Incidence of post-anesthetic respiratory complications in pediatrics. Observational, single-center study in Medellin, Colombia
Abstract
Introduction: Post-anesthetic complications, particularly respiratory complications, continue to be a source of concern due to their high frequency, particularly in pediatrics.
Objective: To describe the incidence of respiratory complications in the post-anesthesia care unit of an intermediate complexity center during a six-month period, and to explore the variables associated with major respiratory complications.
Materials and Methods: Retrospective cohort study based on clinical record reviews. The records of the post-anesthesia care unit of an intermediate complexity pediatric institution located in Medellin, Colombia, were reviewed. This center uses a nursing-based care model that includes patient extubation in the post-anesthesia care unit.
Results: The records of 1181 patients were analyzed. The cumulative incidences of major complications were bronchospasm 1.44%, laryngospasm 0.68% and respiratory depression 0.59%. There were no cases of cardiac arrest or acute pulmonary edema. A history of respiratory infection less than 15 days before the procedure, rhinitis and female sex were associated with major respiratory complications.
Conclusions: A low frequency of respiratory complications was found during care provided by nursing staff trained in anesthesia recovery and pediatric airway in the post-anesthesia care unit.
References
Tay C, Tan G, Ng S. Critical incidents in paediatric anaesthesia: an audit of 10 000 anaesthetics in Singapore. Pediatr Anesth. 2001;11(6):711-8. doi: http://www.doi.org/10.1046/j.1460-9592.2001.00767.x
Murat I, Constant I, Maud’huy H. Perioperative anaesthetic morbidity in children: a database of 24 165 anaesthetics over a 30-month period. Pediatr Anesth. 2004;14(2):158-66. doi: http://www.doi.org/10.1111/j.1460-9592.2004.01167.x
von Ungern-Sternberg BS, Boda K, Chambers NA, Rebmann C, Johnson C, Sly PD, et al. Risk assessment for respiratory complications in paediatric anaesthesia: a prospective cohort study. The Lancet. 2010;376(9743):773-83. doi: http://www.doi.org/10.1016/S0140-6736(10)61193-2
Paterson N, Waterhouse P. Risk in pediatric anesthesia. Pediatr Anesth. 2011;21(8):848-57. doi: http://www.doi.org/10.1111/j.1460-9592.2010.03366.x
Habre W, Disma N, Virag K, Becke K, Hansen TG, Jöhr M, et al. Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe. Lancet Respir Med. 2017;5(5):412-25. doi: http://www.doi.org/10.1016/S2213-2600(17)30116-9
von Ungern-Sternberg BS. Respiratory complications in the pediatric postanesthesia care unit. Anesthesiol Clin. 2014;32(1):45-61. doi: http://www.doi.org/10.1016/j.anclin.2013.10.004
Erb TO, Trachsel D, Ungern‐Sternberg BS. Laryngeal reflex responses in pediatric anesthesia. Pediatr Anesth. 2020;30(3):353-61. doi: http://www.doi.org/10.1111/pan.13807
Sonneborn O, Robers G. Nurse-led extubation in the post-anaesthesia care unit. J Perioper Pract. 2018;28(12):362-5. doi: http://www.doi.org/10.1177/1750458918793366
Lucier MM, Brisson D. Extubation of pediatric patients by PACU nurses. J Perianesth Nurs. 2003;18(2):91-5. doi: http://www.doi.org/10.1053/jpan.2003.50011
Kako H, Corridore M, Seo S, Elmaraghy C, Lind M, Tobias JD. Tracheal extubation practices following adenotonsillectomy in children: effects on operating room efficiency between two institutions. Pediatr Anesth. 2017;27(6):591-5. doi: http://www.doi.org/10.1111/pan.13100
Mamie C, Habre W, Delhumeau C, Barazzone Argiroffo C, Morabia A. Incidence and risk factors of perioperative respiratory adverse events in children undergoing elective surgery. Pediatr Anesth. 2004;14(3):218-24. doi: http://www.doi.org/10.1111/j.1460-9592.2004.01169.x
