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A multicenter retrospective cohort study and narrative review determined the effect of volatile anesthetic agents for the management of life-threatening pediatric asthma.
No profound differences were noted in terms of
the duration of mechanical ventilation or mortality rates between asthmatic
children (5-17 years of age) with and without exposure to volatile anesthetic
agents.
A multicenter retrospective cohort study and
narrative review determined the effect of volatile anesthetic agents for the
management of life-threatening pediatric asthma.
With the aid of the Virtual Pediatric Systems
database, the study incorporated children invasively ventilated for critical
asthma with and without exposure to volatiles. Mortality and ventilation
duration were the major endpoints, while the length of stay, patient
characteristics, and anesthetic-associated noxious events were the secondary
endpoints. A subgroup assessment was done investigating children intubated ≥two
days.
Out of 203 children incorporated in this study, there were 174 (85.7%) without and 29 (14.3%) with exposure to volatiles. No differences were witnessed in the odds of mortality (1.1). Compared to participants without volatile exposure, participants receiving volatile agents witnessed a larger median difference in the odds of extracorporeal life support (9.1), length of stay (4.8), and ventilation duration (2.3).
For participants ventilated ≥two days, there were no differences
in terms of acute renal failure, length of stay, mortality, ventilation
duration, or arrhythmias. But, the odds of extracorporeal life support
continued to be higher for participants receiving volatiles (7.6). No
participant witnessed malignant hyperthermia or liver failure following
volatile exposure.
Exposing children with asthma to volatile
anesthetics does not considerably influence the ventilation duration and
mortality rates. Thus, though volatiles might present a viable rescue treatment
for serious asthma cases, further prospective and robust trials are still
needed.
Pediatric Anesthesia
Volatile anesthetic agents for life-threatening pediatric asthma: A multicenter retrospective cohort study and narrative review
Alicia Lew et al.
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