Predictive Value of Weight Gain and Airway Obstruction in Isolated Robin Sequence

Abstract

Treatment of airway obstruction and feeding difficulties among newborns with isolated Robin sequence is challenging. The lack of clear guidelines may lead to prolonged hospital stays and delays in treatment. Appropriate risk stratification can facilitate treatment planning. We aim to identify factors that prognosticate prolonged hospital stay in children with isolated Robin sequence. We used a retrospective multivariate analysis of 46 patients admitted with isolated Robin sequence at the Hospital for Sick Children, in Toronto, between 2000 and 2007. During the initial 4 weeks following admission, data regarding duration of hospital stay, management of airway obstruction, respiratory rate, management of feeding difficulties, and reflux therapy were collected. Correlation between length of hospital stay, airway management, and weight gain during the initial 4 weeks was noted. No correlation was found between length of hospital stay and respiratory rate, supplemental oxygen requirement, or reflux therapy. Risk stratification is possible in children with isolated Robin sequence. Delayed weight gain in Robin sequence correlates with the degree of airway obstruction. The need for a nasopharyngeal tube and weight gain during the initial 4 weeks of life in newborns with Robin sequence reliably predict length of hospital stay. These prognosticators should contribute to parent and physician expectations, as well as assist in treatment and discharge planning.