Sedation Complication
Conditions
Brief summary
At a tertiary care university hospital a specialized interdisciplinary team of paediatric anaesthesiologists and paediatric intensivists was established for providing analgosedation for diagnostic and therapeutic procedures. The aim of the present study was to analyse the incidence and risk factors of adverse events during procedural sedation performed by the Children's Analgosedation Team (CAST).
Detailed description
At a tertiary care university hospital a dedicated Children's Analgosedation Team (CAST) performs all procedural sedations in children outside the operating room. Often patient age, comorbidities and procedures involving the airway are considered risk factors for adverse events, but previous studies investigating adverse events did not involve implementation of a specialised sedation team. Medical records of all children receiving procedural sedation by the CAST were reviewed for the incidence of adverse events. A bivariate analysis as well as an analysis of variance using type II Wald chi-square tests were conducted for identifying potential risk factors for adverse Events.
Interventions
None listed
Sponsors
Universitätsklinikum Hamburg-Eppendorf
Study design
Observational model
OTHER
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Children (age 0-20 years) receiving procedural sedation * Procedural sedation performed by the Children's Analgosedation Team
Exclusion criteria
* Missing medical records * Procedural sedation not performed by the Children's Analgosedation Team
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of adverse events | From the beginning of sedation (administration of 1. sedation drug) until the end of sedation (patient regained consciousness), assessed up to 6 hours | Respiratory, hemodynamic, and other adverse events |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Age | At the beginning of sedation (administration of 1. sedation drug) | Patient age in month |
| Sex | At the beginning of sedation (administration of 1. sedation drug) | Male or female |
| American Society of Anesthesiology (ASA) status | At the beginning of sedation (administration of 1. sedation drug) | ASA physical status I / II / III / IV |
| Date of sedation | At the beginning of sedation (administration of 1. sedation drug) | Date as YEAR/MONTH/DAY |
| Incidence of serious adverse events | From the beginning of sedation (administration of 1. sedation drug) until the end of sedation (patient regained consciousness), assessed up to 6 hours | Aspiration, vomiting/regurgitation, desaturation \< 90% for \> 30sec, hypotension \< 50% of baseline, laryngospasm, thorax rigidity, unplanned admission to Paediatric Intensive Care Unit (PICU), cardiac arrest, and death |
| Type and dose of sedative | From the beginning of sedation (administration of 1. sedation drug) until the end of sedation (patient regained consciousness), assessed up to 6 hours | Propofol or Midazolam in mg kg-1 |
| Type and dose of analgesic | From the beginning of sedation (administration of 1. sedation drug) until the end of sedation (patient regained consciousness), assessed up to 6 hours | Esketamine in mg kg-1 or remifentanil in µg kg-1 min-1 |
| Upper respiratory tract infection (URI) | At the beginning of sedation (administration of 1. sedation drug) | Signs of runny nose and/or cough |
| Category of the primary diagnosis | At the beginning of sedation (administration of 1. sedation drug) | Diagnosis that prompted the need for the procedure, categorized according to the subspecialty (hematology/oncology, nephrology, hepatology, gastroenterology, metabolic medicine, neurology, pulmonology, cardiology) |
Outcome results
None listed