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Oxygenation during general anesthesia in pediatric patients: A retrospective observational study
Protocols are used in intensive care and emergency settings to limit the use of oxygen. However, in pediatric anesthesiology, such protocols do not exist. This study aimed to investigate the administration of oxygen during pediatric general anesthesia and related these values to PaO2, SpO2 and SaO2....
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| Published in: | Journal of clinical anesthesia 2024-06, Vol.94, p.111406-111406, Article 111406 |
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| container_title | Journal of clinical anesthesia |
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| creator | van Wijk, Jan J. Musaj, Albina Hoeks, Sanne E. Reiss, Irwin K.M. Stolker, Robert Jan Staals, Lonneke M. |
| description | Protocols are used in intensive care and emergency settings to limit the use of oxygen. However, in pediatric anesthesiology, such protocols do not exist. This study aimed to investigate the administration of oxygen during pediatric general anesthesia and related these values to PaO2, SpO2 and SaO2.
Retrospective observational study.
Tertiary pediatric academic hospital, from June 2017 to August 2020.
Patients aged 0–18 years who underwent general anesthesia for a diagnostic or surgical procedure with tracheal intubation and an arterial catheter for regular blood withdrawal were included. Patients on cardiopulmonary bypass or those with missing data were excluded. Electronic charts were reviewed for patient characteristics, type of surgery, arterial blood gas analyses, and oxygenation management.
No interventions were done.
Primary outcome defined as FiO2, PaO2 and SpO2 values were interpreted using descriptive analyses, and the correlation between PaO2 and FiO2 was determined using the weighted Spearman correlation coefficient.
Data of 493 cases were obtained. Of these, 267 were excluded for various reasons. Finally, 226 cases with a total of 645 samples were analyzed. The median FiO2 was 36% (IQR 31 to 43), with a range from 20% to 97%, and the median PaO2 was 23.6 kPa (IQR 18.6 to 28.1); 177 mmHg (IQR 140 to 211). The median SpO2 level was 99% (IQR 98 to 100%). The study showed a moderately positive association between PaO2 and FiO2 (r = 0.52, p |
| doi_str_mv | 10.1016/j.jclinane.2024.111406 |
| format | article |
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Retrospective observational study.
Tertiary pediatric academic hospital, from June 2017 to August 2020.
Patients aged 0–18 years who underwent general anesthesia for a diagnostic or surgical procedure with tracheal intubation and an arterial catheter for regular blood withdrawal were included. Patients on cardiopulmonary bypass or those with missing data were excluded. Electronic charts were reviewed for patient characteristics, type of surgery, arterial blood gas analyses, and oxygenation management.
No interventions were done.
Primary outcome defined as FiO2, PaO2 and SpO2 values were interpreted using descriptive analyses, and the correlation between PaO2 and FiO2 was determined using the weighted Spearman correlation coefficient.
Data of 493 cases were obtained. Of these, 267 were excluded for various reasons. Finally, 226 cases with a total of 645 samples were analyzed. The median FiO2 was 36% (IQR 31 to 43), with a range from 20% to 97%, and the median PaO2 was 23.6 kPa (IQR 18.6 to 28.1); 177 mmHg (IQR 140 to 211). The median SpO2 level was 99% (IQR 98 to 100%). The study showed a moderately positive association between PaO2 and FiO2 (r = 0.52, p < 0.001). 574 of 645 samples (89%) contained a PaO2 higher than 13.3 kPa; 100 mmHg.
Oxygen administration during general pediatric anesthesia is barely regulated. Hyperoxemia is observed intraoperatively in approximately 90% of cases. Future research should focus on outcomes related to hyperoxemia.
