Session/Time	Poster/Thu, 4:30 - 6:30 PM
Title	Postoperative Management of Children Following Reconstructive Airway Surgery
Author	B Saiman, R Brilli, R Cotton, B Jacobs
Affiliation	Division of Critical Care Medicine and Department of Otolaryngology, Children's Hospital Medical Center, Cincinnati, Ohio
Introduction	The postoperative management of intubated children who have under-one laryn-otracheoplasty or tracheal resection, usually includes the use of sedation, physical restraints, and often neuromuscular blockade. This practice can be associated with significant morbidity including atelectasis, pneumonia, stridor,CCP withdrawal syndromes, and muscular weakness that can prolon- PICU and hospital len-th of stay. Over the last 8 years a -we have utilized a postoperative management strategy that minimizes the use of pharmacolo-ic and physical restraints, especially in children > 2 years of ace. The purpose of this study was to examine the safety and efficacy of this management approach.
Method	Medical records of children aaes 2 months to 28 years who underwent laryngotracheoplasty or tracheal resection between 199') and 1998 were reviewed. The focus of the review was postoperative management. The data collected included: patient demographics; the use of sedation, neuromuscular blockade, and restraints; PICU and hospital lenoth 'of stay; and complications durin-the postoperative period, including atelectasis, pneumonia, stridor, sedative withdrawal, muscle Nveakness, and unplanned extubations. Specific outcome measures used to compare intubated non-sedated patients (awake, ambulatory and catin- by mouth) and intubated sedated patients (pharmacologically and physically restrained) included len-th of stay and postoperative complications.
Result
	management strategy that avoids sedatives, paralytics, and physical restraints, and allow s liberal.

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Document created April 12, 1999