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Comparative Study
Frequency of anesthetic cardiac arrests in infants: effect of pediatric anesthesiologists.
- R L Keenan, J H Shapiro, and K Dawson.
- Department of Anesthesiology, Medical College of Virginia/Virginia Commonwealth University, Richmond.
- J Clin Anesth. 1991 Nov 1; 3 (6): 433-7.
Study ObjectiveTo determine whether the presence of pediatric anesthesiologists decreases the frequency of anesthetic-related cardiac arrests in infants (children who are 1 year of age or younger).DesignA comparative retrospective study of anesthetics and cardiac arrests during a 7-year period.SettingThe main operating room (OR) suite of a large university hospital.PatientsAll patients age 1 year or less undergoing surgical anesthesia from July 1983 through March 1990.InterventionsComputerized anesthetic and operative patients records were queried for patient age, ASA physical status, body weight, surgical procedure, intraoperative complications, and the identity of the attending anesthesiologist. In each case, it was determined whether a pediatric anesthesiologist was in attendance and whether a cardiac arrest due to anesthesia occurred. Pediatric anesthesiologists were identified as those with pediatric fellowship training or the equivalent. The study population was divided into two groups: (1) the pediatric anesthesiologist group, with 2,310 patients whose anesthetics were supervised by pediatric anesthesiologists; (2) the nonpediatric anesthesiologist group, with 2,033 patients.Measurements And Main ResultsMean age and weight were comparable in the two groups, and the distribution of physical status did not differ. No anesthesia-related cardiac arrests occurred in the pediatric anesthesiologist group; four anesthetic cardiac arrests occurred in the nonpediatric anesthesiologist group, for a frequency of 19.7 per 10,000 anesthetics. This difference between provider groups is significant (Fisher's exact probability test, p = 0.048).ConclusionsThe results suggest that the use of pediatric anesthesiologists for all infants 1 year of age or younger might decrease anesthetic morbidity in this age-group.
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