Sedation-Associated Complications in Endoscopy - Prospective Multicentre Survey of 191142 Patients

Frieling, Thomas; Heise, J.; Kreysel, C.; Kuhlen, Ralf; Schepke, Michael

doi:10.1055/s-0032-1330441

Cited by 39 publications

(37 citation statements)

References 3 publications

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“…In-hospital sedation in the academic setting tends to be more common. The increased risk with higher ASA status is consistent with prior published studies [5,13,48,49]. The findings of higher risks between 6 pm and 6 AM and for those sedations which were for emergent procedures have not previously been reported and warrant further investigation.…”

Section: Discussionsupporting

confidence: 90%

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Mason

Roback

Chrisp

et al. 2019

JCM

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Background: The incidence of sedation-related adverse events, inclusive of both adults and children, administered by multiple specialty providers from different countries and venues, using standardized definitions, has never been reported on an international level. We are reporting the outcome data of the adverse event sedation reporting tool as an important step toward a more complete risk assessment of sedation-related morbidity, mortality, and etiology. The analysis of the AE sedation reporting data include descriptive measures to evaluate the characteristics of the provider, the patient, sedations performed, adverse events, interventions, and outcomes. The primary outcome was the rate and nature of adverse events. Between 12/14/2010 and 12/11/2018 there were 7952 sedations, from an estimated total of 164,114 sedations administered, of which 622 were reported as adverse events. The mean age of the entire patient population is 33.0 years (0.02-98.7). The providers represented 39 countries across six continents. Oxygen desaturation (75%-90%) for <60 s is the most prevalent adverse event with a rate of 7.8 per 10,000, followed by airway obstruction at a rate of 5.42 per 10,000. Apnea occurred at a rate of 4.75 per 10,000. Significant predictors of adverse events are ≥ ASA score III (p = 0.0003), procedure time (6:00 pm-12:00 am: p < 0.0001, 12:00-6:00 am: p = 0.0003), and non-hospital location (p < 0.0001). The AE sedation reporting tool has demonstrated that the majority of adverse events in children and adults who receive procedural sedation from multi-specialists internationally required minor interventions and had outcomes of minor risk.

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Section: Discussionsupporting

confidence: 90%

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Mason

Roback

Chrisp

et al. 2019

JCM

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“…In mehreren prospektiven Komplikationsregistern [20,179,285,286] zeigte sich eine erhöhte Komplikationshäufigkeit bei Patienten mit ASA-Klasse III und höher sowohl bei der interventionellen Endoskopie als auch bei Notfalluntersuchungen. In einer unizentrischen, prospektiven Fallserie bei Patienten, bei denen interventionelle Endoskopien durchgeführt wurden (mehrheitlich Blutstillung am oberen GI-Trakt sowie ERCP) [176], fand sich eine erhöhte Morbidität und Mortalität, und Patienten mit höhe-rer ASA-Klasse und solche, bei denen Notfallinterventionen erfolgten, waren dem höchsten Risiko ausgesetzt.…”

Section: Anmerkungenunclassified

Update S3-Leitlinie „Sedierung in der gastrointestinalen Endoskopie“ 2014 (AWMF-Register-Nr. 021/014)

