Pediatrics Commons^™

Aberrantly Low Stat3 And Stat5 Responses Are Associated With Poor Outcome And An Inflammatory Gene Expression Signature In Pediatric Acute Myeloid Leukemia., P Narayanan, T-K Man, R B Gerbing, R Ries, A M Stevens, Y-C Wang, X Long, A S. Gamis, T Cooper, S Meshinchi, T A Alonzo, M S Redell

Manuscripts, Articles, Book Chapters and Other Papers

The relapse rate for children with acute myeloid leukemia is nearly 40% despite aggressive chemotherapy and often stem cell transplant. We sought to understand how environment-induced signaling responses are associated with clinical response to treatment. We previously reported that patients whose AML cells showed low G-CSF-induced STAT3 activation had inferior event-free survival compared to patients with stronger STAT3 responses. Here, we expanded the paradigm to evaluate multiple signaling parameters induced by a more physiological stimulus. We measured STAT3, STAT5 and ERK1/2 responses to G-CSF and to stromal cell-conditioned medium for 113 patients enrolled on COG trials AAML03P1 and AAML0531. Low …

Descriptive Study Of The Safety Behaviors And Attitudes Of Portable Pool Owners, Kristyn Jeffries, Kathy W. Monroe, Alicia Webb, Kristin L. Chancellor, Justina C. Goldman, David C. Schwebel

Posters

Background Drowning is the leading cause of injury death for children 1-4 years old and the second leading cause for children 5-9 years old. Most prior epidemiology work has focused on submersions in below-ground swimming pools and natural bodies of water. Portable pools pose a new and emerging risk for drowning due to their affordability, convenience, and easy assembly. Successful drowning prevention consumer products, such as 4-sided fencing, may prove more difficult to implement with portable pools, and currently are not marketed for such use. Furthermore, parental perceptions and knowledge of drowning risks associated with portable pools has not yet …

Pharmacogenetic Testing In Patients With Autism Spectrum Disorder Evaluated In A Pediatric Precision Medicine Clinic, Rachel Goodson, Cy Nadler, Jennifer A. Wagner, Sarah Soden, Sarah Nyp, Tracy L. Sandritter

Posters

Pharmacogenetic Testing In Patients with Autism Spectrum Disorder Evaluated in a Pediatric Precision Medicine Clinic Purpose The purpose of this study is to investigate the demographic and presentation profiles of children with autism spectrum disorder (ASD) who present for evaluation in a pediatric precision medicine clinic. Methods: This retrospective, observational cohort study utilized data extracted from a pediatric precision medicine clinic database between 2010 and 2021 with recorded ICD9/10 codes of Autism Spectrum Disorder, Autistic Disorder, Pervasive Developmental Disorder, or Asperger’s Syndrome. Extracted variables included demographic data, presenting medication regimens and concerns to be addressed by precision medicine. Results: A …

A Proposal For Developing Academic Partnerships Between American Clinical Institutions And Ngos, Anik Patel, Nahreen Ahmed, Alfredo Mena Lora, Riley Jones

Posters

"Humanitarian and health-focused non-governmental organizations, such as MedGlobal, and American clinical institutions can mutually benefit from the formation of academic partnerships. MedGlobal has a longitudinal presence in ongoing humanitarian disasters that can provide rich clinical experiences for academic institutions looking to provide more diverse and equity-driven training for its residents and fellows. American institutions can provide resources, personnel with special skills and knowledge, as well as research assistance to MedGlobal and its partner sites as it continues to promote evidence-based clinical care for refugees. We propose an innovative model that addresses 3 areas of opportunities: education, research/QI, and clinical care. …

