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

Abstract

ObjectivePre-procedural oxygenation (pre-emptive oxygenation started during pre-sedation and/or induction) and procedural oxygenation (pre-emptive oxygenation started during any phase of sedation) is an easy-to-use strategy with potential to decrease adverse events. We describe practice patterns of pre-procedural oxygenation and procedural oxygenation. We hypothesized that patients who received pre-procedural oxygenation or procedural oxygenation would have a lower risk of airway/breathing/circulation interventions during sedation compared to patients without procedural oxygenation. MethodsWe performed a retrospective, multicenter, cross-sectional study of pediatric sedations from April 2020 – 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 pre-procedural oxygenation and procedural oxygenation status. We determined the site-level frequency of pre-procedural oxygenation and procedural oxygenation use. We used inverse-probability of treatment weighting to calculate the risk difference for interventions associated with pre-procedural oxygenation and procedural oxygenation. Results85,599 pediatric sedations; 43,242 (50.5%) received pre-procedural oxygenation (used oxygen pre-sedation and/or at induction) and a total of 52,219 (61.0%) used procedural oxygenation pre-emptively at any time during the sedation. There was no statistical difference in overall interventions with either pre-procedural oxygenation (risk difference -0.06%; 95% CI -4.26%, 4.14%) or procedural oxygenation (risk difference -1.07%; 95% CI -6.44%, 4.30%). ConclusionPre-emptive pre-procedural oxygenation and procedural oxygenation were not associated with a difference in the use of airway/breathing/circulation interventions in pediatric sedations.