•The use of oxygen in intensive care and emergency settings is strictly regulated.•No protocols exist to limit the use of oxygen during pediatric anesthesia.•Intraoperative hyperoxemia was observed in 90% of patients with an arterial line in this single-center study.•Oxygen usage during pediatric anesthesia could be more regulated.</description><identifier>ISSN: 0952-8180</identifier><identifier>EISSN: 1873-4529</identifier><identifier>DOI: 10.1016/j.jclinane.2024.111406</identifier><identifier>PMID: 38325249</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Anesthesia, General - adverse effects ; Blood gas analysis ; Blood Gas Analysis - methods ; Catheters ; Child ; Children & youth ; Clinical outcomes ; Critical Care ; General anesthesia ; Humans ; Hyperoxia ; Intraoperative ; Medical personnel ; Monitoring ; Observational studies ; Oximetry - methods ; Oxygen ; Oxygen saturation ; Oxygen therapy ; Patients ; Pediatrics ; Perioperative care ; Physiology ; Ratios ; Surgery</subject><ispartof>Journal of clinical anesthesia, 2024-06, Vol.94, p.111406-111406, Article 111406</ispartof><rights>2024 The Authors</rights><rights>Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.</rights><rights>2024. The Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c391t-7e99a05a8b1ea641a90387a6631b137a006dedde380d29e1a1a13fe0e3d2aecc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38325249$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Wijk, Jan J.</creatorcontrib><creatorcontrib>Musaj, Albina</creatorcontrib><creatorcontrib>Hoeks, Sanne E.</creatorcontrib><creatorcontrib>Reiss, Irwin K.M.</creatorcontrib><creatorcontrib>Stolker, Robert Jan</creatorcontrib><creatorcontrib>Staals, Lonneke M.</creatorcontrib><title>Oxygenation during general anesthesia in pediatric patients: A retrospective observational study</title><title>Journal of clinical anesthesia</title><addtitle>J Clin Anesth</addtitle><description>Protocols are used in intensive care and emergency settings to limit the use of oxygen. However, in pediatric anesthesiology, such protocols do not exist. This study aimed to investigate the administration of oxygen during pediatric general anesthesia and related these values to PaO2, SpO2 and SaO2.
Retrospective observational study.
Tertiary pediatric academic hospital, from June 2017 to August 2020.
Patients aged 0–18 years who underwent general anesthesia for a diagnostic or surgical procedure with tracheal intubation and an arterial catheter for regular blood withdrawal were included. Patients on cardiopulmonary bypass or those with missing data were excluded. Electronic charts were reviewed for patient characteristics, type of surgery, arterial blood gas analyses, and oxygenation management.
No interventions were done.
Primary outcome defined as FiO2, PaO2 and SpO2 values were interpreted using descriptive analyses, and the correlation between PaO2 and FiO2 was determined using the weighted Spearman correlation coefficient.
Data of 493 cases were obtained. Of these, 267 were excluded for various reasons. Finally, 226 cases with a total of 645 samples were analyzed. The median FiO2 was 36% (IQR 31 to 43), with a range from 20% to 97%, and the median PaO2 was 23.6 kPa (IQR 18.6 to 28.1); 177 mmHg (IQR 140 to 211). The median SpO2 level was 99% (IQR 98 to 100%). The study showed a moderately positive association between PaO2 and FiO2 (r = 0.52, p < 0.001). 574 of 645 samples (89%) contained a PaO2 higher than 13.3 kPa; 100 mmHg.
Oxygen administration during general pediatric anesthesia is barely regulated. Hyperoxemia is observed intraoperatively in approximately 90% of cases. Future research should focus on outcomes related to hyperoxemia.