Severe Hypertriglyceridemia: Care For The Non-Diabetic Patient, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Gastric Sleeve Eras - Use Of Transverse Abdominal Plane (Tap) Blocks And Reduction Of Pain In Laparoscopic Gastric Bypass Patient, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Data-Driven Clustering Identifies Features Distinguishing Multisystem Inflammatory Syndrome From Acute Covid-19 In Children And Adolescents., Alon Geva, Manish M. Patel, Margaret M. Newhams, Cameron C. Young, Mary Beth F. Son, Michele Kong, Aline B. Maddux, Mark W. Hall, Becky J. Riggs, Aalok R. Singh, John S. Giuliano, Charlotte V. Hobbs, Laura L. Loftis, Gwenn E. Mclaughlin, Stephanie P. Schwartz, Jennifer E. Schuster, Christopher J. Babbitt, Natasha B. Halasa, Shira J. Gertz, Sule Doymaz, Janet R. Hume, Tamara T. Bradford, Katherine Irby, Christopher L. Carroll, John K. Mcguire, Keiko M. Tarquinio, Courtney M. Rowan, Elizabeth H. Mack, Natalie Z. Cvijanovich, Julie C. Fitzgerald, Philip C. Spinella, Mary A. Staat, Katharine N. Clouser, Vijaya L. Soma, Heda Dapul, Mia Maamari, Cindy Bowens, Kevin M. Havlin, Peter M. Mourani, Sabrina M. Heidemann, Steven M. Horwitz, Leora R. Feldstein, Mark W. Tenforde, Jane W. Newburger, Kenneth D. Mandl, Adrienne G. Randolph, Overcoming Covid-19 Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Background: Multisystem inflammatory syndrome in children (MIS-C) consensus criteria were designed for maximal sensitivity and therefore capture patients with acute COVID-19 pneumonia.

Methods: We performed unsupervised clustering on data from 1,526 patients (684 labeled MIS-C by clinicians)clusters, followed by recursive feature elimination to identify characteristics of potentially misclassified MIS-C-labeled patients.

Findings: Of 94 clinical features tested, 46 were retained for clustering. Cluster 1 patients (N = 498; 92% labeled MIS-C) were mostly previously healthy (71%), with mean age 7·2 ± 0·4 years, predominant cardiovascular (77%) and/or mucocutaneous (82%) involvement, high inflammatory biomarkers, and mostly SARS-CoV-2 PCR negative (60%). Cluster …

Initiative To Increase The Rate Of Emergency Department Physician Preprocedure Time-Out Documentation., Arjun Sarin, Nikita Sharma, Shobhit Jain

Manuscripts, Articles, Book Chapters and Other Papers

The preprocedure time-out is an important safety measure to verify patient identity and accuracy of a planned procedure. The time-out is an institutional and Joint Commission requirement. However, physicians in our emergency departments (EDs) document it inconsistently. We aimed to improve physician preprocedure time-out documentation for deep sedation (ketamine and/or propofol) from 75% to 90%, and separately for cutaneous abscess incision and drainage (I&D) from 94% to 98% by June 2020.

Methods: We analyzed 1 year of baseline data and weekly electronic medical record (EMR) reports from November 2019 through June 2020. Our outcome measures were the rate of physician …

Brief Musculoskeletal Screen And Patient Education For Down Syndrome-Associated Arthritis., Jordan T. Jones, Chelsey Smith, Nasreen Talib

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Improving Skin And Soft Tissue Antibiotic Duration Concordance With National Guidelines In Pediatric Urgent Care Clinics, Megan Hamner, Amanda Nedved, Holly Austin, Donna Wyly, Alaina N. Burns, Diana King, Brian Lee, Rana El Feghaly

Posters

Introduction: Skin and soft tissue infections (SSTIs) are the second most common diagnosis leading to pediatric antibiotic prescriptions in the outpatient setting after respiratory diagnoses. Children with SSTIs often receive >7 days of antibiotics, although current guidelines recommend 5-7 days for most diagnoses. At CMH urgent care clinics (UCCs), only 58% patients received the recommended 5-7 days of antibiotics. We aimed to increase the percentage of patients receiving 5-7 days of oral antibiotics for SSTIs from 58% to 75% by December 31st, 2021. Methods: We formed a multidisciplinary team in April 2020. A provider survey assessed factors influencing prescribing habits. …

Reconsidering Perioperative Antibiotic Use In Elective Laparoscopic Cholecystectomy, Kayla B. Briggs, James Fraser, Wendy Jo Svetanoff, Charles L. Snyder, Pablo Aguayo, David Juang, Rebecca M. Rentea, Jason D. Fraser, Shawn D. St. Peter Md, Tolulope A. Oyetunji

