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Updated: Dec 24, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Anesthesia timing for children undergoing therapeutic cardiac catheterization after upper respiratory infection: a
Kan Zhang1,2, Siyuan Wang3, Mengqi Li1
1Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine and National Children's Medical Center, Shanghai Jiao Tong University, Shanghai, China.
Insights
Delaying cardiac catheterization for children by two weeks after an upper respiratory infection (URI) significantly reduces the risk of perioperative respiratory adverse events (PRAEs). This timing adjustment is crucial for patient safety.
Area of Science:
- Pediatric Cardiology
- Anesthesiology
- Respiratory Medicine
Background:
- Upper respiratory tract infections (URIs) are common in children.
- Anesthesia and invasive procedures carry inherent risks, especially in vulnerable populations.
- Understanding risk factors for perioperative respiratory adverse events (PRAEs) is critical for optimizing patient outcomes.
Purpose of the Study:
- To investigate the impact of anesthesia timing relative to URI on PRAEs in children undergoing cardiac catheterization.
- To identify risk factors associated with PRAEs in this pediatric population.
Main Methods:
- Prospective study including children undergoing elective therapeutic cardiac catheterization.
- Data collection via questionnaires on URI symptoms and demographics.
- Recording of PRAEs (e.g., laryngospasm, oxygen desaturation) and anesthesia management details.
Main Results:
- Children with URI within two weeks of catheterization had a higher PRAE rate (66.3%) compared to those without URI (46.6%).
- Delaying procedures by 3-8 weeks post-URI lowered PRAE rates to levels comparable to controls.
- Multivariate analysis identified congenital heart disease type, anesthesia timing, and age as significant PRAE risk factors.
Conclusions:
- Postponing elective cardiac catheterization for at least two weeks after URI can significantly decrease PRAE risk in pediatric patients.
- Anesthesia timing is a modifiable factor to improve safety in children with recent URIs.
Background:
We aimed to analyze anesthesia timing and perioperative respiratory adverse event (PRAE) risk factors in children undergoing therapeutic cardiac catheterization after upper respiratory tract infection (URI).
Methods:
We prospectively included children for elective therapeutic cardiac catheterization. Parents or legal guardians were asked to complete a questionnaire on the child's demographics, tobacco exposure, and URI symptoms. PRAEs (laryngospasm, bronchospasm, coughing, airway secretion, airway obstruction, and oxygen desaturation) as well as details of anesthesia management were recorded.
Results:
Of 332 children, 201 had a history of URI in the preceding eight weeks. The occurrence rate of PRAEs in children with URI≤two weeks reached the highest proportion, which was higher than that in children without URI (66.3% vs. 46.6%, P=0.007). The overall incidence of PRAEs in children with URI in 3-8 weeks was significantly lower than that in children with URI in the recent ≤two weeks (49.0% vs. 66.3%, P=0.007), and similar to that in the control group (49.0% vs. 46.6%). Multivariate analysis showed association between PRAEs and type of congenital heart disease (CHD) (P<0.001), anesthesia timing (P=0.007), and age (P=0.021). Delayed schedule (two weeks after URI) minimized the risk of PRAEs to the level comparable to that observed in children without URI (OR, 1.11; 95% CI: 0.64-1.91; P=0.707).
Conclusions:
If treatment is not urgent, a pediatric patient at a high risk of PRAEs will be benefit from the postponement of an interventional operation by at least two weeks after URI.
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