PMID- 36254629
OWN - NLM
STAT- MEDLINE
DCOM- 20221102
LR  - 20221215
IS  - 2154-1671 (Electronic)
IS  - 2154-1671 (Linking)
VI  - 12
IP  - 11
DP  - 2022 Nov 1
TI  - The Nature, Frequency, and Timing of Pediatric Sedation Adverse Events.
PG  - 930-936
LID - 10.1542/hpeds.2022-006531 [doi]
AB  - OBJECTIVES: The nature and frequency of pediatric sedation adverse events (AEs) 
      have been well described. However, the timing of specific AEs in induction, 
      procedure, and recovery phase of sedation remains unknown. The objective was to 
      describe the nature, frequency, and timing of AEs. We hypothesized that most AEs 
      would start at the induction phase. METHODS: We examined prospectively collected 
      data of sedation encounters of children 3 months to 18 years of age, 
      characterized by at least 1 AE, from January 1, 2013 to December 31, 2020. 
      Patient characteristics, primary diagnosis, procedure type, nature, frequency, 
      and timing of AEs were reported. RESULTS: Of 12 012 sedation encounters, the mean 
      age was 7.6 (SD = 4.9) years, most (89%) were American Society of 
      Anesthesiologists II risk, the most common diagnosis was hematology/oncology 
      (27.3%) and the most common procedure radiologic (47.8%). At least 1 AE occurred 
      during 765 (6.4%) encounters. Respiratory AEs were most common (n = 645, 5.4% of 
      all encounters) and started more often during induction (64.5% of respiratory 
      AEs). Partial upper airway obstruction was the most common respiratory AE (2.8% 
      of all encounters). Partial (59.4%) and complete (77.3%) upper airway obstruction 
      and apnea (84%) all began more often during induction. Laryngospasm (48.4% vs 
      46.8%) and hypoxemia (59.3% vs 39%) were similarly distributed between induction 
      and procedure, respectively, though they were rare during recovery. CONCLUSIONS: 
      Most respiratory events in this cohort started during the induction or procedure 
      phases. The sedation team should be especially prepared to administer rescue 
      maneuvers and allocate staff/resources during these phases.
CI  - Copyright (c) 2022 by the American Academy of Pediatrics.
FAU - Boriosi, Juan P
AU  - Boriosi JP
AD  - Department of Pediatrics, University of Wisconsin, Madison, Wisconsin, USA.
FAU - Lasarev, Micheal L
AU  - Lasarev ML
AD  - Department of Biostatistics, University of Wisconsin, Madison, Wisconsin, USA.
FAU - Ferrazano, Peter A
AU  - Ferrazano PA
AD  - Department of Pediatrics, University of Wisconsin, Madison, Wisconsin, USA.
FAU - Peters, Megan E
AU  - Peters ME
AD  - Department of Pediatrics, University of Wisconsin, Madison, Wisconsin, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Hosp Pediatr
JT  - Hospital pediatrics
JID - 101585349
SB  - IM
MH  - Child
MH  - Humans
MH  - *Anesthesia/adverse effects
MH  - Cohort Studies
MH  - Data Collection
MH  - Hypoxia/epidemiology/etiology
MH  - *Airway Obstruction/etiology
MH  - Conscious Sedation/adverse effects
EDAT- 2022/10/19 06:00
MHDA- 2022/11/03 06:00
CRDT- 2022/10/18 04:22
PHST- 2022/10/19 06:00 [pubmed]
PHST- 2022/11/03 06:00 [medline]
PHST- 2022/10/18 04:22 [entrez]
AID - 189743 [pii]
AID - 10.1542/hpeds.2022-006531 [doi]
PST - ppublish
SO  - Hosp Pediatr. 2022 Nov 1;12(11):930-936. doi: 10.1542/hpeds.2022-006531.