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Risk over time and risk factors of intraoperative respiratory events: a historical cohort study of 14,153 children.

ABSTRACT:

Background

The variation in the rate of intraoperative respiratory events (IRE) over time under anesthesia and the influence of anesthesia-related factors have not yet been described. The objectives of this study were to describe the risk over time and the risk factors for IRE in children at a tertiary care hospital in southern Thailand.

Methods

The surveillance anesthetic database and chart review of IRE of 14,153 children who received surgery at Songklanagarind Hospital during January 2005 to December 2011 were used to obtain demographic, surgical and anesthesia-related data. Incidence density of IRE per person-time was determined by a Poisson modelling. Risk of IRE over time was displayed using Kaplan Meier survival and Nelson-Aalen curves. Multivariate Cox regression was employed to identify independent predictors for IRE. Adjusted hazard ratios (HR) and their 95% confidence intervals (CI) were obtained from the final Cox model.

Results

Overall, IRE occurred in 315 out of 14,153 children. The number (%) of desaturation, wheezing or bronchospasm, laryngospasm, reintubation and upper airway obstruction were 235 (54%), 101 (23%), 75 (17%), 21 (5%) and 4 (1%) out of 315 IRE, respectively. The incidence density per 100,000 person-minutes of IRE at the induction period (61.3) was higher than that in the maintenance (13.7) and emergence periods (16.5) (p?ConclusionsIRE risk was highest in the induction and early maintenance period. Assisted ventilation via facemask or LMA and desflurane anesthesia were anesthesia-related risk factors for laryngospasm. Therefore, anesthesiologists should pay more attention during the induction and early maintenance period especially when certain airway devices incorporated with assisted ventilation or desflurane are used.

SUBMITTER: Oofuvong M

PROVIDER: S-EPMC4016417 | biostudies-literature | 2014 Mar

REPOSITORIES: biostudies-literature

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Risk over time and risk factors of intraoperative respiratory events: a historical cohort study of 14,153 children.

Oofuvong Maliwan M Geater Alan Frederick AF Chongsuvivatwong Virasakdi V Pattaravit Ngamjit N Nuanjun Kanjana K

BMC anesthesiology 20140305

<h4>Background</h4>The variation in the rate of intraoperative respiratory events (IRE) over time under anesthesia and the influence of anesthesia-related factors have not yet been described. The objectives of this study were to describe the risk over time and the risk factors for IRE in children at a tertiary care hospital in southern Thailand.<h4>Methods</h4>The surveillance anesthetic database and chart review of IRE of 14,153 children who received surgery at Songklanagarind Hospital during J ...[more]

PMID: 24597484

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Dataset Information

Risk over time and risk factors of intraoperative respiratory events: a historical cohort study of 14,153 children.

Background

Methods

Results

Publications

Risk over time and risk factors of intraoperative respiratory events: a historical cohort study of 14,153 children.

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