Incidence and Risk Factors for Perioperative Adverse Respiratory Events in Children Who Are Obese

Tait, Alan R.; Voepel‐Lewis, Terri; Burke, Constance; Kostrzewa, Amy; Lewis, Ian C.

doi:10.1097/aln.0b013e318164ca9b

Cited by 156 publications

(120 citation statements)

References 26 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies have shown that up to 70% of the pediatric patients have a history of URI within six weeks prior to surgery. [2][3][4][5] There have been reports of increased perioperative morbidity in children presenting to surgery with an actual or recent (\ six weeks) URI. 2,4 An increased number of episodes of laryngospasm, desaturation, increased oral secretion, and coughing has been observed at induction, emergence, and throughout the postoperative phase period.…”

Section: Résumémentioning

confidence: 99%

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Schebesta

Güloglu

Chiari

et al. 2010

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose To determine the effect of topically applied lidocaine on perioperative airway complications when using a laryngeal mask airway device (LMAD) in children either with or without a history of recent or ongoing upper respiratory tract infection (URI). Methods In a randomized controlled double-blind trial, 34 children with a history of recent or ongoing URI and 32 non-URI children-all of whom were younger than age ten and scheduled to undergo minor surgical procedureswere randomly assigned to either a lidocaine or a placebo group. In the lidocaine group, an LMAD was lubricated with lidocaine gel before insertion, and a clear lubricating gel was used in the placebo group. The following data were recorded after standardized anesthesia induction and airway management: postoperative complications, such as coughing, desaturation, laryngospasm, and increased oral secretions, as well as length of stay in the postanesthetic recovery unit. Results Children with URI had a lower overall perioperative complication rate if they received a lidocaine gel (35%) rather than placebo (94%) (P \ 0.01). Also, the incidence of postoperative coughing was less (12% vs 53%; P = 0.03). In non-URI patients, lidocaine did not significantly reduce the rate of airway complications compared with placebo (17% vs 24%, respectively).Conclusion Lubrication of the LMAD with lidocaine gel reduces the incidence of airway complications in children with an upper respiratory tract infection. RésuméObjectif De´terminer l'effet d'une application topique de lidocaı¨ne sur les complications pe´riope´ratoires au niveau des voies ae´riennes lors de l'utilisation d'un masque larynge( LMAD) chez des enfants avec ou sans infection re´cente ou actuelle des voies respiratoires supe´rieures. Méthode Dans une e´tude randomise´e contrôle´e à double insu, 34 enfants avec une infection re´cente ou actuelle des voies respiratoires supe´rieures et 32 enfants sans infection, tous plus jeunes que 10 ans et devant subir des interventions chirurgicales mineures, ont e´te´randomise´s a`recevoir soit de la lidocaı¨ne, soit un placebo. Dans le groupe lidocaı¨ne, un LMAD a e´te´lubrifie´a`l'aide de lidocaı¨ne en gel avant l'insertion, et un gel lubrifiant clair a e´te´utilise´dans le groupe placebo. Les donne´es suivantes ont e´te´enregistre´es apre`s une induction de l'anesthe´sie et une prise en charge standard des voies ae´riennes: les complications postope´ratoires, telles que toux, de´saturation, laryngospasme et se´cre´tions orales accrues, ainsi que la dure´e de se´jour dans la salle de re´veil post-anesthe´sique. Résultats Les enfants souffrant d'infection des voies respiratoires supe´rieures ont montre´un taux global de complications pe´riope´ratoires plus bas lorsqu'ils ont reçu de la lidocaı¨ne en gel (35 %) plutôt que le placebo (94 %) (P\0,01). De plus, l'incidence de toux postope´ratoire e´tait moindre (12 % vs 53 %; P = 0,03). Chez les patients ne souffrant pas d'infection des voies respiratoires supe´rieures, la lidocaı¨ne n'a pas re´duit le taux de ...

show abstract

Section: Résumémentioning

confidence: 99%

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Schebesta

Güloglu

Chiari

et al. 2010

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…5,6 Obese children and adolescents have an increased risk of type 2 diabetes mellitus, asthma, and nonalcoholic fatty liver disease; are more likely to have cardiovascular risk factors; and have greater anesthesia risk. [5][6][7] They may also experience more mental health and psychological issues such as depression 8 and low self-esteem 8-10 compared with nonobese children.…”

Section: Burden Of Diseasementioning

confidence: 99%

Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

Barton¹

2010

Pediatrics

428

152

View full text Add to dashboard Cite

DESCRIPTION: Update of the 2005 US Preventive Services Task Force (USPSTF) statement about screening for overweight in children and adolescents. METHODS: The USPSTF examined the evidence for the effectiveness of interventions that are primary care feasible or referable. It also examined the evidence for the magnitude of potential harms of treatment in children and adolescents. RECOMMENDATION. The USPSTF recommends that clinicians screen children aged 6 years and older for obesity and offer them or refer them to intensive counseling and behavioral interventions to promote improvements in weight status (grade B recommendation).

show abstract

“…Knowledge of the clinical implications of obesity in children is limited, although obesity is associated with an increased risk of serious airway and respira- tory complications during and after anaesthesia [3]. Obese children are more likely to develop co-morbidities such as diabetes, fatty liver infiltration [20], obstructive sleep apnoea, hypertension and asthma [3].…”

Section: Discussionmentioning

confidence: 99%

“…Opioid-induced respiratory depression and paracetamol-induced hepatic injury are examples of potential harm due to accidental overdose. Obese children may also have related co-morbidities such as obstructive sleep apnoea or fatty infiltration of the liver [3]. Dose adjustment according to dosing scalars such as ideal body weight (IBW), lean body mass (LBM) and TBW depends upon the specific drug [1,2,4,5].…”

Section: Introductionmentioning

confidence: 99%

An aid to drug dosing safety in obese children: development of a new nomogram and comparison with existing methods for estimation of ideal body weight and lean body mass

Callaghan

Walker

2014

Anaesthesia

View full text Add to dashboard Cite

SummaryThe risk of accidental over-dosing of obese children poses challenges to anaesthetists during dose calculations for drugs with serious side-effects, such as analgesics. For many drugs, dosing scalars such as ideal body weight and lean body mass are recommended instead of total body weight during weight-based dose calculations. However, the complex current methods of obtaining these dosing scalars are impractical in the peri-operative setting. Arbitrary dose adjustments and guesswork are, unfortunately, tempting solutions for the time-pressured anaesthetist. The study's aim was to develop and validate an accurate, convenient alternative. A nomogram was created and its performance compared with the standard calculation method by volunteers using measurements from 108 obese children. The nomogram was as accurate (bias 0.12 kg vs À0.41 kg, respectively, p = 0.4), faster (mean (SD) time taken 2.8 (1.0) min (vs 3.3 (0.9) min respectively, p = 0.003) and less likely to result in mistakes (significant errors 3% vs 19%, respectively, p = 0.001). We present a system that simplifies estimation of ideal body weight and lean body mass in obese children, providing foundations for safer drug dose calculation.

show abstract

Incidence and Risk Factors for Perioperative Adverse Respiratory Events in Children Who Are Obese

Cited by 156 publications

References 26 publications

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Topical lidocaine reduces the risk of perioperative airway complications in children with upper respiratory tract infections

Screening for Obesity in Children and Adolescents: US Preventive Services Task Force Recommendation Statement

An aid to drug dosing safety in obese children: development of a new nomogram and comparison with existing methods for estimation of ideal body weight and lean body mass

Contact Info

Product

Resources

About