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[Rapid sequence induction in pediatric patients--a questionnaire survey to the children's hospitals in Japan]

Kazuya Tachibana1, Keiko Kinouchi, Muneyuki Takeuchi

  • 1Department of Anesthesia and Intensive Care, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi 594-1101.

Masui. the Japanese Journal of Anesthesiology
|May 18, 2012
PubMed

Insights

Rapid sequence induction practices for pediatric full stomach cases in Japan vary. Procedures differ based on patient age and condition, highlighting the need for tailored approaches in pediatric anesthesia.

Area of Science:

  • Pediatric Anesthesiology
  • Critical Care Medicine
  • Surgical Patient Management

Context:

  • Rapid sequence induction (RSI) is a critical procedure for preventing aspiration in patients with a full stomach.
  • Limited data exists on current RSI practices for pediatric patients with full stomachs in Japanese children's hospitals.
  • Understanding these practices is essential for standardizing care and improving patient safety.

Purpose:

  • To investigate and detail the current practices of rapid sequence induction in Japanese children's hospitals for two distinct full stomach scenarios.
  • To compare RSI methods used for a 4-week-old infant with pyloric stenosis versus a 3-year-old child with ileus.
  • To identify variations and commonalities in anesthetic management for these high-risk pediatric cases.

Summary:

  • A survey of 17 out of 27 pediatric anesthesia departments revealed consistent use of nasogastric tube insertion and suction prior to induction.
  • Atropine use and gentle mask ventilation were more common in the infant (pyloric stenosis) scenario.
  • Awake intubation was not employed, and cricoid pressure use was low (24%) in infants, indicating diverse approaches to RSI in pediatric full stomach cases.

Impact:

  • This study provides the first detailed overview of RSI practices for full stomach pediatric patients in Japan.
  • Findings highlight that anesthetic management for RSI in children is adapted based on age, specific disease, and clinical condition.
  • The results can inform the development of evidence-based guidelines and enhance the safety of pediatric anesthesia in Japan and potentially other regions.
Abstract

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