2015 HSC Section 1 Book of Articles

Original Investigation Research

Sedation Wean After Laryngotracheal Reconstruction

with the goal of improving care based on best practice guide- lines, which significantly decreased the time required for se- dation wean. Our approach to a sedation wean communica- tion in the LTR patient populationmay be potentially studied in other more heterogeneous patient populations requiring standardized sedation wean protocols.

Conclusions We identified variability in sedation wean practices and op- portunities for communication improvement. We imple- mented systemwide process change using IHI methodology

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ARTICLE INFORMATION Submitted for Publication: May 21, 2014; final revision received August 12, 2014; accepted September 15, 2014. Published Online: October 30, 2014. doi:10.1001/jamaoto.2014.2694. Author Contributions: Drs Kozin and Cummings had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Kozin, Cummings, Rogers, Noviski. Acquisition, analysis, or interpretation of data: Kozin, Cummings, Lin, Sethi, Noviski, Hartnick. Drafting of the manuscript: Kozin, Cummings, Noviski. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: Kozin, Cummings, Sethi, Noviski. Administrative, technical, or material support: Kozin, Cummings, Lin. Study supervision: Kozin, Rogers, Noviski, Hartnick. Conflict of Interest Disclosures: None reported. Previous Presentation: This study was presented as an oral presentation at American Society for Pediatric Otolaryngology, Combined Otolaryngological Spring Meeting; May 17, 2014; Las Vegas, Nevada. REFERENCES 1 . Herrington HC, Weber SM, Andersen PE. Modern 2 . Santos D, Mitchell R. The history of pediatric airway reconstruction. Laryngoscope . 2010;120(4): 815-820. 3 . Stauffer JL, Olson DE, Petty TL. Complications and consequences of endotracheal intubation and tracheotomy. Am J Med . 1981;70(1):65-76. 4 . Fearon B, Cotton R. Surgical correction of subglottic stenosis of the larynx. Ann Otol Rhinol Laryngol . 1972;81(4):508-513. 5 . Gallagher TQ, Hartnick CJ. Laryngotracheal reconstruction. Adv Otorhinolaryngol . 2012;73: 31-38. 6 . Cotton RT, Gray SD, Miller RP. Update of the Cincinnati experience in pediatric laryngotracheal reconstruction. Laryngoscope . 1989;99(11):1111-1116. 7 . Hammer GB. Sedation and analgesia in the pediatric intensive care unit following laryngotracheal reconstruction. Otolaryngol Clin North Am . 2008;41(5):1023-1044. 8 . Jacobs BR, Salman BA, Cotton RT, Lyons K, Brilli RJ. Postoperative management of children after single-stage laryngotracheal reconstruction. Crit Care Med . 2001;29(1):164-168. management of laryngotracheal stenosis. Laryngoscope . 2006;116(9):1553-1557.

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JAMA Otolaryngology–Head &Neck Surgery Published online October 30, 2014

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