The incidence of postoperative atelectasis following gastrointestinal procedures in pediatric population.

BACKGROUND

Postoperative pulmonary complications including atelectasis are common complications after surgery. However, the incidence of postoperative atelectasis in pediatric surgical population is not yet well delineated.

METHODS

Using electronic medical record, we identified pediatric patients who underwent gastrointestinal surgery from January 2016 to September 2019 and determined the presence or absence of postoperative atelectasis by postoperative X-ray read. Risk factor analysis of postoperative atelectasis was performed using logistic regression analysis.

RESULTS

We found that 25.6 % of patients had radiographic evidence of postoperative atelectasis. Univariate and multivariate analyses demonstrated that the risk factors included lower weight, higher ASA class, emergency surgery, the use of higher peak airway pressure, lower lung compliance, and the lack of neuromuscular relaxant reversal agent use. In patients who received muscle relaxants, the lack of neuromuscular relaxant reversal agent use was associated with an increased risk of postoperative atelectasis (odds ratio 0.421, 95 % confidence interval 0.235-0.723, p < 0.001).

DISCUSSION: Postoperative atelectasis was frequently observed in pediatric patients undergoing gastrointestinal surgery. For cases where neuromuscular blockade is used, adequate reversal is critical.