Pediatric anesthesia – potential risks and their assessment: part II

Ungern‐Sternberg, Britta S. von; Habre, Walid

doi:10.1111/j.1460-9592.2006.02098.x

Cited by 35 publications

(39 citation statements)

References 80 publications

(83 reference statements)

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“…Grass pollen has also been associated with airway hyper-reactivity and inflammation [10,11], and this is probably the reason for the increase in adverse respiratory events observed in children with high values of IgE antibodies to Gx2 in our study. Most children do not require pre-operative blood samples to be taken before elective surgery [12,13] and in many centres, children and their families are ) and total IgE ( ). The solid black line is the reference line.…”

Section: Discussionmentioning

confidence: 99%

Peri-operative adverse respiratory events in children

et al. 2014

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SummaryThree quarters of all critical incidents and a third of all peri-operative cardiac arrests in paediatric anaesthesia are caused by adverse respiratory events. We screened for risk factors from children's and their families' histories, and assessed the usefulness of common markers of allergic sensitisation of the airway as surrogates for airway inflammation and increased risk for adverse respiratory events. One hundred children aged up to 16 years with two or more risk factors undergoing elective surgery were included in the study. Eosinophil counts, IgE level, specific IgE for D. pteronyssinus, cat epithelia and Gx2 (grass pollen) were measured for each child and adverse respiratory events (bronchospasm, laryngospasm, oxygen desaturation < 95%, severe persistent coughing, airway obstruction and postoperative stridor) were recorded. Twenty-one patients had an adverse respiratory event but allergic markers were poor predictors. Binary logistic regression showed a lack of predictive value of the eosinophil range and adverse respiratory events (p = 0.249). Receiver operating characteristic (ROC) curves for the presence of adverse respiratory events vs level of specific IgE antibody (to Gx2 (AUC 0.614), cat epithelia (0.564) and D. pteronyssinus (0.520)) demonstrated poor predictive values. However, the presence of risk factors was strongly associated with adverse respiratory events (p < 0.001) and a ROC-curve analysis indicated a fair capacity to predict adverse respiratory events (AUC 0.788). There was a significant difference (p = 0.001) between the presence of adverse respiratory events in patients with more than four (p = 0.006), compared with less than four (p = 0.001), risk factors. We conclude that while risk factors taken from the child's (or family) history proved good predictors of adverse respiratory events, immunological markers of allergic sensitisation demonstrated low predictive values. Pre-operative identification of children at high risk for an adverse respiratory event should rely on clinical, rather than immunological, assessment.

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Section: Discussionmentioning

confidence: 99%

Peri-operative adverse respiratory events in children

et al. 2014

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“…Preoperatif değerlendirmede pediatrik hasta detaylı olarak değerlendirilir, hava yolu, sistemik hastalıkları, aşılama durumu, mevcut enfeksiyonlarıaçısından gözden geçirilir. Aile ve çocuk geçi-rilecek operasyona hazırlanır [1][2][3][4][5] . Kliniğimizde operasyondan bir gün önce hastaların değerlendirilmesinin yapıldığı, elektif cerrahi geçirecek üst solunum yolu enfeksiyonu olan hastaların enfksiyonları düzeldikten sonra operasyonlarına izin verildiği, yeni aşılanmış ço-cukların elektif cerrahi girişimeri 3 hafta sonrasına ertelendiği görülmüştür.…”

Section: Bulgularunclassified

“…Anestezi yönteminin belirlenmesinde yapılacak cerrahi girişimin ve pediatrik hastanın özellikleri etkilidir [1][2][3][4][5] . Kliniğimizde pediatrik hastalara uygulanan cerrahi yöntemler özellikle üroloji, göz, kulakburunboğaz, ortopedi ve plastik cerrahi operasyonlarına yönelik olmaktadır.…”

Section: Bulgularunclassified

“…Kliniğimizde pediatrik hastalara uygulanan cerrahi yöntemler özellikle üroloji, göz, kulakburunboğaz, ortopedi ve plastik cerrahi operasyonlarına yönelik olmaktadır. Bu operasyonlar sırasında standart pediatrik anestezi uygulamalarının yapıldığı söylenebilir Çocuk hastalarda premedikasyon operasyondan 30-40 dakika önce uygulanması önerilmektedir [1][2][3][4][5] . Kliniğimizde gözlem odasının olmaması ve servislerde bu hizmeti verecek eğitimli personelin bulunmamasından dolayı premedikasyonun genellikle operasyon odasında uygulandığı gözlemlendi.…”

Section: Bulgularunclassified

“…Bu nedenle pediatrik hastalarda anestezi uygulamaları sırasında tüm bu farklılıklar göz önünde bulundurulmalı, çocuk anestezisinin yetişkin anestezisinden farklı olduğu unutulmamalıdır [1][2][3][4][5] . Bu çalışma, kliniğimizde pediatrik hastaların cerrahilerinde uygulanan anestezi ve analjezi yöntemlerini tespit etmek ve uygulamalarımızı literatürler eşliğinde gözden geçirmek amacıyla yapıldı.…”

Section: Introductionunclassified

See 2 more Smart Citations

Anesthesia and Analgesia Methods that We Used on Pediatric Patients

Başkan¹,

Kayar²,

Gamlı³

et al. 2018

Kafkas J Med Sci

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Routine Preoperative Laboratory Tests for Elective Surgery

Martin

Cifu

2017

JAMA

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Preoperative laboratory tests are a component of the evaluation of the patient for the operation. The aim of this study is to evaluate the necessity of preoperative blood tests in outpatient surgery in children.This study was performed in the pediatric surgery clinic between January 2005 and June 2009 on 3,693 patients who underwent elective outpatient surgery. Results of the routine preoperative tests performed in all patients such as hemogram, liver enzymes, coagulation tests and anti-HCV antibody, hepatitis B antigen, and anti-HIV antibody were evaluated. Two thousand nine hundred of the patients were boys (78.5%) and 793 were girls (21.5%). Mean age was 33±38 months (median 19 months). One or more parameters were found to be abnormal in 194 patients (5.2%). Anemia was detected in 3.1% of the patients (n:117), liver enzymes were found to be elevated in 1.1% (n:40) of the patients and coagulation tests were found to be increased in 0.8% (n:30) of the patients. Operations were postponed in 1.9% (n:70) of the patients for evaluation or treatment. This study demonstrates that routine preoperative blood tests though they might be valuable in a small number of patients; however, they are unnecessary in 94.8% of the patients.

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Pediatric anesthesia – potential risks and their assessment: part II

Cited by 35 publications

References 80 publications

Peri-operative adverse respiratory events in children

Peri-operative adverse respiratory events in children

Anesthesia and Analgesia Methods that We Used on Pediatric Patients

Routine Preoperative Laboratory Tests for Elective Surgery

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