Abstract
Upper respiratory tract infection (URI) symptoms are known to increase perioperative respiratory adverse events (PRAEs) in children undergoing general anaesthesia. General anaesthesia per se also induces atelectasis, which may worsen with URIs and yield detrimental outcomes. However, the influence of URI symptoms on anaesthesia-induced atelectasis in children has not been investigated. This study aimed to demonstrate whether current URI symptoms induce aggravation of perioperative atelectasis in children. Overall, 270 children aged 6 months to 6 years undergoing surgery were prospectively recruited. URI severity was scored using a questionnaire and the degree of atelectasis was defined by sonographic findings showing juxtapleural consolidation and B-lines. The correlation between severity of URI and degree of atelectasis was analysed by multiple linear regression. Overall, 256 children were finally analysed. Most children had only one or two mild symptoms of URI, which were not associated with the atelectasis score across the entire cohort. However, PRAE occurrences showed significant correspondence with the URI severity (odds ratio 1.36, 95% confidence interval 1.10–1.67, p = 0.004). In conclusion, mild URI symptoms did not exacerbate anaesthesia-induced atelectasis, though the presence and severity of URI were correlated with PRAEs in children.Trial registration: Clinicaltrials.gov (NCT03355547).
Highlights
Upper respiratory tract infection (URI) symptoms are known to increase perioperative respiratory adverse events (PRAEs) in children undergoing general anaesthesia
Radiography showed subsegmental atelectasis in the right lower lobe. He recovered spontaneously the day and was discharged. In this prospective observational study, we assessed the correlation between the severity of URI symptoms and anaesthesia-induced atelectasis measured by ultrasonography in children aged 6 months to 6 years
Across the entire age cohort, mild URI was not related to aggravation of anaesthesia-induced atelectasis
Summary
Upper respiratory tract infection (URI) symptoms are known to increase perioperative respiratory adverse events (PRAEs) in children undergoing general anaesthesia. This study aimed to demonstrate whether current URI symptoms induce aggravation of perioperative atelectasis in children. Mild URI symptoms did not exacerbate anaesthesia-induced atelectasis, though the presence and severity of URI were correlated with PRAEs in children. A large number of children with upper respiratory tract infection (URI) undergo general anaesthesia for elective or emergency surgery even though URIs are known to increase perioperative adverse respiratory events (PRAEs)[1,2]. Accurate knowledge on the development of atelectasis in children with URI is essential for optimal perioperative anaesthetic care This prospective observational study aimed to investigate if the severity of URI symptoms is correlated with exacerbation of perioperative atelectasis in children
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