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Complications associated with paediatric airway management during the COVID-19 pandemic: an international,

M B Peterson1, H G Gurnaney2, N Disma3

  • 1Department of Anesthesiology, Children's Hospital Colorado/University of Colorado School of Medicine, Aurora, CO, USA.

Anaesthesia
|March 23, 2022
PubMed

Insights

Children with COVID-19 undergoing general anesthesia face higher risks of hypoxemia during airway management. This study highlights increased respiratory adverse events in pediatric patients with confirmed or suspected COVID-19.

Area of Science:

  • Anesthesiology
  • Pediatric Critical Care
  • Infectious Diseases

Background:

  • Respiratory adverse events during general anesthesia in adults with COVID-19 are severe.
  • A significant knowledge gap exists regarding these events in pediatric populations.

Purpose of the Study:

  • To investigate the incidence of respiratory adverse events, specifically hypoxemia, in children undergoing general anesthesia with COVID-19.
  • To compare outcomes between children with and without COVID-19 and between symptomatic and asymptomatic COVID-19 cases.

Main Methods:

  • An international observational registry was established, collecting data from 78 centers between April 2020 and November 2020.
  • Phase 1 collected data on all pediatric patients (<18 years) undergoing general anesthesia; Phase 2 focused on those with confirmed or suspected COVID-19.
  • Primary outcome was hypoxemia during airway management; secondary outcomes included other complications and first-pass intubation success.

Main Results:

  • A total of 7896 children were analyzed (7567 COVID-19 negative, 329 COVID-19 positive).
  • The incidence of hypoxemia was significantly higher in COVID-19 positive children (7%) compared to COVID-19 negative children (3%).
  • Symptomatic COVID-19 children had a substantially higher hypoxemia rate (19%) than asymptomatic cases (5%).

Conclusions:

  • Children with confirmed or presumed COVID-19 have an elevated risk of hypoxemia during general anesthesia.
  • The findings underscore the importance of vigilant airway management in pediatric patients with COVID-19.

Keywords:
COVID-19airwayairway adverse eventspaediatricstracheal intubation

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