Neonates undergoing pyloric stenosis repair are at increased risk of difficult airway management: secondary analysis of the NEonate and Children audiT of Anaesthesia pRactice IN Europe

Disma N., Engelhardt T., Hansen T. G., De Graaff J. C., Virag K., Habre W.

BRITISH JOURNAL OF ANAESTHESIA, cilt.129, sa.5, ss.734-739, 2022 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 129 Sayı: 5
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.bja.2022.07.041
  • Dergi Adı: BRITISH JOURNAL OF ANAESTHESIA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.734-739
  • Anahtar Kelimeler: airway management, complications, difficult airway, neonatal anaesthesia, pyloric stenosis, tracheal intubation, PEDIATRIC ANESTHESIA, 261 HOSPITALS, INDUCTION, PYLOROMYOTOMY, INTUBATION, PROPOFOL, OUTCOMES, APRICOT
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Hayır

Özet

Background: Hypertrophic pyloric stenosis in otherwise healthy neonates frequently requires urgent surgical procedure but anaesthesia care may result in respiratory complications, such as hypoxaemia, pulmonary aspiration of gastric contents, and postoperative apnoea. The primary aim was to study whether or not the incidence of difficult airway management and of hypoxaemia in neonates undergoing pyloric stenosis repair was higher than that in neonates un-dergoing other surgeries.Methods: Data on neonates and infants undergoing anaesthesia and surgery for pyloric stenosis were extracted from the NEonate and Children audiT of Anesthesia pRactice In Europe (NECTARINE) database, for secondary analysis.Results: We identified 310 infants who had anaesthesia for surgery for pyloric stenosis. Difficult airway management (more than two attempts at laryngoscopy) was higher in children with pyloric stenosis when compared with the entire NECTARINE cohort (7.9% [95% confidence interval {CI}, 5.22-11.53] vs 4.4% [95% CI, 1.99-6.58]; relative risk [RR]=1.81 [95% CI, 1.21-2.69]; P=0.004), whereas transient hypoxaemia with oxygen saturation <90% was comparable between the two cohorts. Postoperative complications occurred in 16 children (5.6%) within the 30-day follow-up. No mortality was re-ported at 30 and 90 days.Conclusions: Children undergoing surgery for pyloric stenosis had a higher incidence of difficult intubation compared with the entire NECTARINE cohort.Clinical trial registration: NCT 02350348.