Effect of upper respiratory infection on anaesthesia induced atelectasis in paediatric patients

Area of Science:

• Pediatric Anesthesiology
• Respiratory Medicine
• Medical Imaging

Background:

• Upper respiratory tract infections (URIs) are linked to increased perioperative respiratory adverse events (PRAEs) in children under general anesthesia.
• General anesthesia can cause atelectasis, potentially exacerbated by URIs, leading to adverse outcomes.
• The specific impact of URI symptoms on anesthesia-induced atelectasis in pediatric patients remains under-investigated.

Purpose of the Study:

• To investigate whether current URI symptoms aggravate perioperative atelectasis in children undergoing general anesthesia.
• To determine the correlation between URI severity and the degree of anesthesia-induced atelectasis.
• To assess the relationship between URI symptoms and the occurrence of PRAEs.

Main Methods:

• Prospective recruitment of 270 children (6 months to 6 years) undergoing surgery.
• URI severity assessment via questionnaire; atelectasis evaluation using sonographic findings (juxtapleural consolidation, B-lines).
• Multiple linear regression analysis to correlate URI severity with atelectasis scores.

Main Results:

• Analysis included 256 children; most presented with mild URI symptoms.
• No significant association was found between mild URI symptoms and the atelectasis score in the overall cohort.
• A significant positive correlation was observed between URI severity and PRAE occurrence (OR 1.36, 95% CI 1.10-1.67, p=0.004).

Conclusions:

• Mild URI symptoms do not appear to exacerbate anesthesia-induced atelectasis in pediatric patients.
• The presence and severity of URI symptoms are significantly correlated with an increased risk of PRAEs in children.
• Further research may clarify the mechanisms linking URIs to PRAEs in this population.