Perioperative Respiratory Adverse Events Among Pediatric Surgical Patients in University Hospitals in Northwest Ethiopia; A Prospective Observational Study

Abstract

IntroductionPerioperative respiratory adverse events (PRAEs) are frequent among pediatrics surgical patients and are accountable for 3/4th of perioperative critical incidents and 1/3rd of cardiac arrests.ObjectiveAssess the prevalence and factors associated with PRAEs among pediatric surgical patients in University Hospitals in Northwest Ethiopia, 2020.MethodologyAfter ethical approval obtained prospective observational study was conducted among 210 pediatric surgical patients. Perioperative respiratory adverse events were defined as the occurrence of any episode of single/combination of coughing, breath holding, hypoxemia, laryngospasm and bronchospasm. Bivariate and multivariate binary logistic regression analyses were performed and variables with p < 0.05 at 95% confidence interval were considered as statistically significant.ResultsThe prevalence of PRAEs was 26.2% (CI: 20.5–30.9%). A total of 129 episodes of PRAEs were occurred and of them, 89 (69.0%) were occurred in the postoperative period. Desaturation was the predominant adverse event which was observed 61 (47.3%) times. Age <1 year (AOR: 3.6, CI: 1.3–10.0), ASA ≥ 3 (AOR: 5.2, CI: 1.9–22.9), upper respiratory tract infections (URTIs) (AOR: 7.6, CI: 1.9–30.2), secretions in the upper airway (AOR: 4.8, CI: 1.4–15.9) and airway related surgery (AOR: 6.0, CI: 1.5–24.1) were significantly associated with PRAEs.ConclusionsPrevalence of PRAEs was high among pediatric surgical patients; the postoperative period was the most critical time for the occurrence of PRAEs and desaturation was the commonest PRAE. Age <1 year, URTIs (recent or active), secretions in the upper airways, ASA ≥ 3 and airway related surgery were significantly associated with PRAEs. Clinicians should perform effective risk assessment, preoperative optimization and preparation for the management of PRAEs.