Retrospective analysis of deep sedation in pediatric population for endoscopic procedures: adverse events and outcomes

2015 ◽  
Vol 2 (4) ◽  
Author(s):  
Berrin Isik ◽  
Volkan Sivgin ◽  
Mustafa Arslan ◽  
Seyfi Kartal ◽  
Yusuf Unal ◽  
...  
Keyword(s):  
Adverse Events ◽  
Retrospective Analysis ◽  
Deep Sedation ◽  
Pediatric Population ◽  
Endoscopic Procedures

scholarly journals Implementation of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) sedation training course in a regular endoscopy unit

Endoscopy ◽  
2020 ◽  
Vol 53 (01) ◽  
pp. 65-71
Author(s):  
Mauro Manno ◽  
Simona Deiana ◽  
Tommaso Gabbani ◽  
Matteo Gazzi ◽  
Alessandro Pignatti ◽  
...  
Keyword(s):  
Adverse Events ◽  
Training Program ◽  
European Society ◽  
Gastrointestinal Endoscopy ◽  
Deep Sedation ◽  
Safe Procedure ◽  
Moderate Sedation ◽  
Endoscopic Procedures ◽  
Endoscopy Unit ◽  
Electronic Reporting

Abstract Background Several scientific societies have endorsed non-anesthesiologist sedation (NAS) during gastrointestinal endoscopy, considering it a safe procedure when administered by adequately trained personnel. This study aimed to evaluate the occurrence of adverse events after implementation of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) sedation training program. Methods From January 2017 to August 2018, data from all consecutive endoscopic procedures in adults (≥ 18 years) performed at our endoscopy unit were collected using an electronic reporting system. Results All staff (physicians and nurses) completed the ESGE-ESGENA sedation course. In total, 12 132 patients underwent endoscopic procedures, 10 755 (88.6 %) of which were performed in a non-anesthesiological setting. Of these, about 20 % used moderate sedation with midazolam + fentanyl and 80 % used deep sedation with additional propofol. No sentinel, 5 (0.05 %) moderate risk, and 18 (0.17 %) minor risk adverse events occurred, all during moderate or deep sedation, and all managed by endoscopy staff without the need for anesthesiologist assistance. Conclusions After completing the ESGE-ESGENA sedation training program, the rate of adverse events was very low in our institution. The findings support implementation of the program in all digestive endoscopy units and inclusion in the curriculum for physicians and nurses to ensure safe endoscopic procedures.

Retrospective Analysis of Adverse Events in Preclinical Ventricular Assist Device Experiments

ASAIO Journal ◽  
2008 ◽  
Vol 54 (4) ◽  
pp. 347-350 ◽  
Author(s):  
Kenneth N. Litwak ◽  
Lauren S. Unger ◽  
Kiyotaka Fukamachi ◽  
Diyar Saeed
Keyword(s):  
Adverse Events ◽  
Retrospective Analysis ◽  
Ventricular Assist Device ◽  
Assist Device ◽  
Ventricular Assist

scholarly journals Safety and effectiveness of deep sedation in pediatric patients undergoing flexible fibroscopy in spontaneous breathing

2021 ◽  
Keyword(s):  
Spontaneous Breathing ◽  
Pediatric Patients ◽  
Deep Sedation ◽  
Pediatric Population ◽  
Arterial Oxygen Saturation ◽  
Vital Signs ◽  
Face Mask ◽  
Arterial Oxygen ◽  
Average Value ◽  
Invasive Diagnostics

Invasive diagnostics and minor surgical procedures with deep sedation on pediatric patients, such as fibroscopic examination, have increased over the past decade. The aim of this study was to evaluate the usefulness and safety of an anesthesiological technique, based on the use of midazolam and ketamine, conducted in spontaneous breathing on a population of pediatric patients with suspected tracheobronchial pathologies. Pediatric patients from birth to 18 years old who underwent sedation diagnostic fibroscopy between April 2018 and March 2019, were enrolled. The anesthesiological technique provided was the intravenous administration of midazolam 0.2 mg/kg and ketamine 2 mg/kg in spontaneous breathing using a face mask with support of O2 and air. Vital signs such as Heart rate (HR), Systolic and Diastolic blood pressure (PAS and PAD) and Arterial oxygen saturation were recorded at the beginning of the procedure, 10 minutes and 30 minutes from the start. Other parameter evaluated were patient’s level of consciousness, quality of the procedure, major and minor complications, adequate recovery of the waking state. Sixteen patients were enrolled, 12 males and 4 females aged between 2 days of life and 7 years. Laryngomalacia tracheomalacia, tracheoesophageal fistula, and congenital airway malformations were the most frequent diseases. As for vital signs: the HR has gone from an average value of 133.4 ± 16.26 bpm at T0 to an average value of 129.3 ± 16.55 bpm at T10 and 133.7 ± 17.35 bpm at T30; PAS and PAD had not significant variations. Among drugs available for the fibroscopic examinations, the combined use of intravenous midazolam 0.2 mg/kg and ketamine 2 mg/kg is safe and well tolerated, reducing the anxiety associated with the examination, without major complications. The current literature is lacking in studies that have included such small and low weight patients. It would be interesting to make a comparison between various sedation techniques in order to identify the safest for the pediatric population.

