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Upper Respiratory Infections and Respiratory Adverse Events and Interventions in Emergency Department Sedation of

Daniel S Tsze1, Nick Barrowman2, Maala Bhatt3

  • 1Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY.

Annals of Emergency Medicine
|April 23, 2025
PubMed

Insights

Children with upper respiratory infections (URIs) undergoing emergency department (ED) sedation do not face an increased risk of respiratory adverse events or interventions. This study found no significant association between URIs and adverse respiratory outcomes in pediatric ED sedation.

Area of Science:

  • Pediatric Emergency Medicine
  • Anesthesiology
  • Respiratory Physiology

Background:

  • Children with upper respiratory infections (URIs) face higher risks during operative anesthesia and procedural sedation.
  • The safety of emergency department (ED) sedation for children with URIs remains unclear.

Purpose of the Study:

  • To determine if URIs increase the risk of respiratory adverse events in children undergoing ED sedation.
  • To assess the association between URIs and serious respiratory interventions in pediatric ED sedation.

Main Methods:

  • Secondary analysis of a prospective cohort study involving 6,292 children (≤17 years) receiving parenteral sedation in pediatric EDs.
  • Multivariable regression analysis to identify associations between URIs and respiratory adverse events, serious adverse events, and interventions.

Main Results:

  • Of 6,292 children, 444 (7.1%) had a URI.
  • No significant increase in risk for respiratory adverse events (aOR 1.00), serious respiratory adverse events (aOR 0.53), or serious respiratory interventions (aOR 1.08) was found in children with URIs.

Conclusions:

  • The presence of a URI in children undergoing ED sedation is not associated with an increased risk of respiratory adverse events.
  • No increased risk for serious respiratory interventions was observed in pediatric patients with URIs receiving ED sedation.
Abstract

Keywords:
Adverse eventsKetaminePediatricSedationUpper respiratory infection

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