Pilot study comparing post-anesthesia care unit length of stay in moderately and severely obese children

2017 ◽  
Vol 31 (4) ◽  
pp. 510-516 ◽  
Author(s):  
Hina Walia ◽  
Onur Balaban ◽  
Megan Jacklen ◽  
Dmitry Tumin ◽  
Vidya Raman ◽  
...  
2020 ◽  
Vol 129 (11) ◽  
pp. 1071-1077
Author(s):  
Dhivyaa Anandan ◽  
Shilin Zhao ◽  
Amy S. Whigham

Objectives: (1) To identify clinical factors and perioperative practices that correlate with longer length of stay (LOS) in the post-anesthesia care unit (PACU) after adenotonsillectomy (T&A) in pediatric populations. (2) To understand the relationship between family presence and PACU LOS for pediatric patients after T&A. Methods: Pediatric patients (ages 3-17) who underwent T&A between February 2016 and December 2016 were retrospectively reviewed. Factors assessed for impact on PACU LOS included BMI, preoperative medications, intraoperative medications/narcotics, postoperative medications/narcotics, method of postoperative medication administration, and family presence in the PACU. Kruskal–Wallis and Spearman tests were used to assess correlations. Statistical significance was set a priori at P < .05. Results: Our cohort included 500 patients. Patients were in the PACU for an average of 135.4 minutes (±65.8). Subset analyses of the type of medications administered intra-operatively and in the PACU show that the intraoperative administration of sedatives is associated with increased LOS ( P = .014). Postoperative administration of any medications ( P < .001), and specifically, postoperative administration of narcotics ( P < .001), analgesics ( P = .043), antihistamines ( P < .001), and dopamine antagonists ( P = .011), are associated with increased LOS. Administration of PACU medications by IV was also correlated with shorter LOS compared to oral administration of PACU medications ( P = .016). A comparison of patients who received PACU medications to those who did not demonstrated that intraoperative administration of acetaminophen was associated with a reduced need for PACU medication administration ( P = .012). Shorter waiting times for family arrival in the PACU was also associated with shorter LOS ( P < .001). Conclusion: Our results suggest that postoperative medication administration and time until family arrival in the PACU are associated with significant differences in LOS. We also find that intraoperative administration of acetaminophen is correlated with reduced need for postoperative medication administration. Standardizing postoperative practices to minimize PACU LOS could result in a more efficient recovery for pediatric patients undergoing T&A.


2020 ◽  
Vol 48 (1) ◽  
pp. 462-462
Author(s):  
Stephanie Lombardi ◽  
Matthew Morrison ◽  
William Baker ◽  
Spencer Martin

2017 ◽  
Vol 32 (4) ◽  
pp. e52-e53
Author(s):  
Marie Andrea Enriquez ◽  
Amber Bullock ◽  
Maria Clarissa Park

2020 ◽  
pp. 175114372090970
Author(s):  
Anwar Hassan ◽  
Maree Milross ◽  
William Lai ◽  
Deepa Shetty ◽  
Jennifer Alison ◽  
...  

Background Intrapulmonary percussive ventilation is used in various clinical settings to promote secretion clearance, reverse or treat atelectasis and improve gas exchange. Despite a few studies reporting the use of intrapulmonary percussive ventilation in critical care, the available data remain insufficient, contributing to weaker evidence toward its effectiveness. Also, there is a paucity of studies evaluating the safety and feasibility of intrapulmonary percussive ventilation application in critical care. This retrospective pilot study has evaluated the safety and feasibility of intrapulmonary percussive ventilation intervention in non-intubated patients admitted to an intensive care unit. Methods The medical records of 35 subjects were reviewed, including 22 subjects who received intrapulmonary percussive ventilation intervention and 13 subjects matched for age, sex, and primary diagnosis who received chest physiotherapy. The records were audited for feasibility, safety, changes in oxygen saturation, chest X-ray changes, and intensive care unit length of stay. Results A total of 104 treatment sessions (IPV 65 and CPT 39) were delivered to subjects admitted with a range of respiratory conditions in critical care. Subjects completed 97% of IPV sessions. No major adverse events were reported with intrapulmonary percussive ventilation intervention. Intensive care unit length of stay in the intrapulmonary percussive ventilation group was 9.6 ± 6 days, and in the CPT group, it was 11 ± 9 days ( p = 0.59). Peripheral oxygen saturation pre to post intervention was 92% ± 4 to 96% ± 4 in IPV group and 95% ± 4 to 95% ± 3 in the CPT group. Conclusion Application of intrapulmonary percussive ventilation intervention was feasible and safe in non-ventilated adult patients in critical care.


2021 ◽  
Vol 36 (4) ◽  
pp. e13
Author(s):  
Team Leader: Eileen Latwis Viellette ◽  
Team Members: Barbara Gonzalez ◽  
Jacqueline Smith Irwin ◽  
Ishoma John Peters

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