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Desaturation in procedural sedation for children with long bone fractures: Does weight status matter?

Danielle G Hirsch1, John Tyo1, Brian H Wrotniak1

  • 1Women and Children's Hospital of Buffalo, University Pediatric Associates, Division of Pediatric Emergency Medicine, 219 Bryant Street, Buffalo, NY 14222, USA; Women and Children's Hospital of Buffalo, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, 3435 Main Street, Buffalo, NY 14214, USA.

The American Journal of Emergency Medicine
|March 2, 2017
PubMed

Insights

Children with obesity undergoing procedural sedation are nearly twice as likely to experience desaturations compared to healthy-weight children. This highlights the need for increased vigilance during sedation for pediatric patients with obesity.

Area of Science:

  • Pediatric Anesthesiology
  • Critical Care Medicine
  • Public Health

Background:

  • Childhood obesity is a significant public health concern in the U.S.
  • Sedation in obese children is associated with adverse events, particularly hypoxemia.
  • Procedural sedation risks in pediatric patients require careful consideration of weight status.

Purpose of the Study:

  • To investigate the association between overweight/obesity and desaturations during procedural sedation in children.
  • To compare desaturation rates in children with obesity versus those of healthy weight.
  • To inform clinical practice regarding sedation safety in pediatric obesity.

Main Methods:

  • Retrospective chart review of 823 pediatric patients (ages 2-17) who received procedural sedation.
  • Weight status categorized using age and gender-specific Body Mass Index (BMI) percentiles.
  • Analysis compared desaturation events across underweight, healthy weight, overweight, and obese groups.

Main Results:

  • Children with obesity exhibited higher desaturation rates (9.9%) compared to other weight categories (5.4%).
  • The difference in desaturation rates between obese and non-obese children was statistically significant (p=0.035).
  • No overall statistical significance was found across all weight categories combined, but obesity emerged as a key risk factor.

Conclusions:

  • Children with obesity are nearly twice as likely to experience desaturation during procedural sedation.
  • Healthcare providers should be aware of the increased risk of desaturation in obese pediatric patients.
  • Enhanced monitoring and preparedness are recommended for procedural sedation in children with obesity.
Abstract

Keywords:
Bone fractureObesityPediatricsSedation

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