title: Pre-operative overnight pulse oximetry to predict high dependency unit intervention in children undergoing adenotonsillectomy for obstructive sleep apnoea.
abstract: BACKGROUND
  Post-operative high dependency unit beds are often requested for patients undergoing adenotonsillectomy for obstructive sleep apnoea. This study evaluated the utilisation of high dependency unit beds for such cases at our institution, a paediatric tertiary referral centre.
  
  
  METHODS
  A retrospective case note review of patients admitted to the high dependency unit following adenotonsillar surgery for obstructive sleep apnoea, over a two-year period, was performed.
  
  
  RESULTS
  Sixty-six cases were identified. Thirty-nine patients underwent pre-operative overnight pulse oximetry; of these, 30 patients had desaturations noted. Seventeen patients had significant post-operative desaturations. These were predicted in all 11 patients who had undergone pre-operative pulse oximetry. The remaining six had not undergone pre-operative pulse oximetry. Nineteen patients required high dependency unit care; eight had experienced post-operative desaturations.
  
  
  CONCLUSIONS
  High dependency unit care may be required following adenotonsillectomy for obstructive sleep apnoea. In this study, pre-operative overnight pulse oximetry had 100 per cent sensitivity in predicting post-operative desaturations, and may therefore aid the appropriate utilisation of high dependency unit beds for patients undergoing adenotonsillectomy for obstructive sleep apnoea.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Chester, UK.
authors.forename: K A
authors.initials: KA
authors.lastname: Lightbody
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Alder Hey Hospital, Liverpool, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Kinshuck
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Alder Hey Hospital, Liverpool, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Donne
mesh_terms: D006801:Humans; D010092:Oximetry / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000601:surgery; D014068:Tonsillectomy / Q000379:methods; D000233:Adenoidectomy / Q000379:methods; D012189:Retrospective Studies; D002648:Child; D005260:Female; D008297:Male; D002675:Child, Preschool; D011300:Preoperative Care / Q000379:methods; D000293:Adolescent; D011183:Postoperative Complications
keywords: Adenoidectomy; Intensive Care, Surgical; Monitoring, Sleep; Obstructive Sleep Apnea; Pulse Oximetry; Tonsillectomy