Author's reply

Galante, Dario; Pellico, Giuseppe; Federico, Annalisa; Schiraldi, R.; Matella, Mario; Milillo, Rosella; Dambrosio, Michele; Cinnella, Gilda

doi:10.1111/j.1460-9592.2006.02054.x

Cited by 6 publications

(5 citation statements)

References 4 publications

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“…The selection of a particular degree and duration of post-procedural monitoring is multifactorial but certainly includes a thoughtful consideration of patient context, comorbidities, known incidence and severity of procedure-related complications, satisfactory anesthetic-related recovery time, and flexibility for emergent intraoperative factors [910]. In general, complications related to PLB in relatively healthy patients are rare and include minor complications such as localized pain, fever, hypotension, or major complications such as bleeding, arteriovenous fistula formation, pneumothorax, hemothorax, organ perforation, biliary leak, and surgical site infection.…”

Section: Discussionmentioning

confidence: 99%

“…Increasingly, the procedure is performed with ultrasound guidance in an outpatient setting with local anesthesia and moderate sedation [34567]. Post-procedural monitoring includes assurance of anesthetic recovery, adequate pain control, and observation for known procedural related complications [8910]. The incidence of PLB-related complications varies by definition and has been reported between 0% to 15.2% [12311121314151617181920].…”

Section: Introductionmentioning

confidence: 99%

“…There is a growing body of literature suggesting lower complication rates using ultrasonography in biopsies performed in children [123131415161718]. Although the greatest risk of bleeding occurs within the first few hours after biopsy, the optimal length of observation to mitigate delayed complications after PLB has not been established [12391221]. The American Association for the Study of Liver Diseases provided guidelines recommending a 2- to 4-hour observation period after PLB for adults undergoing outpatient biopsy [22122].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Same-Day versus Overnight Observation after Outpatient Pediatric Percutaneous Liver Biopsy: A Retrospective Cohort Study

Kozlovich

Sochet

Son

et al. 2019

Pediatr Gastroenterol Hepatol Nutr

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Purpose Percutaneous liver biopsy (PLB), a diagnostic procedure to identify several hepatobiliary disorders, is considered safe with low incidence of associated complications. While postoperative monitoring guidelines are suggested for adults, selection of procedural recovery time for children remains at the discretion of individual operators. We aim to determine if differences exist in frequency of surgical complications, unplanned admissions, and healthcare cost for children undergoing outpatient PLB for cohorts with same-day vs. overnight observation. Methods We performed a retrospective cohort study in children 1 month to 17 years of age undergoing ultrasound-guided PLB from January 2009 to August 2017 at a tertiary care, pediatric referral center. Cohorts were defined by postprocedural observation duration: same-day (≤8 hours) vs. overnight observation. Outcomes included surgical complications, medical interventions, unscheduled hospitalization within 7 days, and total encounter costs. Results One hundred and twelve children met study criteria of which 18 (16.1%) were assigned to same-day observation. No differences were noted in demographics, anthropometrics, comorbidities, biopsy indications, or preoperative coagulation profiles. No major complications or acute hospitalizations after PLB were observed. Administration of analgesia and fluid boluses were isolated and given within 8 hours. Compared to overnight monitoring, same-day observation accrued less total costs (US $992 less per encounter). Conclusion Same-day observation after PLB in children appears well-tolerated with only minor interventions and complications observed within 8 hours of procedure. We recommend a targeted risk assessment prior to selection of observation duration. Same-day observation appears an appropriate recovery strategy in otherwise low-risk children undergoing outpatient PLB.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Same-Day versus Overnight Observation after Outpatient Pediatric Percutaneous Liver Biopsy: A Retrospective Cohort Study

Kozlovich

Sochet

Son

et al. 2019

Pediatr Gastroenterol Hepatol Nutr

View full text Add to dashboard Cite

show abstract

“…Several studies [24,[75][76][77] showed no difference in the incidence of laryngospasm between the two methods. Other studies [73,[78][79][80] suggest that deep extubation reduces the incidence of laryngospasm. On the contrary, in a small sample size of patients, Tsui et al [81] showed no single case of laryngospasm when performing awake extubation using the 'no touch technique' in T&A cases.…”

Section: Prevention In Emergence Phasementioning

confidence: 95%

“…If cuffed ETT are to be used, air leak at less than 25 cm water may decrease the incidence of laryngospasm [18,73]. In a prolonged surgery involving ETT, it is suggested to inflate the cuff with water to avoid N 2 O diffusion and mucosal damage that predisposes to laryngospasm [73].…”

Section: Prevention During Maintenance Phasementioning

confidence: 99%