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Perioperative Respiratory Adverse Events and Associated Factors Among Pediatric Patients in Ethiopian Hospitals: A
Shimelis Seid1, Keder Essa1, Yewlsew Fentie2
1Debre Tabor University, Debre Tabor, Ethiopia.
Insights
The incidence of perioperative respiratory adverse events in Ethiopian pediatric surgical patients was 32.5%. Key risk factors included allergies, pain, and upper respiratory tract infections, highlighting the need for careful patient monitoring.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Critical Care Medicine
Background:
- Perioperative respiratory adverse events significantly increase morbidity and mortality.
- These events are a leading cause of critical incidents in pediatric anesthesia.
- The incidence of these events in Ethiopian healthcare settings was previously unknown.
Purpose of the Study:
- To determine the incidence of perioperative respiratory adverse events.
- To identify associated factors among pediatric surgical patients.
- Study conducted in three north-west Ethiopian hospitals from June 2022 to April 2023.
Main Methods:
- A hospital-based prospective cohort study design was employed.
- Included 424 pediatric surgical patients undergoing various procedures (elective and emergency).
- Data collected on patient characteristics and perioperative outcomes.
Main Results:
- The incidence of perioperative respiratory adverse events was 32.5% (95% CI: 28.3-36.9).
- Associated factors included ketamine anesthesia maintenance, history of allergy, moderate to severe pain, active upper respiratory tract infection, procedures above the neck, and endotracheal intubation.
- Significant associations were identified between specific patient conditions and adverse respiratory outcomes.
Conclusions:
- The incidence of perioperative respiratory adverse events in this cohort is notably high.
- Clinicians should pay close attention to patients with a history of allergy, moderate to severe pain, upper respiratory tract infection, undergoing ENT surgery, receiving intravenous anesthesia, and requiring endotracheal intubation.
- Implementing targeted interventions for these risk factors can help reduce adverse respiratory events in pediatric surgical patients.
Background:
Respiratory adverse events increase morbidity and mortality rates throughout the perioperative period. It also account for most of the critical incidents in pediatric anesthesia. The incidence of these events in Ethiopian health care is unknown.
Objectives:
This study aimed to determine the incidence of perioperative respiratory adverse events and associated factors among pediatric surgical patients from June 2022 to April 2023, at three selected north-west Ethiopian hospitals.
Methods:
A hospital-based prospective cohort study was conducted among pediatric surgical patients who had undergone a variety of surgeries. A total of 424 patients were included, including elective and emergency cases.
Results:
138 (32.5%, 95% CI: 28.3-36.9) patients developed perioperative respiratory adverse events. Variables that showed association with respiratory adverse events included ketamine maintenance of anesthesia, history of allergy, having moderate to severe pain level, history of active upper respiratory tract infection, above neck procedures, and endotracheal intubation.
Conclusion:
Perioperative respiratory adverse events incidence was high compared with other studies. Clinicians need to give careful attention to patients with a history of allergy, moderate to severe pain, upper respiratory tract infection, ENT surgery, intravenous anesthesia maintenance, and endotracheal intubation to decrease adverse respiratory events.
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