PMID- 24661725
OWN - NLM
STAT- MEDLINE
DCOM- 20161012
LR  - 20170103
IS  - 2340-3284 (Electronic)
IS  - 0034-9356 (Linking)
VI  - 61
IP  - 7
DP  - 2014 Aug-Sep
TI  - Adverse events related to gastrointestinal endoscopic procedures in pediatric 
      patients under anesthesia care and a predictive risk model (AEGEP Study).
PG  - 362-8
LID - S0034-9356(14)00026-7 [pii]
LID - 10.1016/j.redar.2014.01.004 [doi]
AB  - BACKGROUND: Multiple studies have analyzed perioperative factors related to 
      adverse events (AEs) in children who require gastrointestinal endoscopic 
      procedures (GEP) in settings where deep sedation is the preferred anesthetic 
      technique over general anesthesia (GA) but not for the opposite case. METHODS: We 
      reviewed our anesthesia institutional database, seeking children less than 12 
      years who underwent GEP over a 5-year period. A logistic regression was used to 
      determine significant associations between preoperative conditions, 
      characteristics of the procedure, airway management, anesthetic approaches and 
      the presence of serious and non-serious AEs. RESULTS: GA was preferred over deep 
      sedation [77.8% vs. 22.2% in 2178 GEP under anesthesia care (n=1742)]. We found 
      96 AEs reported in 77 patients, including hypoxemia (1.82%), bronchospasm (1.14%) 
      and laryngospasm (0.91%) as the most frequent. There were 2 cases of severe 
      bradycardia related to laryngospasm/hypoxemia and a case of aspiration resulting 
      in unplanned hospitalization, but there were no cases of intra- or postoperative 
      deaths. Final predictive model for perioperative AEs included age <1 year, upper 
      respiratory tract infections (URTI) <1 week prior to the procedure and low weight 
      for the age (LWA) as independent risk factors and ventilation by facial mask as a 
      protector against these events (p<0.05). CONCLUSIONS: AEs are infrequent and 
      severe ones are remote in a setting where AG is preferred over deep sedation. 
      Ventilatory AEs are the most frequent and depend on biometrical and comorbid 
      conditions more than anesthetic drugs chosen. Age <1 year, history of URTI in the 
      week prior to the procedure and LWA work as independent risk factors for AEs in 
      these patients.
CI  - Copyright (c) 2013 Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica 
      del Dolor. Published by Elsevier Espana. All rights reserved.
FAU - Ariza, F
AU  - Ariza F
AD  - Department of Anesthesia and Perioperative Medicine, Fundacion Valle del Lili, 
      Cali, Colombia. Electronic address: fredyariza@hotmail.com.
FAU - Montilla-Coral, D
AU  - Montilla-Coral D
AD  - Department of Anesthesia and Perioperative Medicine, Fundacion Valle del Lili, 
      Cali, Colombia.
FAU - Franco, O
AU  - Franco O
AD  - Department of Pediatric Surgery, Fundacion Valle del Lili, Cali, Colombia.
FAU - Gonzalez, L F
AU  - Gonzalez LF
AD  - Department of Anesthesia and Perioperative Medicine, Fundacion Valle del Lili, 
      Cali, Colombia.
FAU - Lozano, L C
AU  - Lozano LC
AD  - Department of Anesthesia and Perioperative Medicine, Fundacion Valle del Lili, 
      Cali, Colombia.
FAU - Torres, A M
AU  - Torres AM
AD  - Department of Anesthesia and Perioperative Medicine, Fundacion Valle del Lili, 
      Cali, Colombia.
FAU - Jordan, J
AU  - Jordan J
AD  - Department of Anesthesia and Perioperative Medicine, Fundacion Valle del Lili, 
      Cali, Colombia.
FAU - Blanco, L F
AU  - Blanco LF
AD  - Department of Anesthesia and Perioperative Medicine, Fundacion Valle del Lili, 
      Cali, Colombia.
FAU - Suarez, L
AU  - Suarez L
AD  - Department of Anesthesia and Perioperative Medicine, Fundacion Valle del Lili, 
      Cali, Colombia.
FAU - Cruz, G
AU  - Cruz G
AD  - Department of Anesthesia and Perioperative Medicine, Fundacion Valle del Lili, 
      Cali, Colombia.
FAU - Cepeda, M
AU  - Cepeda M
AD  - Clinical Research Unit, Fundacion Valle del Lili, Cali, Colombia.
LA  - eng
PT  - Journal Article
DEP - 20140321
PL  - Spain
TA  - Rev Esp Anestesiol Reanim
JT  - Revista espanola de anestesiologia y reanimacion
JID - 0134516
SB  - IM
MH  - Anesthesia, General/*adverse effects
MH  - Bradycardia/etiology
MH  - Bronchial Spasm/etiology
MH  - Child
MH  - Child, Preschool
MH  - Comorbidity
MH  - Deep Sedation
MH  - Endoscopy, Gastrointestinal/*adverse effects
MH  - Female
MH  - Humans
MH  - Hypoxia/etiology
MH  - Laryngismus/etiology
MH  - Male
MH  - Masks
MH  - Models, Theoretical
MH  - Psychomotor Agitation/etiology
MH  - Respiration, Artificial
MH  - Respiratory Tract Infections/epidemiology
MH  - Retrospective Studies
MH  - Risk
OTO - NOTNLM
OT  - Adverse events
OT  - Anestesia general
OT  - Anestesia pediatrica
OT  - Deep sedation
OT  - Endoscopia
OT  - Endoscopy
OT  - Endoscopy procedures
OT  - Eventos adversos
OT  - General anesthesia
OT  - Pediatric anesthesia
OT  - Sedacion profunda
EDAT- 2014/03/26 06:00
MHDA- 2016/10/13 06:00
CRDT- 2014/03/26 06:00
PHST- 2013/07/22 00:00 [received]
PHST- 2013/12/20 00:00 [revised]
PHST- 2014/01/20 00:00 [accepted]
PHST- 2014/03/26 06:00 [entrez]
PHST- 2014/03/26 06:00 [pubmed]
PHST- 2016/10/13 06:00 [medline]
AID - S0034-9356(14)00026-7 [pii]
AID - 10.1016/j.redar.2014.01.004 [doi]
PST - ppublish
SO  - Rev Esp Anestesiol Reanim. 2014 Aug-Sep;61(7):362-8. doi: 
      10.1016/j.redar.2014.01.004. Epub 2014 Mar 21.