Riphaus¹,

Wehrmann²,

Hausmann

et al. 2015

Z Gastroenterol

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Update S3-Leitlinie "Sedierung in der gastrointestinalen Endoskopie" 2014 (AWMF-Register-Nr. 021/014) S3-guidelines "sedation in gastrointestinal endoscopy" 2014 (AWMF register no. 021/014) /6 11/57 72 12 Fax: ++ 49/6 11/57 74 60 5.2.1. Patienteninstruktionen 832 5.2.2. Minimalkriterien für die Entlassung 832 5.2.3. Verwendung von Score-Systemen für die Entlassung 832 5.3. "Street-Fitness" 833 5.3.1. Verkehrstauglichkeit 833 5.4. Dokumentation 834 5.4.1. Allgemeines 834 5.4.2. Arbeitsunfähigkeit 834 5.5. Benchmarking 834 6. Literatur 835 Riphaus A et al. Update S3-Leitlinie "Sedierung … Z Gastroenterol 2015; 53: 802-842 Leitlinie 803 Heruntergeladen von: NYU. Urheberrechtlich geschützt. ▶ Unterstützung der Dokumentation der Verläufe von im Rahmen der Sedierung auftretenden Komplikationen. ▶ Systematische Berücksichtigung der Empfehlungen in der Aus-, Fort-und Weiterbildung und in Qualitätsmanagement-systemen. Riphaus A et al. Update S3-Leitlinie "Sedierung … Z Gastroenterol 2015; 53: 802-842 Leitlinie 804 Heruntergeladen von: NYU. Urheberrechtlich geschützt. ▶ Etablierung einer Grundlage für inhaltlich gezielte ärztliche und pflegerische Aus-, Fort-und Weiterbildungsmaßnahmen. ▶ Systematische Berücksichtigung der Empfehlungen und daraus abgeleiteten Qualitätsindikatoren in der externen, vergleichenden Qualitätssicherung und Vereinheitlichung der Dokumentationsanforderungen. ▶ Flächendeckende Umsetzung einer qualitätsgesicherten Versorgung der Patienten während einer Sedierung im Rahmen der gastrointestinalen Endoskopie.▶ Optimierung der Patientensicherheit.In Ergänzung zu den bereits bestehenden Empfehlungen zur Sedierung in der gastrointestinalen Endoskopie durch Nicht-Anäs-thesisten, die in die Erstellung der Sedierungsleitlinie 2008 eingeflossen waren [6], und auch der unten aufgeführten aktuellen Quell-Leitlinien, sowie zu den weiteren o. g. Projekten und Maß-nahmen soll langfristig die Patientensicherheit sichergestellt werden.

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“…There is little debate regarding patients of ASA physical status IV. Increased ASA class is associated with increased rates of sedation-related adverse events; this has been established both via large retrospective studies [19] and prospective studies [20]. However, as a cut-off criterion for anesthesiology assistance, it remains vague.…”

Section: Contentsmentioning

confidence: 99%

Practice guidelines for propofol sedation by non-anesthesiologists: the Korean Society of Anesthesiologists Task Force recommendations on propofol sedation

Kang

Kim

Choi

et al. 2016

Korean J Anesthesiol

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In South Korea, as in many other countries, propofol sedation is performed by practitioners across a broad range of specialties in our country. However, this has led to significant variation in propofol sedation practices, as shown in a series of reports by the Korean Society of Anesthesiologists (KSA). This has led the KSA to develop a set of evidence-based practical guidelines for propofol sedation by non-anesthesiologists. Here, we provide a set of recommendations for propofol sedation, with the aim of ensuring patient safety in a variety of clinical settings. The subjects of the guidelines are patients aged ≥ 18 years who were receiving diagnostic or therapeutic procedures under propofol sedation in a variety of hospital classes. The committee developed the guidelines via a de novo method, using key questions created across 10 sub-themes for data collection as well as evidence from the literature. In addition, meta-analyses were performed for three key questions. Recommendations were made based on the available evidence, and graded according to the modified Grading of Recommendations Assessment, Development and Evaluation system. Draft guidelines were scrutinized and discussed by advisory panels, and agreement was achieved via the Delphi consensus process. The guidelines contain 33 recommendations that have been endorsed by the KSA Executive Committee. These guidelines are not a legal standard of care and are not absolute requirements; rather they are recommendations that may be adopted, modified, or rejected according to clinical considerations.

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Sedation-Associated Complications in Endoscopy - Prospective Multicentre Survey of 191142 Patients

Cited by 39 publications

References 3 publications

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Results from the Adverse Event Sedation Reporting Tool: A Global Anthology of 7952 Records Derived from >160,000 Procedural Sedation Encounters

Update S3-Leitlinie „Sedierung in der gastrointestinalen Endoskopie“ 2014 (AWMF-Register-Nr. 021/014)

Practice guidelines for propofol sedation by non-anesthesiologists: the Korean Society of Anesthesiologists Task Force recommendations on propofol sedation

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