title: Post-operative complications following adenotonsillectomy in children with severe sleep apnea-hypopnea syndrome. Do they need to be admitted to an intensive care unit?
abstract: OBJECTIVE
  In recent years, with the rise of sleep-disordered breathing, we have been seeing more articles related to post-operative complications after adenotonsillectomy in children with sleep apnea-hypopnea syndrome (OSAS), especially in those with severe sleep apnea. The objective of this study was to evaluate post-operative complications in children with severe OSAS compared to children who had adenotonsillectomy for a different reason, and establish whether they needed admission to an intensive care unit or not.
  
  
  METHODS
  All children undergoing adenotonsillectomy in our hospital in the last 5 years were initially included in this study. Complications were analysed with a retrospective review.
  
  
  RESULTS
  Two hundred and twenty nine children admitted for adenotonsillectomy were finally included. In the whole group, complications occurred in 3.5% of children, 2.2% corresponding to respiratory complications. Children with sleep apnea (3.23% vs 1.47%, P=.39) or severe sleep apnea (3.77% vs 1.70%, P=.32) presented a higher incidence of respiratory complications, which was not statistically significant and was far below those published by other authors. All respiratory complications took place in the immediate post-operative period (operating theatre or anaesthesia recovery), with none in the paediatric ward.
  
  
  CONCLUSIONS
  In our population, children who undergo adenotonsillectomy, without any other comorbidities, malformation syndrome or neuromuscular disease, are more than 2 years old and have an immediate postoperative period without incidence, do not need to be systematically admitted to an intensive care unit, even if they present with severe OSAS.
authors.affiliation: Servicio de Pediatría, Unidad Multidisciplinar del Sueño, Fundación Jiménez Díaz, Madrid, España. Electronic address: vevirio@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: del-Río Camacho
authors.affiliation: Servicio de Pediatría, Unidad Multidisciplinar del Sueño, Fundación Jiménez Díaz, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Martínez González
authors.affiliation: Servicio de ORL, Unidad Multidisciplinar del Sueño, Fundación Jiménez Díaz, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Sanabria Brossart
authors.affiliation: Servicio de Pediatría, Unidad Multidisciplinar del Sueño, Fundación Jiménez Díaz, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Gutiérrez Moreno
authors.affiliation: Servicio de Neumología, Unidad Multidisciplinar del Sueño, Fundación Jiménez Díaz, Madrid, España.
authors.forename: T
authors.initials: T
authors.lastname: Gómez García
authors.affiliation: Servicio de Neumología, Unidad Multidisciplinar del Sueño, Fundación Jiménez Díaz, Madrid, España.
authors.forename: F
authors.initials: F
authors.lastname: Troncoso Acevedo
mesh_terms: D000233:Adenoidectomy / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014068:Tonsillectomy / Q000009:adverse effects*
keywords: Adenoamigdalectomía; Adenotonsillectomy; Complicaciones; Complications; Obstructive sleep apnea syndrome; Síndrome de apnea-hipopnea del sueño