Michael D Mallory1, Curtis Travers2, Courtney E McCracken2, James Hertzog3, Joseph P Cravero4. 1. Pediatric Emergency Medicine Associates, Children's Healthcare of Atlanta at Scottish Rite, Atlanta, Georgia; michael.mallory@pemaweb.org. 2. Department of Pediatrics, Emory University, Children's Healthcare of Atlanta, Atlanta, Georgia. 3. Department of Pediatrics, Division of Critical Care Medicine, Nemours Alfred I. DuPont Hospital for Children, Wilmington, Delaware; and. 4. Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard University, Boston, Massachusetts.
Abstract
BACKGROUND: Upper respiratory infections (URIs) are associated with airway adverse events (AAEs) during general anesthesia. There have been no large studies examining the relationship between URIs and AAEs during pediatric procedural sedation. We hypothesized that there would be a relationship between URI status and AAEs in pediatric procedural sedation. METHODS: We examined prospectively collected data from the Pediatric Sedation Research Consortium database. Specific questions regarding URI status were added to the database to facilitate our analysis. Characteristics of patients, procedure types, adjunctive medications, adverse events, and airway interventions (AIs) were reported. We performed bivariate analysis of adverse events and URI status, then used a multivariable logistic regression model to assess the relationship between URI status and adverse events. We examined the secondary outcome of AI similarly. RESULTS: Of the 105 728 sedations entered into the Pediatric Sedation Research Consortium database during the study period, we were able to use 83 491 for analysis. Controlling for multiple patient, drug, and procedure characteristics, recent and current URI were associated with increased frequency of AAEs. In general, the frequency of AAEs and AIs increased from recent URI, to current URI-clear secretions to current URI-thick secretions. We did not find a relationship between URI status and non-AAEs. CONCLUSIONS: URI status is associated with a statistically significant increase in frequency of AAEs and AI during pediatric procedural sedation for the population sedated by our consortium. Although URI status merits consideration in determining potential risk for sedation, rates of some AAEs and AIs remained low regardless of URI status.
BACKGROUND: Upper respiratory infections (URIs) are associated with airway adverse events (AAEs) during general anesthesia. There have been no large studies examining the relationship between URIs and AAEs during pediatric procedural sedation. We hypothesized that there would be a relationship between URI status and AAEs in pediatric procedural sedation. METHODS: We examined prospectively collected data from the Pediatric Sedation Research Consortium database. Specific questions regarding URI status were added to the database to facilitate our analysis. Characteristics of patients, procedure types, adjunctive medications, adverse events, and airway interventions (AIs) were reported. We performed bivariate analysis of adverse events and URI status, then used a multivariable logistic regression model to assess the relationship between URI status and adverse events. We examined the secondary outcome of AI similarly. RESULTS: Of the 105 728 sedations entered into the Pediatric Sedation Research Consortium database during the study period, we were able to use 83 491 for analysis. Controlling for multiple patient, drug, and procedure characteristics, recent and current URI were associated with increased frequency of AAEs. In general, the frequency of AAEs and AIs increased from recent URI, to current URI-clear secretions to current URI-thick secretions. We did not find a relationship between URI status and non-AAEs. CONCLUSIONS: URI status is associated with a statistically significant increase in frequency of AAEs and AI during pediatric procedural sedation for the population sedated by our consortium. Although URI status merits consideration in determining potential risk for sedation, rates of some AAEs and AIs remained low regardless of URI status.
Authors: S M Green; P L Leroy; M G Roback; M G Irwin; G Andolfatto; F E Babl; E Barbi; L R Costa; A Absalom; D W Carlson; B S Krauss; J Roelofse; V M Yuen; E Alcaino; P S Costa; K P Mason Journal: Anaesthesia Date: 2019-12-02 Impact factor: 6.955
Authors: Zahidee Rodriguez; Andi L Shane; Hans Verkerke; Christopher Lough; Matthew G Zimmerman; Mehul Suthar; Jens Wrammert; Heather MacDonald; Michael Wolf; Shanelle Clarke; John D Roback; Connie M Arthur; Sean R Stowell; Cassandra D Josephson Journal: Blood Adv Date: 2020-09-22