The selection of ventilation devices in children with mild or moderate upper respiratory tract infections: a randomised controlled trial

Abstract

Abstract Background: Practicing anesthesia in children with upper respiratory tract infections ( URTI ) increases the risk of perioperative respiratory adverse events ( PRAE ). Several observational trials have shown the supraglottic airway is a potentially alternative for airway management in children. The purpose of the study was to determine the selection of ventilation devices in children with mild or moderate URTI. Methods: 80 children patients were included with mild or moderate URTI, and received either a laryngeal mask airway ( LMA ) or an endotracheal tube ( ETT ). Patients were observed for the appearance of any complications such as cough, laryngospasm, bronchospasm, breath-holding, postoperative stridor or desaturation less than 90% at the following times: induction of anesthesia, tube placement, during surgery, during tube removal, and in the postanesthesia care unit ( PACU ). Results: 41 children had PRAE in this study. Children receiving an endotracheal tube were more likely to have a PRAE than those who received a LMA (29 [72.5%] vs 12 [31.5%]; risk ratio ( RR )0.417, 95% confidence interval ( CI ), 0.248–0.701, P<0.0001). There was a significantly lower incidence of minor PRAE in the LMA group compared with the ETT group during intraoperatively ( RR 0.364, 95% CI 0.192-0.688, P=0.0001 ). There were differences between groups with respect to the incidence of perioperative cough ( P = 0.043 ) and desaturation ( P = 0.031 ). Conclusions: The supraglottic airway reduced the incidence of coughing, bronchospasm, and oxygen desaturation, and provided an acceptable alternative to the ETT in children with mild or moderate URTI. Trial registration: This randomized controlled trial was approved by the ethics committee of children's hospital of hebei province (Number:165) and Chinese Clinical Trial Registry ( ChiCTR1900025530 ); The full date of first trial registration in the format(31/08/2019).