Risk factors for chloral hydrate sedation failure in pediatric patients: a retrospective analysis.

IF 4.2 4区 医学 Q1 ANESTHESIOLOGY
Korean Journal of Anesthesiology Pub Date : 2024-10-01 Epub Date: 2024-07-02 DOI:10.4097/kja.24125
Young-Eun Jang, Jung-Bin Park, Pyoyoon Kang, Sang-Hwan Ji, Eun-Hee Kim, Ji-Hyun Lee, Hee-Soo Kim, Jin-Tae Kim
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引用次数: 0

Abstract

Background: This study aimed to investigate the risk factors for chloral hydrate sedation failure and complications in a tertiary children's hospital in South Korea.

Methods: A retrospective analysis of pediatric procedural sedation with chloral hydrate between January 1, 2021, and March 30, 2022, was performed. The collected data included patient characteristics, sedation history, and procedure. Multivariable regression analysis was performed to identify the risk factors for procedural sedation failure and complications.

Results: A total of 6,691 procedural sedation were included in the analysis; sedation failure following chloral hydrate (50 mg/kg) occurred in 1,457 patients (21.8%) and was associated with a higher rate of overall complications compared to those with successful sedation (17.5% [225/1457] vs. 6.2% [322/5234]; P < 0.001, odds ratio: 3.236). In the multivariable regression analysis, the following factors were associated with increased risk of sedation failure: general ward or intensive care unit inpatient (compared with outpatient); congenital syndrome; oxygen dependency; history of sedation failure or complications with chloral hydrate; procedure more than 60 min; and magnetic resonance imaging, radiotherapy, or procedures with painful or intense stimuli (all P values < 0.05). Factors contributing to the complications included general ward inpatient, congenital syndromes, congenital heart disease, preterm birth, oxygen dependency, history of complications with chloral hydrate, and current sedation failure with chloral hydrate (all P values < 0.05).

Conclusions: To achieve successful sedation with chloral hydrate, the patient's sedation history, risk factors, and the type and duration of the procedure should be considered.

儿科患者水合氯醛镇静失败的风险因素:回顾性分析。
背景:本研究旨在调查韩国一家三级儿童医院水合氯醛镇静失败和并发症的风险因素:本研究旨在调查韩国一家三级儿童医院水合氯醛镇静失败和并发症的风险因素:方法:对 2021 年 1 月 1 日至 2022 年 3 月 30 日期间使用水合氯醛进行儿科手术镇静的情况进行了回顾性分析。收集的数据包括患者特征、镇静史和手术过程。进行了多变量回归分析,以确定手术镇静失败和并发症的风险因素:共有 6691 例手术镇静纳入分析;1457 例患者(21.8%)在使用水合氯醛(50 毫克/千克)后镇静失败,与镇静成功的患者相比,总并发症发生率更高(17.5% [225 / 1457] vs. 6.2% [322 / 5234];P < 0.001;几率比 3.236)。在多变量回归分析中,以下因素与镇静失败风险增加有关:普通病房或重症监护室住院患者(与门诊患者相比);先天性综合征;氧依赖;水合氯醛镇静失败或并发症史;手术时间超过 60 分钟;磁共振成像、放射治疗或有疼痛或强烈刺激的手术(所有 P 值均小于 0.05)。导致并发症的因素包括普通病房住院病人、先天性综合症、先天性心脏病、早产、氧气依赖、水合氯醛并发症史以及目前水合氯醛镇静失败(所有 P 值均小于 0.05):要成功使用水合氯醛镇静,应考虑患者的镇静史、风险因素、手术类型和持续时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.20
自引率
6.90%
发文量
84
审稿时长
16 weeks
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