Procedural Pediatric Sedation by Nurses: Available, Competent, and Safe

Table 3

Comparison of complications in different studies on pediatric procedural sedation.

Studies	𝑛	Procedures	Mean age ± SD (yr) (min–max)	Described complication	% found in each study	Equivalent % in our cohort
Sury et al., 1999 [3]	1155	MRI	N/A	Failure	5	2.3
Beebe et al., 2000 [9]	572	MRI	5±4; (2 mo–14 yo)	Inadequate sedation	7.9	7.3
				Total	20.1	22
Malviya et al., 1997 [1]	1140	MRI (48%); CT (27%); Cardiac (22%)	3±3.7	Inadequate sedation; Failure; Desaturation ≤90%	13.2; 3.78; 5.5	8; 2.3; 5.77
				Total	6.52	22
Lightdale et al., 2009 [11]	5045	Imaging (81%)	3.3 (1.4–6.4)	Serious adverse events*; Failure; Desaturation^§	1.92; 1.17; 0.57	0; 2.3; 0
Haque and Fadoo, 2010 [12]	499	Oncology	4.2 (6 mo–14 yo)	Desaturation^¥; Apnea	2.4; 0.6	5.77; 0
Cravero et al., 2006 [13]	30037	Imaging (60%); Oncology (9%); GI (6%)	0–6 mo : 6%; 6 mo–2 yo : 23%; 2–8 yo : 47%; 8 yo+ : 29%	Desaturation ≤90%; Apnea	1.57; 0.24	5.77; 0
Cravero et al., 2009 [10]	49836	Imaging (60%); Oncology (14%); GI (11%)	0–6 mo : 2%; 6–12 mo : 6%; 1-2 yo : 12%; 2–4 yo : 21%; 4–8 yo : 28%; 8 yo+ : 29%	Desaturation ≤90% for 30 s; Apnea	1.54; 5.75	5.77; 0
Lavoie, 2012	448	Imaging (41%) GI (10%)	4.1±4.3 (1 mo–18 yo)	Failure; Desaturation ≤90%; Apnea; Major complication	2.3; 5.77; 0; 0	—; —; —; —

*Serious adverse effects define as allergic reaction, aspiration, cardiovascular complications, need for resuscitation, unplanned admission, use of reversal agents, abnormal SpO2, prolonged sedation, and paradoxical reaction.
^§Desaturation defines as a sustained drop in oxygen saturation 5% from baseline for more than 1 minute and unresponsive to blow-by oxygen at 6 L/min, and/or head repositioning, suctioning, or stimulation.
^¥Transient desaturation which was improved by head repositioning and increasing oxygen flow.