BACKGROUND: There is no evidence of the need for oxygen supplementation during upper digestive endoscopies under ketamine sedation in children, and the latest recommendations specifically state that it is not mandatory for the procedure. The aim of our study is to assess the incidence of respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation when performed without oxygen supplementation, in accordance with the latest recommendations. METHODS: Eighty-eight children undergoing ketamine sedation for programmed upper digestive endoscopy at our Pediatric Intensive Care Unit were included. Patients needing other sedative agents different from ketamine were excluded. No patients received previous oxygen therapy. Suction equipment, oxygen, a bag-valve-mask, and age-appropriate equipment for advanced airway management were immediately available. The primary outcome measure was the incidence of desaturation episodes (i.e. FiO
Conscious Sedation/adverse effects , Deep Sedation/adverse effects , Endoscopy, Digestive System , Hypnotics and Sedatives/adverse effects , Ketamine/adverse effects , Respiration Disorders/etiology , Adolescent , Child , Child, Preschool , Female , Humans , Hypnotics and Sedatives/therapeutic use , Incidence , Infant , Ketamine/therapeutic use , Male , Prospective Studies , Respiration Disorders/epidemiology , Respiration Disorders/therapy
Leclercia adecarboxylata y Raoultella ornithinolytica constituyen bacterias Gram-negativas emergentes. Los casos descritos son excepcionales. En los últimos años, las mejoras en las técnicas de diagnóstico microbiológico han permitido su detección y conocimiento. Se presenta el caso de un niño de 11 años con enfermedad mitocondrial, portador de catéter venoso central de larga duración, que desarrolló dos episodios de sepsis por L. adecarboxylata y R. ornithinolytica, respectivamente. En los casos de infección asociada al uso de catéter, es posible, en ocasiones, el tratamiento sin su retirada con evolución favorable. Es importante reconocer L. adecarboxylata y R. ornithinolytica como patógenos de diagnóstico cada vez más frecuentes, sobre todo, en pacientes inmunodeprimidos o con patologías crónicas asociadas.
Leclercia adecarboxylata and Raoultella ornithinolytica are emergent Gram-negative bacteria. Infections caused by these microorganisms are exceptional. Improvement of microbiologist techniques in the last years has enabled their detection and more accurate knowledge. We present the case of an 11-year-old boy with mitochondrial disease with a longterm central catheter who suffered from two sepsis caused by L. adecarboxylata and R. ornithinolytica, respectively. In catheter-related infections, sometimes it is possible to provide antimicrobial treatment without removal of catheter with good results, as in our patient. It is important to recognize L. adecarboxylata and R. ornithinolytica like increasingly frequent pathogenic bacteria, mostly in immunocompromised or chronic patients.
Humans , Male , Child , Pediatrics , Mitochondrial Diseases , Enterobacteriaceae , Catheter-Related Infections
Leclercia adecarboxylata and Raoultella ornithinolytica are emergent Gram-negative bacteria. Infections caused by these microorganisms are exceptional. Improvement of microbiologist techniques in the last years has enabled their detection and more accurate knowledge. We present the case of an 11-year-old boy with mitochondrial disease with a longterm central catheter who suffered from two sepsis caused by L. adecarboxylata and R. ornithinolytica, respectively. In catheter-related infections, sometimes it is possible to provide antimicrobial treatment without removal of catheter with good results, as in our patient. It is important to recognize L. adecarboxylata and R. ornithinolytica like increasingly frequent pathogenic bacteria, mostly in immunocompromised or chronic patients.
Leclercia adecarboxylata y Raoultella ornithinolytica constituyen bacterias Gram-negativas emergentes. Los casos descritos son excepcionales. En los últimos años, las mejoras en las técnicas de diagnóstico microbiológico han permitido su detección y conocimiento. Se presenta el caso de un niño de 11 años con enfermedad mitocondrial, portador de catéter venoso central de larga duración, que desarrolló dos episodios de sepsis por L. adecarboxylata y R. ornithinolytica, respectivamente. En los casos de infección asociada al uso de catéter, es posible, en ocasiones, el tratamiento sin su retirada con evolución favorable. Es importante reconocer L. adecarboxylata y R. ornithinolytica como patógenos de diagnóstico cada vez más frecuentes, sobre todo, en pacientes inmunodeprimidos o con patologías crónicas asociadas.
Anti-Bacterial Agents/administration & dosage , Catheter-Related Infections/drug therapy , Enterobacteriaceae Infections/drug therapy , Sepsis/drug therapy , Catheter-Related Infections/microbiology , Child , Enterobacteriaceae/isolation & purification , Enterobacteriaceae Infections/microbiology , Humans , Male , Mitochondrial Diseases/therapy , Sepsis/microbiology