•The use of oxygen in intensive care and emergency settings is strictly regulated.•No protocols exist to limit the use of oxygen during pediatric anesthesia.•Intraoperative hyperoxemia was observed in 90% of patients with an arterial line in this single-center study.•Oxygen usage during pediatric anesthesia could be more regulated.</description><subject>Anesthesia, General - adverse effects</subject><subject>Blood gas analysis</subject><subject>Blood Gas Analysis - methods</subject><subject>Catheters</subject><subject>Child</subject><subject>Children & youth</subject><subject>Clinical outcomes</subject><subject>Critical Care</subject><subject>General anesthesia</subject><subject>Humans</subject><subject>Hyperoxia</subject><subject>Intraoperative</subject><subject>Medical personnel</subject><subject>Monitoring</subject><subject>Observational studies</subject><subject>Oximetry - methods</subject><subject>Oxygen</subject><subject>Oxygen saturation</subject><subject>Oxygen therapy</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Perioperative care</subject><subject>Physiology</subject><subject>Ratios</subject><subject>Surgery</subject><issn>0952-8180</issn><issn>1873-4529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkUlPwzAQhS0EgrL8BWSJC5cUL9nMiapikypxgbNx7Sk4SpNgJxX990wp5cAF-WBZ_ubNzHuEnHM25oznV9W4srVvTANjwUQ65pynLN8jI14WMkkzofbJiKlMJCUv2RE5jrFijOEHPyRHspQiE6kakdenz_UbNKb3bUPdEHzzRvENwdQUxWP_DtEb6hvagfOmD97SDmlo-nhNJzRAH9rYge39Cmg7jxBW32JYH_vBrU_JwcLUEc5-7hPycnf7PH1IZk_3j9PJLLFS8T4pQCnDMlPOOZg85UYxWRYmzyWfc1kYxnIHzoEsmRMKuMEjF8BAOmHAWnlCLre6XWg_BhxcL320UNe4RTtELZTARlJlEtGLP2jVDgEn3lCyFEWR5RlS-ZayuGAMsNBd8EsT1pozvclAV3qXgd5koLcZYOH5j_wwX4L7LduZjsDNFgD0Y-Uh6GjRUIsGBzRSu9b_1-MLL7qcjg</recordid><startdate>202406</startdate><enddate>202406</enddate><creator>van Wijk, Jan J.</creator><creator>Musaj, Albina</creator><creator>Hoeks, Sanne E.</creator><creator>Reiss, Irwin K.M.</creator><creator>Stolker, Robert Jan</creator><creator>Staals, Lonneke M.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>202406</creationdate><title>Oxygenation during general anesthesia in pediatric patients: A retrospective observational study</title><author>van Wijk, Jan J. ; 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However, in pediatric anesthesiology, such protocols do not exist. This study aimed to investigate the administration of oxygen during pediatric general anesthesia and related these values to PaO2, SpO2 and SaO2.
Retrospective observational study.
Tertiary pediatric academic hospital, from June 2017 to August 2020.
Patients aged 0–18 years who underwent general anesthesia for a diagnostic or surgical procedure with tracheal intubation and an arterial catheter for regular blood withdrawal were included. Patients on cardiopulmonary bypass or those with missing data were excluded. Electronic charts were reviewed for patient characteristics, type of surgery, arterial blood gas analyses, and oxygenation management.
No interventions were done.
Primary outcome defined as FiO2, PaO2 and SpO2 values were interpreted using descriptive analyses, and the correlation between PaO2 and FiO2 was determined using the weighted Spearman correlation coefficient.
Data of 493 cases were obtained. Of these, 267 were excluded for various reasons. Finally, 226 cases with a total of 645 samples were analyzed. The median FiO2 was 36% (IQR 31 to 43), with a range from 20% to 97%, and the median PaO2 was 23.6 kPa (IQR 18.6 to 28.1); 177 mmHg (IQR 140 to 211). The median SpO2 level was 99% (IQR 98 to 100%). The study showed a moderately positive association between PaO2 and FiO2 (r = 0.52, p < 0.001). 574 of 645 samples (89%) contained a PaO2 higher than 13.3 kPa; 100 mmHg.
Oxygen administration during general pediatric anesthesia is barely regulated. Hyperoxemia is observed intraoperatively in approximately 90% of cases. Future research should focus on outcomes related to hyperoxemia.
•The use of oxygen in intensive care and emergency settings is strictly regulated.•No protocols exist to limit the use of oxygen during pediatric anesthesia.•Intraoperative hyperoxemia was observed in 90% of patients with an arterial line in this single-center study.•Oxygen usage during pediatric anesthesia could be more regulated.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>38325249</pmid><doi>10.1016/j.jclinane.2024.111406</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of clinical anesthesia, 2024-06, Vol.94, p.111406-111406, Article 111406 |
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| subjects | Anesthesia, General - adverse effects Blood gas analysis Blood Gas Analysis - methods Catheters Child Children & youth Clinical outcomes Critical Care General anesthesia Humans Hyperoxia Intraoperative Medical personnel Monitoring Observational studies Oximetry - methods Oxygen Oxygen saturation Oxygen therapy Patients Pediatrics Perioperative care Physiology Ratios Surgery |
| title | Oxygenation during general anesthesia in pediatric patients: A retrospective observational study |
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