Intensive care experience with sclerotherapy for cervicofacial lymphatic malformations.
OBJECTIVE
To describe a cohort of patients needing intensive care support after sclerotherapy for cervicofacial lymphatic malformations.


METHODS
Retrospective review of case records of patients undergoing sclerotherapy between January 2004 and November 2006.


METHODS
A tertiary, university-affiliated, pediatric teaching hospital.


METHODS
Five patients needing admission to a pediatric intensive care unit (PICU) following sclerotherapy with OK432.


METHODS
None.


RESULTS
Five patients needed a total of 13 PICU admissions. Ages ranged from 4 months to 19 months. All patients had extensive lesions that involved the airways, mediastinum, or floor of the mouth, documented by magnetic resonance imaging. Nine admissions involved elective intubation and ventilation following sclerotherapy due to the extent of lesions. There were four urgent admissions to the PICU with respiratory distress ranging from 3 to 18 days after sclerotherapy. The mean duration of admission was 7 days (total 93 days, range 2-22 days). Total ventilated hours were 1656 hrs with a range of 16.5-370 hrs per admission. Multiple procedures, such as drainage of cysts and further sclerotherapy procedures, were performed before extubation on the PICU.


CONCLUSIONS
Children with extensive disease and airway involvement need multiple PICU admissions. The potential for life-threatening respiratory embarrassment is unpredictable following sclerotherapy. Consideration should be given to performing further sclerotherapy while the patients are intubated in the PICU. The PICU provides a safe and secure environment for such procedures.
Ravindranathan
Hari
H
Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Sydney, Australia.
Gillis
Jonathan
J
Lord
David J E
DJ
D015331:Cohort Studies; D005145:Face; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D044148:Lymphatic Abnormalities / Q000175:diagnosis / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008485:Medical Audit; D009333:Neck; D010844:Picibanil / Q000627:therapeutic use*; D012189:Retrospective Studies; D015911:Sclerotherapy
D010844:Picibanil