Outcomes Using a Postoperative Protocol in Pediatric Single-Stage Laryngotracheal Reconstruction.
The Annals of otology, rhinology, and laryngology
OBJECTIVES: The aim of this study was to evaluate single-stage laryngotracheal reconstruction (ssLTR) outcomes before and after the implementation of a postoperative care protocol in pediatric patients.
METHODS: A case-control study with chart review was conducted at 2 tertiary academic centers from 2010 to 2016. Pediatric patients who underwent ssLTR with a postoperative care protocol were compared with those who did not receive care under this protocol. Data regarding perioperative management were collected and compared using χ
RESULTS: Nineteen patients completed ssLTR after the protocol was initiated, and 26 prior patients were used as control subjects. Planned extubation failed in 9 patients (35%) in the control group compared with 1 patient (5%) in the protocol group (
CONCLUSIONS: The authors propose an intensive care unit protocol that uses a combination of pharmacologic agents to optimally reduce the risk for adverse events that delay time to extubation and thus decannulation. Timely extubation was more likely with the use of this postoperative care protocol using a multidisciplinary approach involving otolaryngologists, pharmacists, intensivists, and anesthesiologists.
Thottam PJ, Gilliland T, Ettinger N, Baijal R, Mehta D. Outcomes Using a Postoperative Protocol in Pediatric Single-Stage Laryngotracheal Reconstruction. Ann Otol Rhinol Laryngol. 2021 Aug;130(8):861-867. doi: 10.1177/0003489419830107. Epub 2019 Feb 15. PMID: 30767561.