scholarly journals Prognosis of Immune-related Adverse Events in Patients With Advanced Gastric Cancer Treated With Nivolumab or Pembrolizumab: A Multicenter Retrospective Analysis

In Vivo ◽  
2021 ◽  
Vol 35 (1) ◽  
pp. 475-482
Author(s):  
TAKAYUKI ANDO ◽  
AKIRA UEDA ◽  
KOHEI OGAWA ◽  
IORI MOTOO ◽  
SHINYA KAJIURA ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adverse Events ◽  
Advanced Gastric Cancer ◽  
Retrospective Analysis

Solid Organ Biopsies

2018 ◽  
pp. 246-249
Author(s):  
Jennifer Biber ◽  
Jenna Wheeler
Keyword(s):  
Adverse Events ◽  
General Anesthesia ◽  
Operating Room ◽  
Local Anesthesia ◽  
Deep Sedation ◽  
Recovery Period ◽  
Contingency Planning ◽  
Solid Organ ◽  
Sedation And Analgesia ◽  
Pediatric Sedation

While solid organ biopsies are routinely done on adults with only local anesthesia or minimal sedation, children frequently require deep sedation or general anesthesia to achieve acceptable conditions (stillness, anxiolysis, analgesia) to facilitate these procedures. This is more frequently being done with pediatric sedation/anesthesia outside the operating room. Issues unique to sedation for these procedures are pain, the need for relative patient immobility (both during the procedure and following it), and the nonstandard positioning required during the procedure. Regardless of the medications chosen, adequate monitoring should occur during the procedure as well as during the recovery period. With a good sedation plan for both sedation and analgesia, adequate monitoring, and contingency planning for adverse events, this can safely be performed in institutions with highly motivated and organized sedation services.

scholarly journals A Three Point Assessment Protocol for Tympanoplasty Outcomes: A Retrospective Analysis

2020 ◽  
Vol 24 (04) ◽  
pp. e438-e443
Author(s):  
P. Naina ◽  
Apar Pokharel ◽  
Kamran Asif Syed ◽  
Mary John ◽  
Ajoy Mathew Varghese ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Otitis Media ◽  
Surgical Outcome ◽  
Pediatric Population ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Factors Affecting ◽  
Assessment Protocol ◽  
Membrane Perforation ◽  
The Status

Abstract Introduction The surgical outcome of chronic otitis media (COM) of the mucosal type in the pediatric population with high rates of recurrent tympanic membrane perforation is indeed a concern for the attending surgeon. Objective The present study was done to evaluate the outcome of tympanoplasty in children with chronic otitis media mucosal type. Methods A retrospective analysis of the medical records of all children, aged < 16 years old, who underwent tympanoplasty for COM of the mucosal type was performed. These patients were addressed by a three-point assessment, for predicting outcome of tympanoplasty, which included the age of the patient, addressing the nasal/pharyngeal issues, and the status of the COM (discharging or dry). Surgical success was assessed in terms of graft uptake and improvement of hearing. Factors affecting the surgical outcome were also analyzed. Results A total of 90 children underwent type 1 tympanoplasty; 7 were lost to follow-up and 10 had incomplete audiometric results. In the 73 tympanoplasties analyzed, graft uptake was seen in 91.7% of the patients. Children with longer duration of ear discharge (> 8 years) had greater hearing loss. Children aged > 8 years old showed statistically significant higher chance of graft uptake (p = 0.021). Five of the six children who had graft rejection had bilateral disease. Conclusion A three-point assessment in the management of pediatric COM of the mucosal type offers good outcomes with post-tympanoplasty graft uptake rates > 90%.

scholarly journals A Systematic Review of Pediatric and Adult In-Flight Medical Emergencies

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Christina Sul ◽  
Sherif M. Badawy
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Health Outcomes ◽  
Pediatric Population ◽  
Air Travel ◽  
Serious Adverse Events ◽  
Significant Events ◽  
Medical Emergencies ◽  
The Subject

In-flight medical emergencies (IMEs) are acute onboard events of illnesses or injuries with potential immediate risk to a passenger’s short- or long-term health, or life. IMEs are significant events that are related to public safety concerns. With the increasing amount of annual air travel every year, it is expected that the number of encountered IMEs will continue to grow. Thus, it will be critical to develop and implement appropriate measures to manage IMEs with the best possible outcome. Despite the fact that most IMEs are self-limited with no serious adverse events, serious IME can lead to death, disability, or other unfavorable health outcomes, particularly as a result of suboptimal medical care. In this article, we systematically reviewed the published up-to-date evidence on the subject of in-flight emergencies with a specific focus on pediatric population.

Sign in / Sign up

Export Citation Format

Share Document