• Ann Emerg Med · Nov 2024

    Multicenter Study

    Preprocedural Oxygenation and Procedural Oxygenation During Pediatric Procedural Sedation: Patterns of Use and Association With Interventions.

    • Joyce Li, Baruch Krauss, Michael C Monuteaux, Sarah Cavallaro, and Eric Fleegler.
    • Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA. Electronic address: joyce.li@childrens.harvard.edu.
    • Ann Emerg Med. 2024 Nov 1; 84 (5): 473485473-485.

    Study ObjectivePreprocedural oxygenation (pre-emptive oxygenation started during presedation and/or induction) and procedural oxygenation (pre-emptive oxygenation started during any phase of sedation) are easy-to-use strategies with potential to decrease adverse events. Here, we describe practice patterns of preprocedural oxygenation and procedural oxygenation. We hypothesized that patients who received preprocedural oxygenation or procedural oxygenation would have a lower risk of airway/breathing/circulation interventions during sedation compared with patients without procedural oxygenation.MethodsWe performed a retrospective, multicenter, cross-sectional study of pediatric sedations from April 2020 to July 2023 using the Pediatric Sedation Research Consortium multicenter database. The patient-level and sedation-level characteristics were described using frequencies and proportions, stratified by preprocedural oxygenation and procedural oxygenation status. We determined the site-level frequency of preprocedural oxygenation and procedural oxygenation use. We used inverse probability of treatment weighting to calculate the risk difference for interventions associated with preprocedural oxygenation and procedural oxygenation.ResultsThis study included a total of 85,599 pediatric sedations; 43,242 (50.5%) patients received preprocedural oxygenation (used oxygen before sedation and/or at induction) and a total of 52,219 (61.0%) received procedural oxygenation pre-emptively at any time during the sedation. There was no statistical difference in overall interventions with either preprocedural oxygenation (risk difference -0.06%; 95% confidence interval -4.26% to 4.14%) or procedural oxygenation (risk difference -1.07%; 95% confidence interval -6.44% to 4.30%).ConclusionPre-emptive preprocedural oxygenation and procedural oxygenation were not associated with a difference in the use of airway/breathing/circulation interventions in pediatric sedations.Copyright © 2024 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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