Anaesthetic death of a child with a cold

Jones, A.

doi:10.1111/j.1365-2044.1993.tb07150.x

Cited by 15 publications

(9 citation statements)

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“…We believe that our sample of patients is representative of the general population of pediatric patients aged 6 and under presenting for anesthesia, since there were a wide range of case types including inpatient and outpatient, emergent and nonemergent cases, and across various subspecialties. The incidence of perioperative respiratory adverse events was similar to previously published studies …”

Section: Discussionmentioning

confidence: 99%

“…The incidence of perioperative respiratory adverse events was similar to previously published studies. 8,12,14 We chose to limit our study to the ages of 0-6 years of age because these children are at the highest risk for having a perioperative respiratory adverse event that proceeds to respiratory or cardiac arrest, given their smaller reserve. Being age under 6 has also been shown to be an independent risk factor for perioperative respiratory adverse events.…”

Section: Generalizabilitymentioning

confidence: 99%

“…Bronchial hyperreactivity may trigger laryngospasm and bronchospasm, respectively, which can both lead to life‐threatening hypoxemia . There have been at least two reported deaths in pediatric patients who underwent surgery with a history of a URI . A recent study found the incidence of cardiovascular instability at 2% …”

Section: Introductionmentioning

confidence: 99%

“…11,13 There have been at least two reported deaths in pediatric patients who underwent surgery with a history of a URI. 14,15 A recent study found the incidence of cardiovascular instability at 2%. 16 The decision to proceed with anesthesia and surgery has been controversial in pediatric patients with perioperative respiratory adverse event risk factors.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative respiratory adverse event risk assessment in children with upper respiratory tract infection: Validation of the COLDS score

Lee

Bernardo

Grogan

et al. 2018

Pediatric Anesthesia

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Summary Background The decision to proceed with anesthesia and surgery has been controversial in pediatric patients with an upper respiratory tract infection. The COLDS score was proposed by Lee and August as a potential risk stratification scheme, but no validation has been performed on this scale. Aims The aim of this study was to evaluate the utility of the COLDS score in predicting perioperative respiratory adverse events and optimize its predictive ability. Methods COLDS scores, incidence of perioperative respiratory adverse events, surgical procedure type, and age were prospectively collected for 536 patients who met inclusion criteria. Area under the receiver operating characteristic curves was computed for total COLDS score and individual COLDS score categories. Multivariable regression was used create an optimized score. To quantify the decrease in risk associated with case cancelation due to illness, the other risk factors in COLDS were assessed separately from upper respiratory infection status and a risk model was created. Results The area under the receiver operating characteristic curve for the total COLDS score was 0.69, suggesting that the COLDS score has a moderate predictive ability for perioperative respiratory adverse events. When split into individual component scores, the area under the receiver operating characteristic curve ranged from 0.55 to 0.63. We also found that the area under the receiver operating characteristic curve for the scoring system was higher in younger children than for children aged 4‐6 (area under receiver operating characteristic curve of 0.70‐0.71 vs 0.66). The area under the receiver operating characteristic curve for the optimized scoring system was 0.71. Conclusion The COLDS score has the potential to be a valuable risk assessment tool for prediction of perioperative respiratory adverse events and appears to have a better predictive value in certain subpopulations.

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Section: Discussionmentioning

confidence: 99%

Section: Generalizabilitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perioperative respiratory adverse event risk assessment in children with upper respiratory tract infection: Validation of the COLDS score

Lee

Bernardo

Grogan

et al. 2018

Pediatric Anesthesia

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“…It is known that viral RTIs cause inflammation, increased secretions and oedema of the nasal mucosa throat and larynx causing nasal airway obstruction and an irritable airway. The systemic effects of pyrexia, myalgia, malaise and toxaemia are also well known but there is a possibility of a viral toxaemia causing a pancarditis which may be implicated in the unexpected deaths of people being stressed from exercising or having an anaesthetic while suffering from a viral cold (Konarzewski et al 1992;Bloch 1993;Jones 1993).…”

Section: What Are the Pathophysiological Effects Of A Viral Rti?mentioning

confidence: 99%

Anaesthesia in children with viral respiratory tract infections

Walt

1995

Pediatric Anesthesia

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The effects and consequences of anaesthesia in a child with a respiratory tract infection (RTI) are controversial. There is a high incidence of viral RTI in children presenting for surgery and anaesthesia. The social and economic impact of postponing the procedure is significant; for the child, family and institution. The clinical effects of the common cold are well known, affecting the respiratory tract from the nose down to the small airways and lung parenchyma. The systemic effects of the toxic viraemic phase are also well recognized but not so the potential risk of a viral myocarditis. There is an increased incidence of intra- and postoperative respiratory related complications up to six weeks after a RTI. These include airway obstruction, laryngeal spasm, vagally mediated reflex bronchoconstriction, increased bronchial secretions, desaturation, atelectasis and postoperative respiratory complications. Children with symptoms of a moderate to severe RTI presenting for elective surgery should be postponed for six weeks. Emergency surgery should proceed with a mask anaesthetic for minor surgery or by adopting a modified rapid sequence induction (atropine but no cricoid pressure) to gain rapid control of the airway to avoid laryngeal spasm and vagally mediated reflex bronchoconstriction; IPPV, awake extubation, postoperative monitoring of respiratory function and appropriate analgesia.

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Anesthesia and Perioperative Medicine

Bösenberg

2013

Anesthesia, Intensive Care and Pain in Neonates and Children

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Anaesthetic death of a child with a cold

Cited by 15 publications

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Perioperative respiratory adverse event risk assessment in children with upper respiratory tract infection: Validation of the COLDS score

Perioperative respiratory adverse event risk assessment in children with upper respiratory tract infection: Validation of the COLDS score

Anaesthesia in children with viral respiratory tract infections

Anesthesia and Perioperative Medicine

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