Posters

Introduction: Prophylactic preoperative antibiotics (PPA) are questionable in cases with a low rate of surgical site infection (SSI). We report institutional PPA usage and SSI rates after elective laparoscopic cholecystectomy in a children’s hospital. Methods: Children <18 years old who underwent outpatient laparoscopic cholecystectomy between 7/2010 and 8/2020 were included. SSI was defined as clinical signs of infection, requiring antibiotics, within 30 days of surgery. Results: 502 patients met inclusion criteria; 50% were pre-operatively diagnosed with symptomatic cholelithiasis, 47% biliary dyskinesia, 2% hyperkinetic gallbladder, and 1% gallbladder polyp(s). The majority were female (78%) and Caucasian (80%). 60% (n=301) of patients received PPA while 40% (n=201) did not; 1.3% (n=4) of those who received PPA developed SSI compared to 5.5% (n=11) of those who did not (p=0.01). Though PPA use was associated with an 84% reduction in risk of SSI on multivariate analysis (p=0.01), all SSIs were superficial. One child required readmission for intravenous antibiotics while the remainder were treated with outpatient antibiotics. Gender, age, BMI, ethnicity, and preoperative diagnosis did not influence the likelihood of receiving PPA (Table 1). Conclusion: Given the relatively low morbidity of the superficial SSI, conservative use of PPA should be carefully considered in outpatient laparoscopic cholecystectomy to avoid contributing to antibiotic-related complications.

Mortality In Children Treated With Maintenance Peritoneal Dialysis: Findings From The International Pediatric Peritoneal Dialysis Network Registry., Sophie Ploos Van Amstel, Marlies Noordzij, Dagmara Borzych-Duzalka, Nicholas C. Chesnaye, Hong Xu, Lesley Rees, Il-Soo Ha, Zenaida L. Antonio, Nakysa Hooman, William Wong, Karel Vondrak, Yok Chin Yap, Hiren Patel, Maria Szczepanska, Sara Testa, Monica Galanti, Jameela A. Kari, Charlotte Samaille, Sevcan A. Bakkaloglu, Wai-Ming Lai, Luisa Fernanda Rojas, Mabel Sandoval Diaz, Biswanath Basu, Alicia Neu, Bradley A. Warady, Kitty J. Jager, Franz Schaefer

Manuscripts, Articles, Book Chapters and Other Papers

RATIONALE & OBJECTIVE: Research on pediatric kidney replacement therapy (KRT) has primarily focused on Europe and North America. In this study, we describe the mortality risk of children treated with maintenance peritoneal dialysis (MPD) in different parts of the world and characterize the associated demographic and macroeconomic factors.

STUDY DESIGN: Prospective cohort study.

SETTING & PARTICIPANTS: Patients younger than 19 years at inclusion into the International Pediatric Peritoneal Dialysis Network registry, who initiated MPD between 1996 and 2017.

EXPOSURE: Region as primary exposure (Asia, Western Europe, Eastern Europe, Latin America, North America, and Oceania). Other demographic, clinical, and macroeconomic (4 …

Umbilical Access In Laparoscopic Surgery In Infants Less Than 3 Months: Single Institution Retrospective Review, James Fraser, Kayla B. Briggs, Wendy Jo Svetanoff, Rebecca M. Rentea, Pablo Aguayo, David Juang, Jason D. Fraser, Charles L. Snyder, Richard J. Hendrickson, Shawn D. St Peter, Tolulope A. Oyetunji

Presentations

PURPOSE: Umbilical access in laparoscopic surgery has been cited as a potential factor for increased complications in low birth weight infants and those less than three months old. Previous series noted a self-reported complication rate of 10.6% among 329 pediatric surgeons via anonymous survey, citing carbon dioxide (CO2) embolism as the most common complication. We report four-year outcomes with blunt transumbilical laparoscopic access to examine the safety of this technique. METHODS: Following IRB approval, a retrospective database of patients less than three months of age who underwent laparoscopic pyloromyotomy or inguinal hernia repair from 2016-2019 at a tertiary care academic …

Pulmonary Embolism, Intermediate/High Risk, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Care Process Models)

No abstract provided.