Hagberg CA, Artime CA. Extubación del paciente perioperatorio con una vía aérea difícil. Colombian Journal of Anesthesiology. 2014;42(4):295-301. doi: http://dx.doi.org/10.1016/j.rca.2014.05.005
Arai Y-CP, Kandatsu N, Ito H, Sato J, Ushida T, Suetomi K, et al. Behavior of children emerging from general anesthesia correlates with their heart rate variability. J Anesth. 2010;24(2):317-8. doi: https://doi.org/10.1007/s00540-010-0887-4
Guignard B. Monitoring analgesia. Best Pract Res Clin Anaesthesiol. 2006;20(1):161-80. doi: http://www.doi.org/10.1016/j.bpa.2005.09.002
Naraghi L, Peev MP, Esteve R, Chang Y, Berger DL, Thayer SP, et al. The influence of anesthesia on heart rate complexity during elective and urgent surgery in 128 patients. J Crit Care. 2015;30(1):145-9. doi: http://www.doi.org/10.1016/j.jcrc.2014.08.008
Morray JP, Geiduschek JM, Ramamoorthy C, Haberkern CM, Hackel A, Caplan RA, et al. Anesthesia-related cardiac arrest in children: initial findings of the pediatric perioperative cardiac arrest (POCA) registry. Anesthesiol J Am Soc Anesthesiol. 2000;93(1):6-14. doi: http://www.doi.org/10.1213/01.ane.0000268712.00756.dd
Bhananker SM, Ramamoorthy C, Geiduschek JM, Posner KL, Domino KB, Haberkern CM, et al. Anesthesia-related cardiac arrest in children: Update from the pediatric perioperative cardiac arrest registry. Anesth Analg. 2007;105(2). doi: http://www.doi.org/10.1213/01.ane.0000268712.00756.dd
Auroy Y, Ecoffey C, Messiah A, Rouvier B. Relationship between complications of pediatric anesthesia and volume of pediatric anesthetics. Anesth Analg. 1997;84(1):234-5. doi: http://www.doi.org/10.1097/00000539-199701000-00060
Echeverry Marín PC. Los nuevos retos de la anestesia pediátrica en Colombia. Colombian Journal of Anesthesiology. 2017;45(1):5-7. doi: http://www.doi.org/10.1016/j.rca.2016.10.003
Regli A, Becke K, von Ungern-Sternberg BS. An update on the perioperative management of children with upper respiratory tract infections: Curr Opin Anaesthesiol. 2017;30(3):362-7. doi: http://www.doi.org/10.1097/aco.0000000000000460
Virag K, Sabourdin N, Thomas M, Veyckemans F, Habre W. Epidemiology and incidence of severe respiratory critical events in ear, nose and throat surgery in children in Europe: A prospective multicentre observational study. Eur J Anaesthesiol. 2019;36(3):185-93. doi: http://www.doi.org/10.1097/EJA.0000000000000951
Zheng M, Wang X, Zhang L. Association between allergic and nonallergic rhinitis and obstructive sleep apnea. Curr Opin Allergy Clin Immunol. 2018;18(1):16-25. doi: http://www.doi.org/10.1097/ACI.0000000000000414
Weiss M, Dullenkopf A, Fischer JE, Keller C, Gerber AC, European, et al. Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J Anaesth. 2009;103(6):867-73. doi: http://www.doi.org/10.1093/bja/aep290
Shi F, Xiao Y, Xiong W, Zhou Q, Huang X. Cuffed versus uncuffed endotracheal tubes in children: a meta-analysis. J Anesth. 2016;30(1):3-11. doi: http://www.doi.org/10.1007/s00540-015-2062-4
Elwood T, Cecchin F, Low JI, Bradford HM, Goldstein B. Pilot study of preoperative heart rate variability and adverse events in children emerging from anesthesia. Pediatr Crit Care Med. 2005;6(1):54-7. doi: http://www.doi.org/10.1097/01.PCC.0000149316.36372.2A
Luce V, Harkouk H, Brasher C, Michelet D, Hilly J, Maesani M, et al. Supraglottic airway devices vs tracheal intubation in children: a quantitative meta-analysis of respiratory complications. Pediatr Anesth. 2014;24(10):1088-98. doi: http://www.doi.org/10.1111/pan.12495
Warner DO, Warner MA, Barnes RD, Offord KP, Schroeder DR, Gray DT, et al. Perioperative respiratory complications in patients with asthma. Anesthesiol J Am Soc Anesthesiol. 1996;85(3):460-7. doi: http://www.doi.org/10.1097/00000542-199609000-00003
Downloads
Article metrics | |
---|---|
Abstract views | |
Galley vies | |
PDF Views | |
HTML views | |
Other views |