Preprocedural Oxygenation and Procedural Oxygenation During Pediatric Procedural Sedation: Patterns of Use and Association With Interventions - 12/06/24
, Baruch Krauss, MD a, Michael C. Monuteaux, ScD a, Sarah Cavallaro, MD a, Eric Fleegler, MD, MPH bAbstract |
Study objective |
Preprocedural oxygenation (pre-emptive oxygenation started during presedation and/or induction) and procedural oxygenation (pre-emptive oxygenation started during any phase of sedation) are easy-to-use strategies with potential to decrease adverse events. Here, we describe practice patterns of preprocedural oxygenation and procedural oxygenation. We hypothesized that patients who received preprocedural oxygenation or procedural oxygenation would have a lower risk of airway/breathing/circulation interventions during sedation compared with patients without procedural oxygenation.
Methods |
We performed a retrospective, multicenter, cross-sectional study of pediatric sedations from April 2020 to July 2023 using the Pediatric Sedation Research Consortium multicenter database. The patient-level and sedation-level characteristics were described using frequencies and proportions, stratified by preprocedural oxygenation and procedural oxygenation status. We determined the site-level frequency of preprocedural oxygenation and procedural oxygenation use. We used inverse probability of treatment weighting to calculate the risk difference for interventions associated with preprocedural oxygenation and procedural oxygenation.
Results |
This study included a total of 85,599 pediatric sedations; 43,242 (50.5%) patients received preprocedural oxygenation (used oxygen before sedation and/or at induction) and a total of 52,219 (61.0%) received procedural oxygenation pre-emptively at any time during the sedation. There was no statistical difference in overall interventions with either preprocedural oxygenation (risk difference −0.06%; 95% confidence interval −4.26% to 4.14%) or procedural oxygenation (risk difference −1.07%; 95% confidence interval −6.44% to 4.30%).
Conclusion |
Pre-emptive preprocedural oxygenation and procedural oxygenation were not associated with a difference in the use of airway/breathing/circulation interventions in pediatric sedations.
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| Please see page XX for the Editor’s Capsule Summary of this article. |
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| Supervising editor: Steven M. Green, MD. Specific detailed information about possible conflicts of interest for individual editors is available at editors. |
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| Author contributions: All authors helped conceive and design the study. JL, MCM, and EF supervised data collection and review from the Pediatric Sedation Research Consortium. MCM, BK, and EF provided statistical advice on study design and analysis and analyzed the data. JL drafted the manuscript, and all authors contributed substantially to its revision. JL takes responsibility for the paper as a whole. |
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| Data sharing statement: Partial or complete data sets and data dictionary are available upon request to Dr. Daniel Tsze, at dst2141@cumc.columbia.edu, Pediatric Sedation Research Consortium Research Committee Chair pending Pediatric Sedation Research Consortium Research Committee approval. |
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| All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals’ policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist. The authors report this article did not receive any outside funding or support. |
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| Presentation information: Our study was presented as a poster at the Pediatric Academics Societies in Washington DC in April 30, 2023. |
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