Gastric Sleeve Eras - Ketorolac In Gastric Bypass Patients And Risk Of Bleeding, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Are Body Surface Area Based Estimates Of Liver Volume Applicable To Children With Overweight Or Obesity? An In Vivo Validation Study., Chelsea Hosey-Cojocari, Sherwin S. Chan, Chance S. Friesen, Amie L. Robinson, Veronica Williams, Erica Swanson, Daniel O'Toole, Jansynn Radford, Neil J. Mardis, Trevor N. Johnson, J Steven Leeder, Valentina Shakhnovich

Manuscripts, Articles, Book Chapters and Other Papers

The liver is the primary organ responsible for clearing most drugs from the body and thus determines systemic drug concentrations over time. Drug clearance by the liver appears to be directly related to organ size. In children, organ size changes as children age and grow. Liver volume has been correlated with body surface area (BSA) in healthy children and adults and has been estimated by functions of BSA. However, these relationships were derived from "typical" populations and it is unknown whether they extend to estimations of liver volumes for population "outliers," such as children with overweight or obesity, who today …

Identifying The Content And Context Of Pain Within Paediatric Rheumatology Healthcare Professional Curricula In The Uk: A Summative Content Analysis., Rebecca Rachael Lee, Janet E. Mcdonagh, Mark Connelly, Sarah Peters, Lis Cordingley

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The curriculum for professionals working in paediatric rheumatology should include pain but it is unclear to what extent this currently occurs. The aim of this study was to identify pain-related curriculum content and the context in which pain is presented in educational and training documentation for healthcare professionals in this clinical speciality.

METHODS: Core curricula documents from UK based professional organisations were identified in partnership with healthcare professionals. Documents were analysed using a summative content analysis approach. Key pain terms were quantified and weighted frequencies were used to explore narrative pain themes. Latent content was interpreted qualitatively to explore …

Rumination Syndrome In Children And Adolescents: A Mini Review., Marc Martinez, Sandeep Rathod, Hunter J. Friesen, John Rosen, Craig A. Friesen, Jennifer Verrill Schurman

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: Rumination syndrome involves recurrent regurgitation of food and is believed to be underdiagnosed with patients experiencing long delays in diagnosis. It can be associated with significant social consequences, high rates of school absenteeism, and medical complications such as weight loss. The primary aims of the current review are to assess the literature regarding prevalence, pathophysiology, and treatment outcomes with a focus on neurotypical children and adolescents.

Results: Population studies in children/adolescents, 5 years of age or older, range from 0 to 5.1%. There are fewer studies in clinical settings, but the prevalence appears to be higher in patients with …

Ability Of Video Telemetry To Predict Unplanned Hospital Admissions For Single Ventricle Infants., Doaa Aly, Lori Erickson, Hayley S. Hancock, Johnathan Apperson, Monica Gaddis, Girish S. Shirali, Suma Goudar

Manuscripts, Articles, Book Chapters and Other Papers

Background: Our Cardiac High Acuity Monitoring Program (CHAMP) uses home video telemetry (HVT) as an adjunct to monitor infants with single ventricle during the interstage period. This study describes the development of an objective early warning score using HVT, for identification of infants with single ventricle at risk for clinical deterioration and unplanned hospital admissions (UHA).

Methods and Results: Six candidate scoring parameters were selected to develop a pragmatic score for routine evaluation of HVT during the interstage period. We evaluated the individual and combined ability of these parameters to predict UHA. All infants with single ventricle monitored at home …

Ventricular Fibrillation Due To A Likely Pathogenic Sos1 Variant: An Unrecognized Etiology Of Infantile Sudden Death?, Christopher Follansbee, Lindsey Malloy-Walton

Manuscripts, Articles, Book Chapters and Other Papers

We present the case of a female infant presenting after a ventricular fibrillation arrest found to have ectopic atrial tachycardia (EAT). Evaluation revealed a likely pathogenic variant in SOS1 not previously reported in affected individuals. SOS1 variants are associated with Noonan syndrome, which belongs to a family of related genetic syndromes affecting the RAS/MAPK signaling pathway. To date, this is the first case reported of a ventricular fibrillation arrest in a patient with a RASopathy-related variant prior to development of the typically associated structural cardiac phenotype and may represent a previously unrecognized etiology of sudden death during infancy.

