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MINERVA PEDIATRICA

Rivista di Pediatria, Neonatologia, Medicina dell’Adolescenza
e Neuropsichiatria Infantile


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Minerva Pediatrica 2017 Feb 07

DOI: 10.23736/S0026-4946.16.04758-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation

Jose C. FLORES-GONZÁLEZ 1, Alfonso M. LECHUGA SANCHO 2, Mónica SALDAÑA VALDERAS 3, Gema JIMENEZ GOMEZ 4, Maria D. CRUZADO GARCIA 5, Cristina PEREZ ARAGON 6, Jose A. BLANCA GARCIA 6

1 Pediatric Intensive Care Unit, Puerta del Mar University Hospital, Cádiz, Spain; 2 Mother and Child Health, and Radiology Department, Cádiz University, Cadiz, Spain; 3 Clinical Farmacology Unit, Puerta del Mar University Hospital, Cadiz, Spain; 4 Research Unit, Puerta del Mar University Hospital, Cadiz, Spain; 5 Pediatric Intensive Care Unit, Puerta del Mar University Hospital, Cádiz, Spain; 6 Pediatric Gastroenterology Unit, Puerta del Mar University Hospital, Cadiz, Spain


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BACKGROUND: There is no evidence of the need for oxygen supplementation during upper digestive endoscopies under Ketamine sedation in children, and the latest recommendations specifically state that it is not mandatory for the procedure. The aim of our study is to assess the incidence of respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation when performed without oxygen supplementation, in accordance with the latest recommendations.
METHODS: 88 children undergoingketamine sedation for programmed upper digestive endoscopy at our Pediatric Intensive Care Unit were included. Patients needing other sedative agents different from ketamine were excluded. No patients received previous oxygen therapy. Suction equipment, oxygen, a bag-valve-mask, and age-appropriate equipment for advanced airway management were immediately available. The primary outcome measure was the incidence of desaturation episodes (i.e. FiO2 below 90% requiring an intervention).
RESULTS: Fifty five patients (62.5%) presented a desaturation episode during the procedure. Most desaturation episodes occurred during the endoscope introduction (78.2%), and 5 episodes were previous to the endoscope introduction (minute 0). Around sixty percent of patients (58.9%) required oxygen therapy and four patients required bag-mask ventilation. Once oxygen therapy was initiated, 34 patients (70.5 %) required it during the complete procedure or part of it.
CONCLUSIONS: Desaturation episodes occur frequently early on in the procedure. Our data suggest that the role of oxygen supplementation prior to, and during upper digestive endoscopies under ketamine sedation in children should be thoroughly assessed for future recommendations.


KEY WORDS: Ketamine - Upper digestive endoscopy - Sedation - Oxygen therapy - Adverse events

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Per citare questo articolo

Flores-González JC, Lechuga Sancho AM, Saldaña Valderas M, Jimenez Gomez G, Cruzado Garcia MD, Perez Aragon C, et al. Respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation. Minerva Pediatr 2017 Feb 07. DOI: 10.23736/S0026-4946.16.04758-7 

Corresponding author e-mail

carlosflogon@gmail.com