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.
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Disma Nicola, Engelhardt Thomas, Hansen Tom G, de Graaff Jurgen C, Virag Katalin, Habre Walid, NECTARINE Group of the European Society of Anaesthesiology and Intensive, AUSTRIA (Maria Vittinghoff), BELGIUM (Francis Veyckemans), CROATIA (Sandra Kralik), CZECH REPUBLIC (Jiří Žurek), DENMARK (Tom Hansen), ESTONIA (Reet Kikas), FINLAND (Tuula Manner), FRANCE (Christophe Dadure, Anne Lafargue), GERMANY (Karin Becke, Claudia Hoehne), GREECE (Anna Malisiova), HUNGARY (Andrea Székely), IRELAND (Brendan O’Hare), ITALY (Nicola Disma), LATVIA (Zane Straume), LITHUANIA (Laura Lukosiene), LUXEMBOURG (Bernd Schmitz), MALTA (Francis Borg), NETHERLANDS (Jurgen de Graaff), NORWAY (Wenche B Boerke), POLAND (Marzena Zielinska), PORTUGAL (Maria Domingas Patuleia), ROMANIA (Radu Tabacaru), SERBIA (Dusica Simic), SLOVAKIA (Miloslav Hanula), SLOVENIA (Jelena Berger), SPAIN (Ignacio Gálvez Escalera), SWEDEN (Albert Castellheim), SWITZERLAND (Walid Habre), TURKEY (Dilek Özcengiz - Zehra Hatipoğlu), UKRAINE (Dmytro Dmytriiev), UNITED KINGDOM (Thomas Engelhardt, Suellen Walker), Management Team
Аннотация
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 reported 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: NCT02350348.