained effective, with infants continuing to thrive after discharge home, and has a low complication rate.
Anderson
K D
KD
Birmingham Children's Hospital. KDAnderson@doctors.org.uk
Cole
A
A
Chuo
C B
CB
Slator
R
R
D000402:Airway Obstruction / Q000451:nursing / Q000628:therapy*; D002972:Cleft Palate / Q000209:etiology / Q000451:nursing / Q000628:therapy; D004750:Enteral Nutrition / Q000295:instrumentation / Q000379:methods*; D006701:Home Nursing / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007441:Intubation, Gastrointestinal; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay; D010855:Pierre Robin Syndrome / Q000150:complications / Q000451:nursing / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome