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Hypotension and adverse neurodevelopmental outcomes among children with multiple exposures to general anesthesia: Subanalysis of the Mayo Anesthesia Safety in Kids (MASK) Study
Background The potential adverse effects of exposures to general anesthesia on the developing human brain remain controversial. It has been hypothesized that hypotension accompanying anesthesia could be contributory. We hypothesized that among children exposed to multiple anesthetics prior to age 3,...
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| Published in: | Pediatric anesthesia 2021-03, Vol.31 (3), p.282-289 |
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| cites | cdi_FETCH-LOGICAL-c4436-caf216ab99355da7e1292442b4351962ce2042ea317269d386d7689b13e6fbad3 |
| container_end_page | 289 |
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| container_start_page | 282 |
| container_title | Pediatric anesthesia |
| container_volume | 31 |
| creator | Gleich, Stephen J. Shi, Yu Flick, Randall Zaccariello, Michael J. Schroeder, Darrell R. Hanson, Andrew C. Warner, David O. Vutskits, Laszlo |
| description | Background
The potential adverse effects of exposures to general anesthesia on the developing human brain remain controversial. It has been hypothesized that hypotension accompanying anesthesia could be contributory. We hypothesized that among children exposed to multiple anesthetics prior to age 3, children developing adverse neurodevelopmental outcomes would be more likely to have intraoperative hypotension.
Methods
Two previously published study cohorts were utilized for analysis: the retrospective and prospective Mayo Anesthesia Safety in Kids cohorts. The two lowest consecutive systolic blood pressure measurements were ed and standardized by calculating a z‐score for noninvasive blood pressure reference ranges for children. The lowest systolic blood pressure z‐score (continuous variable) and intraoperative hypotension (lowest systolic blood pressure z‐score |
| doi_str_mv | 10.1111/pan.14106 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8237208</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2493122023</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4436-caf216ab99355da7e1292442b4351962ce2042ea317269d386d7689b13e6fbad3</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhSMEoqWw4AXQldjQRVr_xTNmgTSqgKK2gDSwtpz4ZsZVYgc7mZK34hExTBnBAm-u5fv5XB-fonhOyRnN63ww_owKSuSD4pgKSUpVKfYw72lVlZUU1VHxJKVbQihnkj0ujjjnjHDFjosfl_MQRvTJBQ_GWzB2hzEheJxisLjDLgw9-tF0EKaxCT0mMH3wG2i2rrMRPdy5cQv91I1u6BDw-xDSFDM2Btigx5ivGo9p3GJy5jWsp9p4083JJQgt5GO4MXOA1YGBtWlxnMF5uHI2waub1frqFNbjZOenxaPWdAmf3deT4uu7t18uLsvrT-8_XKyuy0YILsvGtIxKUyvFq8qaBVKmmBCsFryiSrIGGREMDacLJpXlS2kXcqlqylG2tbH8pHiz1x2mukfb5C_IRvQQXW_irINx-t-Od1u9CTu9ZHzByDILvLwXiOHblK3p2zDFbDxpJhSnjBHGM3W6p5oYUorYHiZQon-Fq3O4-ne4mX3x95MO5J80M3C-B-5ch_P_lfTn1ce95E93ZbJ2</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2493122023</pqid></control><display><type>article</type><title>Hypotension and adverse neurodevelopmental outcomes among children with multiple exposures to general anesthesia: Subanalysis of the Mayo Anesthesia Safety in Kids (MASK) Study</title><source>Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list)</source><creator>Gleich, Stephen J. ; Shi, Yu ; Flick, Randall ; Zaccariello, Michael J. ; Schroeder, Darrell R. ; Hanson, Andrew C. ; Warner, David O. ; Vutskits, Laszlo</creator><contributor>Vutskits, Laszlo</contributor><creatorcontrib>Gleich, Stephen J. ; Shi, Yu ; Flick, Randall ; Zaccariello, Michael J. ; Schroeder, Darrell R. ; Hanson, Andrew C. ; Warner, David O. ; Vutskits, Laszlo ; Vutskits, Laszlo</creatorcontrib><description>Background
The potential adverse effects of exposures to general anesthesia on the developing human brain remain controversial. It has been hypothesized that hypotension accompanying anesthesia could be contributory. We hypothesized that among children exposed to multiple anesthetics prior to age 3, children developing adverse neurodevelopmental outcomes would be more likely to have intraoperative hypotension.
Methods
Two previously published study cohorts were utilized for analysis: the retrospective and prospective Mayo Anesthesia Safety in Kids cohorts. The two lowest consecutive systolic blood pressure measurements were ed and standardized by calculating a z‐score for noninvasive blood pressure reference ranges for children. The lowest systolic blood pressure z‐score (continuous variable) and intraoperative hypotension (lowest systolic blood pressure z‐score <−1.0) were used to assess the association of intraoperative hypotension with the incidence of learning disabilities or attention‐deficit/hyperactivity disorder(retrospective cohort) and factor scores/cluster membership (prospective cohort).
Results
One hunderd and sixteen and 206 children with multiple exposures to general anesthesia were analyzed in the retrospective and prospective cohorts with mean lowest systolic blood pressure z‐scores −0.26 (SD 1.02) and −0.62 (SD 1.10), respectively. There was no overall association of the lowest z‐score or hypotension with learning disabilities or attention‐deficit/hyperactivity disorder in the retrospective cohort. In the prospective cohort, there was no overall association of the lowest systolic blood pressure or hypotension with factor scores or cluster membership.
Conclusions
We did not find evidence to support the hypothesis that, among children exposed to multiple anesthetics prior to age 3, children developing adverse neurodevelopmental outcomes would be more likely to have intraoperative hypotension compared with those who did not.</description><identifier>ISSN: 1155-5645</identifier><identifier>EISSN: 1460-9592</identifier><identifier>DOI: 10.1111/pan.14106</identifier><identifier>PMID: 33320392</identifier><language>eng</language><publisher>France: Wiley Subscription Services, Inc</publisher><subject>Anesthesia, General - adverse effects ; anesthetic neurotoxicity ; Blood Pressure ; Child ; Child, Preschool ; children ; General anesthesia ; Humans ; Hypotension ; Hypotension - chemically induced ; Hypotension - epidemiology ; Learning disabilities ; neurodevelopment ; Prospective Studies ; Retrospective Studies</subject><ispartof>Pediatric anesthesia, 2021-03, Vol.31 (3), p.282-289</ispartof><rights>2020 John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons Ltd.</rights><rights>Copyright © 2021 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4436-caf216ab99355da7e1292442b4351962ce2042ea317269d386d7689b13e6fbad3</citedby><cites>FETCH-LOGICAL-c4436-caf216ab99355da7e1292442b4351962ce2042ea317269d386d7689b13e6fbad3</cites><orcidid>0000-0002-3791-5015 ; 0000-0003-3925-0157</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33320392$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Vutskits, Laszlo</contributor><creatorcontrib>Gleich, Stephen J.</creatorcontrib><creatorcontrib>Shi, Yu</creatorcontrib><creatorcontrib>Flick, Randall</creatorcontrib><creatorcontrib>Zaccariello, Michael J.</creatorcontrib><creatorcontrib>Schroeder, Darrell R.</creatorcontrib><creatorcontrib>Hanson, Andrew C.</creatorcontrib><creatorcontrib>Warner, David O.</creatorcontrib><creatorcontrib>Vutskits, Laszlo</creatorcontrib><title>Hypotension and adverse neurodevelopmental outcomes among children with multiple exposures to general anesthesia: Subanalysis of the Mayo Anesthesia Safety in Kids (MASK) Study</title><title>Pediatric anesthesia</title><addtitle>Paediatr Anaesth</addtitle><description>Background
The potential adverse effects of exposures to general anesthesia on the developing human brain remain controversial. It has been hypothesized that hypotension accompanying anesthesia could be contributory. We hypothesized that among children exposed to multiple anesthetics prior to age 3, children developing adverse neurodevelopmental outcomes would be more likely to have intraoperative hypotension.
Methods
Two previously published study cohorts were utilized for analysis: the retrospective and prospective Mayo Anesthesia Safety in Kids cohorts. The two lowest consecutive systolic blood pressure measurements were ed and standardized by calculating a z‐score for noninvasive blood pressure reference ranges for children. The lowest systolic blood pressure z‐score (continuous variable) and intraoperative hypotension (lowest systolic blood pressure z‐score <−1.0) were used to assess the association of intraoperative hypotension with the incidence of learning disabilities or attention‐deficit/hyperactivity disorder(retrospective cohort) and factor scores/cluster membership (prospective cohort).
Results
One hunderd and sixteen and 206 children with multiple exposures to general anesthesia were analyzed in the retrospective and prospective cohorts with mean lowest systolic blood pressure z‐scores −0.26 (SD 1.02) and −0.62 (SD 1.10), respectively. There was no overall association of the lowest z‐score or hypotension with learning disabilities or attention‐deficit/hyperactivity disorder in the retrospective cohort. In the prospective cohort, there was no overall association of the lowest systolic blood pressure or hypotension with factor scores or cluster membership.
Conclusions
We did not find evidence to support the hypothesis that, among children exposed to multiple anesthetics prior to age 3, children developing adverse neurodevelopmental outcomes would be more likely to have intraoperative hypotension compared with those who did not.</description><subject>Anesthesia, General - adverse effects</subject><subject>anesthetic neurotoxicity</subject><subject>Blood Pressure</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>children</subject><subject>General anesthesia</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Hypotension - chemically induced</subject><subject>Hypotension - epidemiology</subject><subject>Learning disabilities</subject><subject>neurodevelopment</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><issn>1155-5645</issn><issn>1460-9592</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kc1u1DAUhSMEoqWw4AXQldjQRVr_xTNmgTSqgKK2gDSwtpz4ZsZVYgc7mZK34hExTBnBAm-u5fv5XB-fonhOyRnN63ww_owKSuSD4pgKSUpVKfYw72lVlZUU1VHxJKVbQihnkj0ujjjnjHDFjosfl_MQRvTJBQ_GWzB2hzEheJxisLjDLgw9-tF0EKaxCT0mMH3wG2i2rrMRPdy5cQv91I1u6BDw-xDSFDM2Btigx5ivGo9p3GJy5jWsp9p4083JJQgt5GO4MXOA1YGBtWlxnMF5uHI2waub1frqFNbjZOenxaPWdAmf3deT4uu7t18uLsvrT-8_XKyuy0YILsvGtIxKUyvFq8qaBVKmmBCsFryiSrIGGREMDacLJpXlS2kXcqlqylG2tbH8pHiz1x2mukfb5C_IRvQQXW_irINx-t-Od1u9CTu9ZHzByDILvLwXiOHblK3p2zDFbDxpJhSnjBHGM3W6p5oYUorYHiZQon-Fq3O4-ne4mX3x95MO5J80M3C-B-5ch_P_lfTn1ce95E93ZbJ2</recordid><startdate>202103</startdate><enddate>202103</enddate><creator>Gleich, Stephen J.</creator><creator>Shi, Yu</creator><creator>Flick, Randall</creator><creator>Zaccariello, Michael J.</creator><creator>Schroeder, Darrell R.</creator><creator>Hanson, Andrew C.</creator><creator>Warner, David O.</creator><creator>Vutskits, Laszlo</creator><general>Wiley Subscription Services, Inc</general><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>K9.</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3791-5015</orcidid><orcidid>https://orcid.org/0000-0003-3925-0157</orcidid></search><sort><creationdate>202103</creationdate><title>Hypotension and adverse neurodevelopmental outcomes among children with multiple exposures to general anesthesia: Subanalysis of the Mayo Anesthesia Safety in Kids (MASK) Study</title><author>Gleich, Stephen J. ; Shi, Yu ; Flick, Randall ; Zaccariello, Michael J. ; Schroeder, Darrell R. ; Hanson, Andrew C. ; Warner, David O. ; Vutskits, Laszlo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4436-caf216ab99355da7e1292442b4351962ce2042ea317269d386d7689b13e6fbad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anesthesia, General - adverse effects</topic><topic>anesthetic neurotoxicity</topic><topic>Blood Pressure</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>children</topic><topic>General anesthesia</topic><topic>Humans</topic><topic>Hypotension</topic><topic>Hypotension - chemically induced</topic><topic>Hypotension - epidemiology</topic><topic>Learning disabilities</topic><topic>neurodevelopment</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gleich, Stephen J.</creatorcontrib><creatorcontrib>Shi, Yu</creatorcontrib><creatorcontrib>Flick, Randall</creatorcontrib><creatorcontrib>Zaccariello, Michael J.</creatorcontrib><creatorcontrib>Schroeder, Darrell R.</creatorcontrib><creatorcontrib>Hanson, Andrew C.</creatorcontrib><creatorcontrib>Warner, David O.</creatorcontrib><creatorcontrib>Vutskits, Laszlo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatric anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gleich, Stephen J.</au><au>Shi, Yu</au><au>Flick, Randall</au><au>Zaccariello, Michael J.</au><au>Schroeder, Darrell R.</au><au>Hanson, Andrew C.</au><au>Warner, David O.</au><au>Vutskits, Laszlo</au><au>Vutskits, Laszlo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypotension and adverse neurodevelopmental outcomes among children with multiple exposures to general anesthesia: Subanalysis of the Mayo Anesthesia Safety in Kids (MASK) Study</atitle><jtitle>Pediatric anesthesia</jtitle><addtitle>Paediatr Anaesth</addtitle><date>2021-03</date><risdate>2021</risdate><volume>31</volume><issue>3</issue><spage>282</spage><epage>289</epage><pages>282-289</pages><issn>1155-5645</issn><eissn>1460-9592</eissn><abstract>Background
The potential adverse effects of exposures to general anesthesia on the developing human brain remain controversial. It has been hypothesized that hypotension accompanying anesthesia could be contributory. We hypothesized that among children exposed to multiple anesthetics prior to age 3, children developing adverse neurodevelopmental outcomes would be more likely to have intraoperative hypotension.
Methods
Two previously published study cohorts were utilized for analysis: the retrospective and prospective Mayo Anesthesia Safety in Kids cohorts. The two lowest consecutive systolic blood pressure measurements were ed and standardized by calculating a z‐score for noninvasive blood pressure reference ranges for children. The lowest systolic blood pressure z‐score (continuous variable) and intraoperative hypotension (lowest systolic blood pressure z‐score <−1.0) were used to assess the association of intraoperative hypotension with the incidence of learning disabilities or attention‐deficit/hyperactivity disorder(retrospective cohort) and factor scores/cluster membership (prospective cohort).
Results
One hunderd and sixteen and 206 children with multiple exposures to general anesthesia were analyzed in the retrospective and prospective cohorts with mean lowest systolic blood pressure z‐scores −0.26 (SD 1.02) and −0.62 (SD 1.10), respectively. There was no overall association of the lowest z‐score or hypotension with learning disabilities or attention‐deficit/hyperactivity disorder in the retrospective cohort. In the prospective cohort, there was no overall association of the lowest systolic blood pressure or hypotension with factor scores or cluster membership.
Conclusions
We did not find evidence to support the hypothesis that, among children exposed to multiple anesthetics prior to age 3, children developing adverse neurodevelopmental outcomes would be more likely to have intraoperative hypotension compared with those who did not.</abstract><cop>France</cop><pub>Wiley Subscription Services, Inc</pub><pmid>33320392</pmid><doi>10.1111/pan.14106</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-3791-5015</orcidid><orcidid>https://orcid.org/0000-0003-3925-0157</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Pediatric anesthesia, 2021-03, Vol.31 (3), p.282-289 |
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| source | Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list) |
| subjects | Anesthesia, General - adverse effects anesthetic neurotoxicity Blood Pressure Child Child, Preschool children General anesthesia Humans Hypotension Hypotension - chemically induced Hypotension - epidemiology Learning disabilities neurodevelopment Prospective Studies Retrospective Studies |
| title | Hypotension and adverse neurodevelopmental outcomes among children with multiple exposures to general anesthesia: Subanalysis of the Mayo Anesthesia Safety in Kids (MASK) Study |
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