Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.
Ann Emerg Med. 2024 Nov;84(5):473-485. doi: 10.1016/j.annemergmed.2024.04.014. Epub 2024 Jun 12.
Preprocedural oxygenation (pre-emptive oxygenation started during presedation and/or induction) and procedural oxygenation (pre-emptive oxygenation started during any phase of sedation) are easy-to-use strategies with potential to decrease adverse events. Here, we describe practice patterns of preprocedural oxygenation and procedural oxygenation. We hypothesized that patients who received preprocedural oxygenation or procedural oxygenation would have a lower risk of airway/breathing/circulation interventions during sedation compared with patients without procedural oxygenation.
We performed a retrospective, multicenter, cross-sectional study of pediatric sedations from April 2020 to July 2023 using the Pediatric Sedation Research Consortium multicenter database. The patient-level and sedation-level characteristics were described using frequencies and proportions, stratified by preprocedural oxygenation and procedural oxygenation status. We determined the site-level frequency of preprocedural oxygenation and procedural oxygenation use. We used inverse probability of treatment weighting to calculate the risk difference for interventions associated with preprocedural oxygenation and procedural oxygenation.
This study included a total of 85,599 pediatric sedations; 43,242 (50.5%) patients received preprocedural oxygenation (used oxygen before sedation and/or at induction) and a total of 52,219 (61.0%) received procedural oxygenation pre-emptively at any time during the sedation. There was no statistical difference in overall interventions with either preprocedural oxygenation (risk difference -0.06%; 95% confidence interval -4.26% to 4.14%) or procedural oxygenation (risk difference -1.07%; 95% confidence interval -6.44% to 4.30%).
Pre-emptive preprocedural oxygenation and procedural oxygenation were not associated with a difference in the use of airway/breathing/circulation interventions in pediatric sedations.
术前氧合（在镇静诱导前开始的预防性氧合）和术中氧合（在镇静的任何阶段开始的预防性氧合）是易于使用的策略，具有降低不良事件的潜力。在这里，我们描述了术前氧合和术中氧合的实践模式。我们假设与未行术中氧合的患者相比，接受术前氧合或术中氧合的患者在镇静期间气道/呼吸/循环干预的风险较低。
我们使用小儿镇静研究联合会多中心数据库，进行了一项回顾性、多中心、横断面研究，纳入了 2020 年 4 月至 2023 年 7 月期间的小儿镇静病例。使用频率和比例描述了患者水平和镇静水平的特征，并按术前氧合和术中氧合状态进行分层。我们确定了术前氧合和术中氧合使用的地点水平频率。我们使用逆概率治疗加权法计算与术前氧合和术中氧合相关的干预措施的风险差异。
这项研究共纳入了 85599 例小儿镇静病例；43242 例（50.5%）患者接受了术前氧合（在镇静和/或诱导前吸氧），共有 52219 例（61.0%）患者在镇静过程中的任何时间接受了术中预防性氧合。术前氧合（风险差异-0.06%；95%置信区间-4.26%至 4.14%）或术中氧合（风险差异-1.07%；95%置信区间-6.44%至 4.30%）均与总体干预措施无统计学差异。
术前预防性氧合和术中预防性氧合与小儿镇静中气道/呼吸/循环干预的使用无差异。
