ORIGINAL ARTICLE   Free

Minerva Anestesiologica 2020 August;86(8):835-43

DOI: 10.23736/S0375-9393.20.14293-7

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Anesthesia timing for children undergoing therapeutic cardiac catheterization after upper respiratory infection: a prospective observational study

Kan ZHANG ^{1, 2}, Siyuan WANG ³, Mengqi LI ¹, Chi WU ^{1, 2}, Liping SUN ¹, Sen ZHANG ^{1, 2}, Jie BAI ¹, Mazhong ZHANG ^{1, 2}, Jijian ZHENG ^{1, 2} ✉

¹ Department of Anesthesiology, Shanghai Children’s Medical Center, School of Medicine and National Children’s Medical Center, Shanghai Jiao Tong University, Shanghai, China; ² Pediatric Clinical Pharmacology Laboratory, Shanghai Children’s Medical Center, School of Medicine and National Children’s Medical Center, Shanghai Jiao Tong University, Shanghai, China; ³ Department of Anesthesiology, Health Science Center, 3201 Hospital, Xi’an Jiaotong University, Hanzhong, China

BACKGROUND: We aimed to analyze anesthesia timing and perioperative respiratory adverse event (PRAE) risk factors in children undergoing therapeutic cardiac catheterization after upper respiratory tract infection (URI).
METHODS: We prospectively included children for elective therapeutic cardiac catheterization. Parents or legal guardians were asked to complete a questionnaire on the child’s demographics, tobacco exposure, and URI symptoms. PRAEs (laryngospasm, bronchospasm, coughing, airway secretion, airway obstruction, and oxygen desaturation) as well as details of anesthesia management were recorded.
RESULTS: Of 332 children, 201 had a history of URI in the preceding eight weeks. The occurrence rate of PRAEs in children with URI≤two weeks reached the highest proportion, which was higher than that in children without URI (66.3% vs. 46.6%, P=0.007). The overall incidence of PRAEs in children with URI in 3-8 weeks was significantly lower than that in children with URI in the recent ≤two weeks (49.0% vs. 66.3%, P=0.007), and similar to that in the control group (49.0% vs. 46.6%). Multivariate analysis showed association between PRAEs and type of congenital heart disease (CHD) (P<0.001), anesthesia timing (P=0.007), and age (P=0.021). Delayed schedule (two weeks after URI) minimized the risk of PRAEs to the level comparable to that observed in children without URI (OR, 1.11; 95% CI: 0.64-1.91; P=0.707).
CONCLUSIONS: If treatment is not urgent, a pediatric patient at a high risk of PRAEs will be benefit from the postponement of an interventional operation by at least two weeks after URI.

KEY WORDS: Respiratory tract infections; Pediatrics; Heart diseases; Cardiac catheterization