Perioperative Cardiac Arrests in Children between 1988 and 2005 at a Tertiary Referral Center

Flick, Randall P.; Šprung, Juraj; Harrison, Tracy E.; Gleich, Stephen J.; Schroeder, Darrell R.; Hanson, Andrew C.; Buenvenida, Shonie L.; Warner, David O.

doi:10.1097/00000542-200702000-00009

Cited by 261 publications

(231 citation statements)

References 25 publications

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“…61 Despite under-representation in studies, children with heart disease account for 80-100% of cardiac arrests and deaths, most during cardiac surgery or interventions. 13,30,40,62 A different pattern was found in the POCA Registry. Of 372 cases of cardiac arrest, heart disease was present in only 34%, and 54% cases of cardiac arrest occurred in the general operating room.…”

Section: South African Health Carementioning

confidence: 92%

“…13 The mortality rate for complex cardiac operations may be up to 100-fold higher that of noncardiac surgery. 30 There are relatively little paediatric data from developing countries, compared to those from high-income countries. Anaesthetic-related mortality in middle-income countries is 2-3 times higher than that in developed countries.…”

Section: Incidence Of Morbiditymentioning

confidence: 99%

“…13,30,45 Anaesthetic-related mortality is conversely low in high-risk age groups, indicating causes of cardiac arrest that predominantly relate to the patient's condition. 11,45 Low anaesthetic-related mortality may also be due to management by experienced anaesthetists at appropriate levels of care, 13,30,45,57 and the influence of a restrictive or inclusive definition. 13 …”

Section: Agementioning

confidence: 99%

“…Although death from anaesthesia is not nonexistent, this confirms the inherent safety of anaesthesia in these patients. 11,29,30,33,36,45,57 However, the vulnerability of even healthy children anaesthetised with cardiac depressants and arrhythmogenic volatile agents 31 was demonstrated in the first Pediatric Perioperative Cardiac Arrest (POCA) Registry. A decrease in such arrests with the use of sevoflurane, in combination with the routine use of pulse oximetry to detect hypoxia, capnography to detect hypoventilation and hypercapnia, and advances in airway management, e.g.…”

Section: South African Health Carementioning

confidence: 99%

“…The contribution of anaesthesia may be underestimated when using restrictive definitions. 27,30,31 Thinking in "silos" is avoided with the use of inclusive definitions, while a wider range of cases relevant to anaesthetists is included. 16 Definitions in which multiple categories apply are complex, and are more likely to be subjective.…”

Section: Introductionmentioning

confidence: 99%

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A review of paediatric anaesthetic-related mortality, serious adverse events and critical incidents

Cronjé

2015

Southern African Journal of Anaesthesia and Analgesia

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Anaesthetists increasingly face questions from parents on the long-term outcomes of anaesthesia, and yet more immediate anaesthetic risks are not understood, nor explained to families. This review focused on paediatric anaesthetic-related mortality, cardiac arrest and anaesthetic-related serious adverse events and critical incidents during general anaesthesia, and within 24 hours of anaesthesia ending. Anaesthetic-related mortality is rare in the developed world, and is approximately 1 per 10 000 anaesthetics, but increases in high-risk children. Serious anaesthetic-related adverse events occur in 1.4 per 1 000 anaesthetics in the developed world. Data are lacking from the developing world but anaesthetic mortality is 2-3 times higher in middle-income countries and may be up to 100-fold greater in low-income countries. A critical incident occurs in 3-8% of anaesthetics and this figure is double that in low-income countries. Anaesthetic-related events are predominantly preventable. Brief recommendations on preventative strategies are made and research goals outlined.

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Section: South African Health Carementioning

confidence: 92%

Section: Incidence Of Morbiditymentioning

confidence: 99%

Section: Agementioning

confidence: 99%

Section: South African Health Carementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A review of paediatric anaesthetic-related mortality, serious adverse events and critical incidents

Cronjé

2015

Southern African Journal of Anaesthesia and Analgesia

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Factors Associated With Nasolacrimal Duct Probing Failure Among Children in the Intelligent Research in Sight Registry

et al. 2023

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ImportanceUnderstanding the factors associated with nasolacrimal duct probing failure in young children may help inform practice patterns.ObjectiveTo identify factors associated with repeated nasolacrimal duct probing in young children.Design, Setting, and ParticipantsThis retrospective cohort study analyzed data from the Intelligent Research in Sight (IRIS) Registry for all children who underwent nasolacrimal duct probing before 4 years of age between January 1, 2013, and December 31, 2020.Main Outcomes and MeasuresThe Kaplan-Meier estimator was used to assess the cumulative incidence of a repeated procedure within 2 years of the initial procedure. Hazard ratios (HRs) derived from multivariable Cox proportional hazards regression models were used to evaluate the association between repeated probing and patient age, sex, race and ethnicity, geographic region, operative side, laterality of obstruction, type of initial procedure, and surgeon volume.ResultsThis study included 19 357 children (9823 [50.7%] male; mean [SD] age, 1.40 [0.74] years) undergoing nasolacrimal duct probing. The cumulative incidence of repeated nasolacrimal duct probing was 7.2% (95% CI, 6.8%-7.5%) within 2 years of the initial procedure. Among 1333 repeated procedures, the second procedure involved silicone intubation in 669 (50.2%) and balloon catheter dilation in 256 (19.2%). Among 12 008 children aged 1 year or younger, office-based simple probing was associated with a slightly higher probability of reoperation compared with facility-based simple probing (9.5% [95% CI, 8.2%-10.8%] vs 7.1% [95% CI, 6.5%-7.7%]; P &lt; .001). In the multivariable model, a greater risk of repeated probing was associated with bilateral obstruction (HR, 1.48; 95% CI, 1.32-1.65; P &lt; .001) and office-based simple probing (HR, 1.33; 95% CI, 1.13-1.55; P &lt; .001), and a lower risk was associated with primary balloon catheter dilation (HR, 0.69; 95% CI, 0.56-0.85; P &lt; .001) and procedures performed by high-volume surgeons (HR, 0.84; 95% CI, 0.73-0.97; P = .02). Age, sex, race and ethnicity, geographic region, and operative side were not associated with reoperation risk in the multivariable model.Conclusions and RelevanceIn this cohort study, most children in the IRIS Registry undergoing nasolacrimal duct probing before 4 years of age did not require any additional intervention. Factors associated with lower risk of reoperation include surgeon experience, probing performed under anesthesia, and primary balloon catheter dilation.

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The Neonatologist’s Role in Pediatric Anesthesia Neurotoxicity

2014

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Perioperative Cardiac Arrests in Children between 1988 and 2005 at a Tertiary Referral Center

Cited by 261 publications

References 25 publications

A review of paediatric anaesthetic-related mortality, serious adverse events and critical incidents

A review of paediatric anaesthetic-related mortality, serious adverse events and critical incidents

Factors Associated With Nasolacrimal Duct Probing Failure Among Children in the Intelligent Research in Sight Registry

The Neonatologist’s Role in Pediatric Anesthesia Neurotoxicity

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