Risk Factors for Perioperative Adverse Respiratory Events in Children with Upper Respiratory Tract Infections

2001 ◽  
Vol 95 (2) ◽  
pp. 299-306 ◽  
Author(s):  
Alan R. Tait ◽  
Shobha Malviya ◽  
Terri Voepel-Lewis ◽  
Hamish M. Munro ◽  
Monica Siewert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Oxygen Saturation ◽  
Breath Holding ◽  
Upper Respiratory Tract ◽  
Asymptomatic Children ◽  
Respiratory Events ◽  
History Of ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Adverse Respiratory Events

Background Anesthesia for the child who presents for surgery with an upper respiratory infection (URI) presents a challenge for the anesthesiologist. The Current prospective study was designed to determine the incidence of and risk factors for adverse respiratory events in children with URTs undergoing elective surgical procedures. Methods The study population included 1,078 children aged 1 month to 18 yr who presented for an elective surgical procedure. Parents were given a short questionnaire detailing their child's demographics, medical history, and presence of any symptoms of a URT. Data regarding the incidence and severity of perioperative respiratory events were collected prospectively. Adverse respiratory events (any episode of laryngospasm, bronchospasm, breath holding > 15 s, oxygen saturation < 90%, or severe cough) were recorded. In addition, parents were contacted 1 and 7 days after surgery to determine the child's postoperative course. Results There were no differences between children with active URIs, recent URIs (within 4 weeks), and asymptomatic children with respect to the incidences of laryngospasm and bronchospasm. However, children with active and recent URIs had significantly more episodes of breath holding, major desaturation (oxygen saturation < 90%) events, and a greater incidence of overall adverse respiratory events than children with no URIs. Independent risk factors for adverse respiratory events in children with active URIs included use of an endotracheal tube (< 5 yr of age), history of prematurity, history of reactive airway disease, paternal smoking, surgery involving the airway, the presence of copious secretions, and nasal congestion. Although children with URIs had a greater incidence of adverse respiratory events, none were associated with any long-term adverse sequelae. Conclusions The current study identified several risk factors for perioperative adverse respiratory events in children with lulls. Although children with acute and recent URIs are at greater risk for respiratory complications, these results suggest that most of these children can undergo elective procedures without significant increase in adverse anesthetic outcomes.

Upper Respiratory Infection

2018 ◽  
Author(s):  
Kenneth Wayman ◽  
Nancy B. Samol ◽  
Eric Wittkugel
Keyword(s):  
Adverse Events ◽  
Anesthetic Management ◽  
Airway Disease ◽  
Upper Respiratory Tract ◽  
Upper Respiratory Infection ◽  
Reactive Airway Disease ◽  
Respiratory Events ◽  
History Of ◽  
Upper Respiratory ◽  
Adverse Respiratory Events

The child with an upper respiratory tract infection presenting for surgery is probably the most common dilemma that faces the pediatric anesthesiologist. While cancellation of such a child’s operation had been a common practice in the past, nowadays, an anesthesiologist will more than likely proceed with the anesthetic management of a child with a mild common cold. Research has shown that while perioperative respiratory adverse events are likely to occur in a child with a mild cold, these events are very easily managed. In addition, the use of a laryngeal mask airway which prevents instrumentation of a child’s airway drastically decreases the incidence of perioperative adverse events in this patient population. Planned airway surgery, history of prematurity, reactive airway disease, and passive smoking in the home are factors that increase the incidence of perioperative adverse respiratory events in a child with an active cold.

scholarly journals A STUDY ON THE DEMOGRAPHIC AND CLINICAL PROFILE OF WHEEZING IN THE FIRST YEAR OF LIFE

2021 ◽  
pp. 167-170
Author(s):  
Sunita Das ◽  
Deshish Kumar Panda ◽  
Kedarnath Das ◽  
Saiprasanna Behera
Keyword(s):  
Risk Factors ◽  
Respiratory Tract ◽  
Birth Asphyxia ◽  
Clinical Profile ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Young Infants ◽  
History Of ◽  
Upper Respiratory ◽  
Tract Infections

This hospital based observational cross sectional study having a sample size of 100 was undertaken at S.C.B. Medical College and S.V.P.P.G.I.P.,Cuttack,with an objective to study the clinical profile and risk factors for wheezing in infancy from November 2018 to November 2020. Wheezing is accountable for a high demand of medical consultations and emergency care services with relatively high rates of hospitalization.In this study, several risk factors were identified for wheezing in less than one year of age which had little resemblance to similar studies made in various other age groups.However,maternal smoking as a risk factor could not be found in our study due to social cultural lifestyle in the study population. Factors like caesarean section, history of birth asphyxia, NICU admissions and living in kuccha house were not found to impose risk for wheezing in infancy in the study in contrary to similar such studies in other age groups.The present study revealed, that among all other etiology, the viral respiratory tract infections including bronchiolitis was the most common cause of wheezing in infancy (64%) followed by WALRI (wheeze associated lower respiratory tract infection). In conclusion, if an infant with wheezing has risk factors like male sex, preterm, more than six months age, family history of atopy or repeated upper respiratory tract illness or overcrowding in family, anticipating the severity recurrence should be suspected. These infants should be monitored closely for signs of clinical deterioration. Proper health education,ante natal and neonatal care,promoting of breast feeding and creating awareness to the public regarding modifiable risk factors like separation of family members having upper respiratory illness from young infants will reduce the severity of wheezing and will help prevent their recurrence to much extent.

scholarly journals Laryngeal Mask Airway Is Associated with an Increased Incidence of Adverse Respiratory Events in Children with Recent Upper Respiratory Tract Infections

2007 ◽  
Vol 107 (5) ◽  
pp. 714-719 ◽  
Author(s):  
Britta S. von Ungern-Sternberg ◽  
Krisztina Boda ◽  
Craig Schwab ◽  
Craig Sims ◽  
Chris Johnson ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Respiratory Tract Infections ◽  
Oxygen Desaturation ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Respiratory Events ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Adverse Respiratory Events

Background The laryngeal mask airway (LMA) has been advocated as an alternative technique to tracheal intubation for airway management of children with recent upper respiratory tract infections (URIs). The authors determined the occurrence of adverse respiratory events and identified the associated risk factors to assess the safety of LMA in children. Methods During a period of 5 months, parents of children scheduled to undergo general anesthesia with an LMA were asked to fill out a questionnaire regarding their child's medical history and potential symptoms of URI. In addition, all episodes of adverse respiratory events in the perioperative period (laryngospasm, bronchospasm, coughing, airway obstruction, and oxygen desaturation) as well as details of anesthesia management were recorded. Results Among the 831 children included in the study, 27% presented with a history of a recent URI within the last 2 weeks before anesthesia. The presence of a recent URI doubled the incidence of laryngospasm (odds ratio, 2.6; 95% confidence interval, 1.3-5.0), coughing (odds ratio, 2.7; 95% confidence interval, 1.7-4.3), and oxygen desaturation (odds ratio, 1.9; 95% confidence interval, 1.2-2.8). This incidence was even higher in young children; in those undergoing ear, nose, and throat surgery; and when there were multiple attempts to insert the LMA. Conclusion An LMA used in children with recent URIs was associated with a higher incidence of laryngospasm, cough, and oxygen desaturation compared with healthy children. However, the overall incidence of adverse respiratory events was low, suggesting that if anesthesiologists allow at least a 2-week interval after a URI, they can safely proceed with anesthesia using an LMA.

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