Atypical Presentation Of Systemic Arthritis In A Toddler With Down Syndrome., Emily Worley, Weijie Li, Jordan T. Jones

Manuscripts, Articles, Book Chapters and Other Papers

Systemic juvenile idiopathic arthritis (sJIA) is a chronic, inflammatory disease of childhood, which is characterized by the combination of arthritis, serositis, daily, high-spiking fevers, and evanescent macular rash and can present with the life-threatening complication of macrophage activation syndrome (MAS). Children with Down syndrome (DS) have complex medical challenges related to abnormalities in their immune system, which can cause a broad spectrum of disease manifestations, which can occur atypically. Children with DS are at increased risk for arthritis and interstitial lung disease (ILD) associated with sJIA that has high mortality. This case report outlines an atypical presentation of sJIA in …

An Update On The Assessment And Management Of Pediatric Abdominal Pain., Craig A. Friesen, Jennifer Colombo, Amanda D. Deacy, Jennifer Verrill Schurman

Manuscripts, Articles, Book Chapters and Other Papers

Chronic abdominal pain is very common in children and adolescent and results in high personal and social costs. Most youth with chronic abdominal pain fulfill criteria for a functional abdominal pain disorder (FAPD) as defined by Rome criteria. These are complex conditions with a wide array of biological, psychological, and social factors contributing to the experience of pain. The purpose of the current review is to provide an overview of the pathophysiology of FAPDs and an up-to-date summary of the literature related to FAPDs in children and adolescents, with additional focus on several areas (eg, diet and probiotics) where patients …

Pooled Safety Analysis Of Tisagenlecleucel In Children And Young Adults With B Cell Acute Lymphoblastic Leukemia., John E. Levine, Stephan A. Grupp, Michael A. Pulsipher, Andrew C. Dietz, Susana Rives, Douglas Myers, Keith August, Michael R. Verneris, Jochen Buechner, Theodore W. Laetsch, Henrique Bittencourt, Andre Baruchel, Michael W. Boyer, Barbara De Moerloose, Muna Qayed, Stella M. Davies, Christine L. Phillips, Timothy A. Driscoll, Peter Bader, Krysta Schlis, Patricia A. Wood, Rajen Mody, Lan Yi, Mimi Leung, Lamis K. Eldjerou, Carl H. June, Shannon L. Maude

Manuscripts, Articles, Book Chapters and Other Papers

Background: Tisagenlecleucel, an anti-CD19 chimeric antigen receptor T cell therapy, has demonstrated efficacy in children and young adults with relapsed/refractory B cell acute lymphoblastic leukemia (B-ALL) in two multicenter phase 2 trials (ClinicalTrials.gov, NCT02435849 (ELIANA) and NCT02228096 (ENSIGN)), leading to commercialization of tisagenlecleucel for the treatment of patients up to age 25 years with B-ALL that is refractory or in second or greater relapse.

Methods: A pooled analysis of 137 patients from these trials (ELIANA: n=79; ENSIGN: n=58) was performed to provide a comprehensive safety profile for tisagenlecleucel.

Results: Grade 3/4 tisagenlecleucel-related adverse events (AEs) were reported in 77% of …

Effect Of Low Lactose Formula On The Short-Term Outcomes Of Neonatal Abstinence Syndrome: A Systematic Review., Mahdi Alsaleem, Jarrod Dusin, Gangaram Akangire

Manuscripts, Articles, Book Chapters and Other Papers

The use of low lactose formula (LLF) in term and near-term infants in infants with neonatal abstinence syndrome (NAS) has been increasing recently. However, the clinical evidence of such use is limited. Our aim in this paper was to systematically review the current literature about the use of LLF in infants with NAS. We searched PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Database of Systematic Reviews for articles published between 2015 and 2020. Only randomized controlled trials, prospective, and retrospective studies. The risk of bias was assessed by using published tools appropriate for the study …

Pharmacoepidemiology Of Drug Exposure In Intubated And Non-Intubated Preterm Infants With Severe Bronchopulmonary Dysplasia., Tamorah R. Lewis, William E Truog, L Nelin, N Napolitano, R L Mckinney

Manuscripts, Articles, Book Chapters and Other Papers

Background: Infants with severe bronchopulmonary dysplasia (BPD) are commonly treated with off-label drugs due to lack of approved therapies. To prioritize drugs for rigorous efficacy and safety testing, it is important to describe exposure patterns in this population.

