Peri-operative respiratory adverse events in children with upper respiratory tract infections allowed to proceed with anaesthesia: A French national cohort study.
Eur J Anaesthesiol
; 35(12): 919-928, 2018 12.
Article
en En
| MEDLINE
| ID: mdl-30124501
ABSTRACT
BACKGROUND:
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.OBJECTIVE:
To determine the incidence and risk factors of PRAE in children with URTI allowed to proceed to anaesthesia.DESIGN:
Multicentre cohort study performed over 6 months in France.SETTING:
Sixteen centres with dedicated paediatric anaesthetists. PATIENTS Eligible patients were aged from 0 to 18 years with URTI symptoms on admission or a history of such over the preceding 4 weeks. MAINOUTCOMES:
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.RESULTS:
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.CONCLUSION:
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. TRIAL REGISTRATION The study was registered in the European Networks of Centers for Pharmacoepidemiology and Pharmacovigilance (EUPAS16436).
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
/
Infecciones del Sistema Respiratorio
/
Atención Perioperativa
/
Anestesia General
Tipo de estudio:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur J Anaesthesiol
Asunto de la revista:
ANESTESIOLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Laos