0793 Postoperative Monitoring in Children less than 2 years of Age undergoing Adenotonsillectomy for Obstructive Sleep Apnea

Abstract Introduction To analyze variables associated with postoperative monitoring in children <2 years of age undergoing adenotonsillectomy (T&A) for the management of obstructive sleep apnea (OSA). Methods Retrospective case series of children <2 years of age who underwent T&A for the management of OSA between 1/1/08-6/1/18. Postoperative respiratory complications and hospital course were analyzed to determine higher acuity of monitoring in Intensive Care Unit (ICU) versus observation unit was indicated. Results A total of 69 children were analyzed. Fifty-two (75.4%) patients were male, and their mean age was 18.8 months. Fifty-six (81.2%) children had severe OSA, 6 (8.7%) had moderate OSA, and 7 (10.1%) children had mild OSA. Thirty-seven (53.6%) children were monitored in the ICU; one (2.7%) child was admitted to the ICU directly from the sleep lab, and3 (8.1%) children were intubated. The average Apnea Hypopnea Index (AHI) for those who were intubated was 64.6 events/hour and low SpO2 average was 66.3%, when compared to an average of 36.2 events/hour and 75.5% respectively for the entire group. Three (8.1%) patients needed >2 liters/minute of O2, and 5 (13.5%) had minor O2 requirements. Only 7/32 (21.9%) patients monitored in the observation unit required supplemental O2. Conclusion A greater severity of AHI and low SpO2 nadir were associated with respiratory issues requiring monitoring of children in ICU after T&A for OSA. No specific PSG cut-off values for ICU versus observation unit were noted. Low incidences of respiratory issues were observed, and most children could have been monitored safely outside of the ICU setting. Support (If Any) None