Objective: Our objective was to compare rates of drug exposure between preterm infants with severe bronchopulmonary dysplasia based on respiratory support status at or beyond 36 weeks post-menstrual age.

Methods: A cross-sectional cohort study was performed on October 29, 2019. Preterm infants with severe BPD were eligible and details of respiratory support and drug therapy were recorded. Wilcoxon paired signed rank test …

Momhealth: A Feasibility Study Of A Multibehavioral Health Intervention For Pregnant And Parenting Adolescent Mothers., Karen A. Wambach, Ann M. Davis, Eve Lynn Nelson, Kelli Snow, Annie Yungmeyer, Rachel Muzzy, Karman Romero, Megan Murray

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: In 2016, 209,809 babies were born to mothers 15 - 19 years of age, for a live birth rate of 20.3 per 1,000 in this age group. Many health issues surround adolescent mothers and their infants, many of which can be addressed through behavioral change. The main purpose of this study was to examine the feasibility, acceptability, usability, and relevance of momHealth, an innovative multiple health behavior change (MHBC) education and support mHealth intervention, focused on breastfeeding, healthy eating and active living, and depression prevention among pregnant and parenting adolescents. We also evaluated the proposed online surveys and physical …

Survey Of Telemedicine By Pediatric Nephrologists During The Covid-19 Pandemic., Rupesh Raina, Nikhil Nair, Hui Kim Yap, Guido Filler, Sidharth K. Sethi, Arvind Bagga, Pankaj Hari, Timothy Bunchman, Sharon Bartosh, Katherine Twombley, Gaurav Kapur, Mignon Mcculloch, Bradley A. Warady, Maria Díaz-González De Ferris, Sarah Rush

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: The slow increase in use of telemedicine began to expand rapidly, along with reimbursement changes, during the coronavirus disease-2019 (COVID-19) pandemic. Standardized protocols for these services are lacking but are needed for effective and equitable health care. In this study, we queried pediatric nephrologists and their patients about their telemedicine experiences during the pandemic.

Methods: Surveys that were in compliance with the Health Insurance Portability and Accountability Act were deployed online to patients and physicians.

Results: We collected survey responses from 400 patients and 197 pediatric nephrologists. Patients reported positive experiences with telemedicine visits as it was logistically easier …

2021-2022 Pediatric Subspecialty Trainees, Children's Mercy Hospital

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in adolescent medicine, advance non-invasive imaging, allergy/immunology, child abuse pediatrics, child neurology, coagulation, congenital cardiac surgery, clinical child psychology, developmental-behavioral pediatrics, epilepsy, headache medicine, hospice & palliative care, laboratory genetics & genomics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric bioethics, pediatric cardiology, pediatric clinical pharmacology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric EM/child abuse, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric ophthalmology; pediatric optometry, pediatric orthopedic surgery, pediatric otolaryngology, pediatric pulmonology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, sleep medicine, pharmacy, pediatric residency …

Asthma Exacerbation Cpg -Albuterol Via Metered Dose Inhaler Dosing (Weight-Based Vs. Age-Based Dosing), Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Update On The Safety Of Anesthesia In Young Children Presenting For Adenotonsillectomy., Stephanie R. Mcguire, Nichole M. Doyle

Manuscripts, Articles, Book Chapters and Other Papers

Tonsillectomy with and without adenoidectomy is a frequently performed surgical procedure in children. Although a common procedure, it is not without significant risk. It is critical for anesthesiologists to consider preoperative, intraoperative, and postoperative patient factors and events to optimize safety, especially in young children. In the majority of cases, the indication for adenotonsillectomy in young children is obstructive breathing. Preoperative evaluation for patient comorbidities, especially obstructive sleep apnea, risk factors for a difficult airway, and history of recent illness are crucial to prepare the patient for surgery and develop an anesthetic plan. Communication and collaboration with the otolaryngologist is …