Perioperative respiratory adverse events in children undergoing triple endoscopy

Abstract

Objectives: Children with aerodigestive disorders often have many of the reported risk factors for development of perioperative respiratory adverse events. This study sought to evaluate the incidence of such events in this group of patients undergoing general anesthesia for "triple endoscopy" (flexible bronchoscopy with bronchoalveolar lavage, rigid laryngoscopy and bronchoscopy, and esophagogastroduodenoscopy) and to identify any patient-specific or procedure-specific risk factors associated with higher incidence of perioperative respiratory adverse events. Methods:We performed a retrospective chart review of children 18 years or younger who underwent triple endoscopy as part of an aerodigestive evaluation. Data collected from medical records included: preoperative polysomnography, symptoms of acute respiratory illness, medical comorbidities, demographics, postoperative hospital or intensive care unit admission, and all respiratory events and interventions in the perioperative period. Patient-specific and procedure-specific factors were investigated via univariate analysis for any correlations with perioperative respiratory adverse events. Results:Of the 122 patients undergoing triple endoscopy, 69 (57%) experienced a perioperative respiratory adverse event. We found no difference in the incidence of perioperative respiratory adverse events among children with documented lung disease compared with those with no lung disease (OR: 0.89, p = .8 95% CI: 0.43, 1.8), and no significant difference between those children who had a respiratory illness at the time of surgery, 1-2 weeks prior, 3-4 weeks prior, and those with no preceding respiratory illness. A higher percentage of males had a perioperative respiratory adverse event, compared with females (OR: 2.7, p = .01 95% CI: 1.3, 5.09). Conclusion:Patients undergoing triple endoscopy for evaluation of aerodigestive disorders at our institution experienced perioperative respiratory adverse events at a rate of 57%.

Effect of Tulobuterol Patch Versus Placebo on the Occurrence of Respiratory Adverse Events in Children Undergoing Tonsillectomies: A Randomized Controlled Trial

“…Therefore, these vulnerable patients require special attention in perioperative management. 6–8 Several methods have been suggested to reduce respiratory complications in children undergoing tonsillectomy, including using laryngeal masks instead of tracheal intubation and intravenous anesthesia instead of inhalation anesthesia. 9–14…”

“…Therefore, these vulnerable patients require special attention in perioperative management. [6][7][8] Several methods have been suggested to reduce respiratory complications in children undergoing tonsillectomy, including using laryngeal masks instead of tracheal intubation and intravenous anesthesia instead of inhalation anesthesia. [9][10][11][12][13][14] Inhalation of the short-acting β-2 adrenergic agonists, salbutamol and albuterol, has demonstrated benefits in children at risk of PRAEs, including those undergoing surgical procedures on the airways, those with upper respiratory infections, and those <7 years of age.…”

Development and Validation of a Risk Nomogram Model for Perioperative Respiratory Adverse Events in Children Undergoing Airway Surgery: An Observational Prospective Cohort Study

“…In children, PRAEs are the most common adverse events in patients undergoing anesthesia, the incidence of URTI, obesity, and airway surgery presenting for anesthesia were high. 15 The incidence of PRAEs in previous studies was 13% to 15%, and in airway surgery, the incidence can be up to 50%. 4 , 6 , 9 The prevalence was 44.29% since this study population was all undergoing airway surgery.…”

Wildfire Smoke Exposure Is Associated with Adverse Respiratory Events under General Anesthesia in At-risk Pediatric Patients

“…This rate is consistent with other reported rates of adverse respiratory events in the pediatric anesthesia literature. 37–39 The most common adverse respiratory event was desaturation, defined by an oxygen saturation less than 95% for 1 min. Although we did not collect data on the method of anesthesia induction (intravenous vs .…”

“…This rate is consistent with other reported rates of adverse respiratory events in the pediatric anesthesia literature. [37][38][39] The most common adverse respiratory event was desaturation, defined by an oxygen saturation less than 95% for 1 min. Although we did not collect data on the method of anesthesia induction (intravenous vs. inhalational), a recent meta-analysis demonstrated no significant difference in the occurrence of adverse respiratory events between inhalation and intravenous induction.…”