Cosgrove et al identified predictors for laryngospasm in pediatric patients undergoing procedural sedation. This can help to identify a patient who may require additional preparations. The authors are from Boston's Children's Hospital, Royall Belfast Hospital for Sick Children and Harvard Medical School.
Patient selection: pediatric patient undergoing procedural sedation
Consequences of laryngospasm included:
(1) oxygen desaturation
(2) emergency airway intervention and/or endotracheal intubation
(3) incomplete or canceled procedure
(4) aspiration
(5) unplanned admission
(6) increased length of stay
(7) cardiac arrest
Predictors for laryngospasm:
(1) younger age (aOR 1.3 for < 1 year; 0.7 for age 10-14; 0.5 for age >= 15 years)
(2) ASA category (aOR 0.6 for ASA 1; aOR 1.9 for ASA 4)
(3) concurrent upper respiratory infection (aOR 3.7)
(4) propofol in a combination with ketamine or dexmedetomidine)
(5) ketofol (aOR 2.5)
(6) location endoscopy unit or critical care unit (aOR 2.4)
(7) airway procedure (aOR 3.7; bronchoscopy, upper endoscopy, dental)
(8) painful procedure (aOR 1.5)
