TY - JOUR
T1 - Neonates undergoing pyloric stenosis repair are at increased risk of difficult airway management
T2 - secondary analysis of the NEonate and Children audiT of Anaesthesia pRactice IN Europe
AU - Disma, Nicola
AU - Engelhardt, Thomas
AU - NECTARINE Group of the European Society of Anaesthesiology and Intensive Care Clinical Trial Network
AU - Hansen, Tom G.
AU - de Graaff, Jurgen C.
AU - Virag, Katalin
AU - Habre, Walid
N1 - Funding
European Society of Anaesthesiology and Intensive Care - Clinical Trial Network (ESAIC-CTN).
Publisher Copyright: © 2022 British Journal of Anaesthesia
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Background: Hypertrophic pyloric stenosis in otherwise healthy neonates frequently requires urgent surgical procedure but anaesthesia care may result in respiratory complications, such as hypoxaemia, pulmonary aspiration of gastric contents, and postoperative apnoea. The primary aim was to study whether or not the incidence of difficult airway management and of hypoxaemia in neonates undergoing pyloric stenosis repair was higher than that in neonates undergoing other surgeries. Methods: Data on neonates and infants undergoing anaesthesia and surgery for pyloric stenosis were extracted from the NEonate and Children audiT of Anesthesia pRactice In Europe (NECTARINE) database, for secondary analysis. Results: We identified 310 infants who had anaesthesia for surgery for pyloric stenosis. Difficult airway management (more than two attempts at laryngoscopy) was higher in children with pyloric stenosis when compared with the entire NECTARINE cohort (7.9% [95% confidence interval {CI}, 5.22–11.53] vs 4.4% [95% CI, 1.99–6.58]; relative risk [RR]=1.81 [95% CI, 1.21–2.69]; P=0.004), whereas transient hypoxaemia with oxygen saturation <90% was comparable between the two cohorts. Postoperative complications occurred in 16 children (5.6%) within the 30-day follow-up. No mortality was reported at 30 and 90 days. Conclusions: Children undergoing surgery for pyloric stenosis had a higher incidence of difficult intubation compared with the entire NECTARINE cohort. Clinical trial registration: NCT 02350348.
AB - Background: Hypertrophic pyloric stenosis in otherwise healthy neonates frequently requires urgent surgical procedure but anaesthesia care may result in respiratory complications, such as hypoxaemia, pulmonary aspiration of gastric contents, and postoperative apnoea. The primary aim was to study whether or not the incidence of difficult airway management and of hypoxaemia in neonates undergoing pyloric stenosis repair was higher than that in neonates undergoing other surgeries. Methods: Data on neonates and infants undergoing anaesthesia and surgery for pyloric stenosis were extracted from the NEonate and Children audiT of Anesthesia pRactice In Europe (NECTARINE) database, for secondary analysis. Results: We identified 310 infants who had anaesthesia for surgery for pyloric stenosis. Difficult airway management (more than two attempts at laryngoscopy) was higher in children with pyloric stenosis when compared with the entire NECTARINE cohort (7.9% [95% confidence interval {CI}, 5.22–11.53] vs 4.4% [95% CI, 1.99–6.58]; relative risk [RR]=1.81 [95% CI, 1.21–2.69]; P=0.004), whereas transient hypoxaemia with oxygen saturation <90% was comparable between the two cohorts. Postoperative complications occurred in 16 children (5.6%) within the 30-day follow-up. No mortality was reported at 30 and 90 days. Conclusions: Children undergoing surgery for pyloric stenosis had a higher incidence of difficult intubation compared with the entire NECTARINE cohort. Clinical trial registration: NCT 02350348.
UR - http://www.scopus.com/inward/record.url?scp=85137692010&partnerID=8YFLogxK
U2 - 10.1016/j.bja.2022.07.041
DO - 10.1016/j.bja.2022.07.041
M3 - Article
C2 - 36085092
AN - SCOPUS:85137692010
SN - 0007-0912
VL - 129
SP - 734
EP - 739
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 5
ER -