Peri-operative respiratory adverse events in children with upper respiratory tract infections allowed to proceed with anaesthesia
| Autor: | Christopher Brasher, Fabrice Michel, Florence Julien-Marsollier, Jean-Vincent Aubineau, Christophe Dadure, Corinne Lejus, Eric Woodey, Thomas Vacher, Souhayl Dahmani, Nada Sabourdin, Gilles Orliaguet |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Anesthesia General Perioperative Care Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors 030202 anesthesiology Anesthesiology medicine Humans Prospective Studies 030212 general & internal medicine Laryngospasm Respiratory system Child Adverse effect Prospective cohort study Respiratory Tract Infections Respiratory tract infections business.industry Incidence (epidemiology) Infant Newborn Infant 3. Good health Anesthesiology and Pain Medicine Child Preschool Anesthesia Female France medicine.symptom business Cohort study |
| Zdroj: | European Journal of Anaesthesiology. 35:919-928 |
| ISSN: | 0265-0215 |
| DOI: | 10.1097/eja.0000000000000875 |
| Popis: | Peri-operative respiratory adverse events (PRAEs) in paediatric patients with upper respiratory tract infections (URTIs) remain inadequately explored in patients allowed to proceed to anaesthesia and surgery.To determine the incidence and risk factors of PRAE in children with URTI allowed to proceed to anaesthesia.Multicentre cohort study performed over 6 months in France.Sixteen centres with dedicated paediatric anaesthetists.Eligible patients were aged from 0 to 18 years with URTI symptoms on admission or a history of such over the preceding 4 weeks.The primary outcome of the study was to determine predictors of PRAE. Secondary outcomes were: predictors of peri-operative arterial desaturation and of the decision to proceed with anaesthesia and surgery in children with URTI.Overall, 621 children were included and 489 (78.7%) anaesthetised. Of those anaesthetised, 165 (33.5%) and 97 (19.8%) experienced PRAE and arterial desaturation, respectively. Factors predictive of PRAE included patient age, tracheal intubation and the absence of midazolam premedication. Factors predictive of peri-operative arterial desaturation included patient age, anaesthetist experience, endoscopic procedures and the presence of other PRAE. Factors predicting proceeding to anaesthesia in the context of URTI included anaesthetist experience, emergency procedures and the absence of severe URTI symptoms.The risk of PRAE in patients anaesthetised in the presence of URTI was similar to previous publications - close to 30%. In the light of our findings, first, current rescheduling indications should be questioned, and second, further medical and organisational strategies should be investigated to reduce PRAE in children with URTI.The study was registered in the European Networks of Centers for Pharmacoepidemiology and Pharmacovigilance (EUPAS16436). |
| Databáze: | OpenAIRE |
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