Pediatric Clinical Pharmacology Laboratory, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Acta Anaesthesiol Scand. 2018 Aug;62(7):915-923. doi: 10.1111/aas.13113. Epub 2018 Mar 22.
Recent upper respiratory tract infection (URI) is associated with increased incidence of perioperative complications in children undergoing open heart surgery. As a result, surgery is often postponed. However, the effect of recent URI on the incidence of perioperative complications in children undergoing therapeutic cardiac catheterisation is unknown. We investigated the perioperative outcomes of congenital heart disease (CHD) children with recent URI who underwent elective therapeutic catheterisation.
We prospectively included children treated for CHD. Before surgery, parents or legal guardians were interviewed to complete a questionnaire on the child's demographics, history of asthma and passive smoking, and URI symptoms. Recorded perioperative respiratory adverse events (PRAEs) included laryngospasm, bronchospasm, breath holding, oxygen desaturation, and severe cough. Information on postoperative dysphoria, fever, copious sputum, and vomiting was obtained by telephone 24 h after surgery.
Of 363 included children, 169 had recently (within 2 weeks) had a URI. The URI did not affect the incidence of laryngospasm, bronchospasm, breath holding, fever, or vomiting. The incidence of desaturation, severe cough, dysphoria, and copious sputum were significantly increased. Independent risk factors for PRAEs in children with a recent URI included age, passive smoking, and presence of rhinorrhoea or moist cough. The lengths of stay in the hospital and intensive care unit were not significantly different between groups.
Although recent URI increased the incidence of PRAEs in children undergoing therapeutic cardiac catheterisation, most CHD patients with recent URI can undergo elective therapeutic cardiac catheterisation without serious adverse events or prolonged hospitalisation.
近期上呼吸道感染(URI)与儿童接受心脏直视手术围手术期并发症的发生率增加有关。因此,手术经常被推迟。然而,近期 URI 对接受治疗性心导管术的儿童围手术期并发症发生率的影响尚不清楚。我们研究了近期患有 URI 并接受择期治疗性心导管术的先天性心脏病(CHD)儿童的围手术期结局。
我们前瞻性地纳入了接受 CHD 治疗的儿童。手术前,通过访谈父母或法定监护人,完成一份关于儿童人口统计学、哮喘和被动吸烟史以及 URI 症状的问卷。记录围手术期呼吸不良事件(PRAE)包括喉痉挛、支气管痉挛、屏气、氧饱和度下降和剧烈咳嗽。通过术后 24 小时电话询问获得术后烦躁、发热、大量咳痰和呕吐的信息。
在 363 名纳入的儿童中,有 169 名最近(2 周内)有 URI。URI 并未影响喉痉挛、支气管痉挛、屏气、发热或呕吐的发生率。但脱氧、剧烈咳嗽、烦躁不安和大量咳痰的发生率显著增加。近期 URI 儿童 PRAE 的独立危险因素包括年龄、被动吸烟以及有流涕或湿咳。URI 组和无 URI 组的住院时间和重症监护病房时间无显著差异。
尽管近期 URI 增加了接受治疗性心导管术的儿童 PRAE 的发生率,但大多数患有近期 URI 的 CHD 患者可接受择期治疗性心导管术,而不会发生严重不良事件或延长住院时间。