Association between preoperative respiratory symptoms and perioperative respiratory adverse events in pediatric patients with positive viral testing - 09/09/23
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Abstract |
Study objective |
To determine the association between the presence of upper respiratory tract viral infection symptoms and occurrence of perioperative respiratory adverse events (PRAE) in children with positive viral screening, and to analyze the risk of PRAE in children with SARS-CoV-2 compared to non-SARS-CoV-2 infection.
Design |
A prospective cohort study.
Setting |
A tertiary, freestanding pediatric hospital in Dallas, Texas.
Patients |
Children <18 years of age with positive respiratory viral testing who underwent general anesthesia.
Intervention |
Measurement of incidence of PRAE and severe adverse events during the first 7 postoperative days.
Measurements |
The primary outcome was a composite of PRAE: oxygen saturation < 90% for >5 min, supplemental oxygen for >2 h after anesthesia, laryngospasm, and bronchospasm. The secondary outcome was severe adverse events: high flow nasal cannula >6 l of oxygen per minute, admission to the ICU for escalation of respiratory support post-anesthetic, acute respiratory distress syndrome, postoperative pneumonia, cardiovascular arrest, extracorporeal life support, and death.
Main results |
In this convenience sample of 196 children, 83 were symptomatic and 113 were asymptomatic. The risk of PRAE was similar in children with active viral symptoms and asymptomatic children (risk difference: −1.9%; 95% CI: −10.9, 7.9%), but higher among children with documented fever within 48 h of the anesthetic (risk difference: 20.8%; 95% CI: 5.3, 39.7%). The multivariable adjusted odds ratio of PRAE was 0.68 (95% CI: 0.25, 1.85) for symptomatic compared to asymptomatic patients, and 0.46 (95% CI: 0.14, 1.44) for patients with SARS-CoV-2 compared to non-SARS-CoV-2 infection.
Conclusions |
There was no significant difference in the incidence of PRAE between symptomatic and asymptomatic children with laboratory confirmed viral respiratory infection, and between children with the Omicron variant of SARS-CoV-2 compared to non-SARS-CoV-2 respiratory viruses. However, the risk was increased in children with recent fever.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Respiratory symptoms not associated with complications when viral testing positive. |
• | Preoperative fever associated with increased risk of respiratory complications. |
• | Risk of adverse events is lower with Omicron SARS-CoV-2 compared to other viruses. |
Keywords : Child, Prospective studies, Virus diseases, Anesthetics, SARS-CoV-2
Plan
Vol 90
Article 111241- novembre 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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