Upper Respiratory Infections and Respiratory Adverse Events and Interventions in Emergency Department Sedation of Children.
Daniel S Tsze, Nick Barrowman, Maala Bhatt
Annals of emergency medicine April 22, 2025 DOI: 10.1016/j.annemergmed.2025.03.016 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective cohort study (secondary analysis) Peer reviewed |
|---|---|
| Sample size | 6,292 |
| Population | Children aged 17 years or younger who received parenteral sedation for a painful procedure in 1 of 6 pediatric emergency departments |
| Intervention | parenteral sedation |
| Topics | Ketamine |
| Keywords | Adverse events Upper respiratory infection Pediatric sedation Respiratory infections Emergency medicine Patient safety Procedural sedation |
| Citations | 1 |
| Key findings | No increase in risk of respiratory adverse events or serious respiratory interventions was associated with upper respiratory infection in children undergoing emergency department sedation. |
Abstract
Children with upper respiratory infections (URIs) have an increased risk of respiratory adverse events when undergoing operative anesthesia and in general populations of children receiving procedural sedation. It is unclear if children with URI undergoing emergency department (ED) sedation share the same increased risk. We aimed to determine if the presence of a URI in children undergoing ED sedation is associated with increased risk of respiratory adverse events and serious respiratory interventions. We conducted a secondary analysis of a prospective cohort study of children aged 17 years or younger who received parenteral sedation for a painful procedure in 1 of 6 pediatric EDs. A multivariable regression model was used to identify potential associations between URI and respiratory adverse events, serious respiratory adverse events (ie, complete airway obstruction, apnea, laryngospasm, clinically apparent pulmonary aspiration, and death), and serious respiratory interventions (ie, bag-valve-mask ventilation and endotracheal intubation). We analyzed 6,292 children; 444 (7.1%) had a URI. The risk of respiratory adverse events, serious respiratory adverse events, or serious respiratory interventions was adjusted odds ratio (aOR) 1.00 (95% confidence interval [CI] 0.78 to 1.29), 0.53 (95% CI 0.18 to 1.58), and 1.08 (95% CI 0.68 to 1.71), respectively. In this study, we found no increase in risk of any respiratory adverse events or serious respiratory interventions associated with URI in children undergoing ED sedation.
Comparable studies
Other observational and cohort studies on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Taming the Ketamine Tiger Volunteers from a prison population | 2010 | Observational study | n = 20 |
| Increased spontaneous MEG signal diversity for psychoactive doses of ketamine, LSD and psilocybin Humans | 2017 | Observational study | |
| Disruption of Frontal–Parietal Communication by Ketamine, Propofol, and Sevoflurane Surgical patients undergoing induction of anesthesia with intravenous ketamine | 2013 | Observational cohort | n = 30 |
| Do the dissociative side effects of ketamine mediate its antidepressant effects? Treatment-resistant inpatients with major depressive disorder or bipolar disorder | 2014 | Observational cohort | n = 108 |
| Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder | 2012 | Observational cohort | n = 30 |