Pediatric Sedation/Anesthesia for MRI: Results From the Pediatric Sedation Research Consortium.

Background: Magnetic resonance imaging (MRI) is the most common imaging procedure requiring sedation/anesthesia in children. Understanding adverse events associated with sedation/anesthesia is important in making decisions regarding MRI vs. other imaging modalities.

Sedatives used in children to obtain head CT in the emergency department.

Objectives: Children in the emergency department who require computerized tomography (CT) of the head often are given sedative medications to facilitate completion of the study with adequate imaging. A prior study found the two most common medications used to obtain head CT in children were pentobarbital and chloral hydrate; however, these medications have become less popular. We hypothesized that there was variability in medication choice amongst providers in the emergency department and there has been a change in the preferred sedatives used in the last decade.

Radiologic Imaging in Trauma Patients with Cervical Spine Immobilization at a Pediatric Trauma Center.

Background: Pediatric trauma patients with cervical spine (CS) immobilization using a cervical collar often require procedural sedation (PS) for radiologic imaging. The limited ability to perform airway maneuvers while CS immobilized with a cervical collar is a concern for emergency department (ED) staff providing PS.

Objective: To describe the use of PS and analgesia for radiologic imaging acquisition in pediatric trauma patients with CS immobilization.

Procedural Sedation Outside the Operating Room and Potential Neurotoxicity: Analysis of an At-Risk Pediatric Population.

Objectives: To determine the characteristics of children who met the risk criteria for potential neurotoxicity defined by the US Food and Drug Administration (FDA; 2016 warning) in a procedural sedation (PS) service.

Study Design: A single-center retrospective review of all infants and children aged <3 years receiving PS outside the operating room from 2014 to 2016. Demographics, duration of, and the reason for PS were analyzed.

Upper Respiratory Infections and Airway Adverse Events in Pediatric Procedural Sedation.

Background: Upper respiratory infections (URIs) are associated with airway adverse events (AAEs) during general anesthesia. There have been no large studies examining the relationship between URIs and AAEs during pediatric procedural sedation. We hypothesized that there would be a relationship between URI status and AAEs in pediatric procedural sedation.

Experience with the use of propofol for radiologic imaging in infants younger than 6 months of age.

Background: There is an increased risk associated with procedural sedation of infants younger than 6 months of age. The use of propofol for radiologic imaging of this age group is not well studied.

Objective: We hypothesize that adverse events are higher in the infant population receiving propofol for radiologic imaging.

Evaluation of methohexital as an alternative to propofol in a high volume outpatient pediatric sedation service.

Background: Propofol is a preferred agent for many pediatric sedation providers because of its rapid onset and short duration of action. It allows for quick turn around times and enhanced throughput. Occasionally, intravenous (IV) methohexital (MHX), an ultra-short acting barbiturate is utilized instead of propofol.

Practice Patterns and Adverse Events of Nitrous Oxide Sedation and Analgesia: A Report from the Pediatric Sedation Research Consortium.

Objectives: To describe practice patterns and adverse events associated with nitrous oxide (N2O) administration as the primary sedative outside the operating room in varied settings by a diverse range of providers, and to identify patient and sedation characteristics associated with adverse events.

Study Design: Data prospectively collected by the Pediatric Sedation Research Consortium, which is comprised of 40 children's and general/community hospitals, was retrospectively analyzed for children who received N2O as the primary sedative. Descriptive measures of patient and sedation characteristics and adverse events were reported.

The impact of obesity on pediatric procedural sedation-related outcomes: results from the Pediatric Sedation Research Consortium.

Objectives: To evaluate the impact of obesity on adverse events and required interventions during pediatric procedural sedation.

Methods: The Pediatric Sedation Research Consortium database of prospectively collected procedural sedation encounters was queried to identify patients for whom body mass index (BMI) could be calculated. Obesity was defined as BMI ≥95th percentile for age and gender.

A clinical decision tool for predicting patient care characteristics: patients returning within 72 hours in the emergency department.

The primary purpose of this study was to develop a clinical tool capable of identifying discriminatory characteristics that can predict patients who will return within 72 hours to the Pediatric emergency department (PED). We studied 66,861 patients who were discharged from the EDs during the period from May 1 2009 to December 31 2009. We used a classification model to predict return visits based on factors extracted from patient demographic information, chief complaint, diagnosis, treatment, and hospital real-time ED statistics census.

Emergency physician-administered propofol sedation: a report on 25,433 sedations from the pediatric sedation research consortium.

Study Objective: We describe the adverse events observed in a large sample of children sedated with propofol by emergency physicians and identify patient and procedure characteristics predictive of more serious adverse events.

Methods: We identified sedations performed by emergency physicians using propofol as the primary sedative, included in the Pediatric Sedation Research Consortium database from July 2004 to September 2008. We describe the characteristics of the patients, procedures, location, adjunctive medications, and adverse events.

Propofol vs pentobarbital for sedation of children undergoing magnetic resonance imaging: results from the Pediatric Sedation Research Consortium.

Background: Pentobarbital and propofol are commonly used to sedate children undergoing magnetic resonance imaging (MRI). The Pediatric Sedation Research Consortium (PSRC) was created in 2003 to improve pediatric sedation process and outcomes.

Objective: To use PSRC records to compare the effectiveness, efficiency and adverse events of propofol vs pentobarbital for sedation of children undergoing MRI.

Etomidate versus pentobarbital for computed tomography sedations: report from the Pediatric Sedation Research Consortium.

Objective: To compare efficacy, sedation duration, and adverse events after administration of etomidate or pentobarbital for diagnostic computed tomography (CT) scans.

Methods: A cohort of children sedated for CT scans between July 2004 and October 2005 was identified from a prospectively generated Pediatric Sedation Research Consortium database. The 24 Pediatric Sedation Research Consortium institutions prospectively record consecutive sedation data and adverse events on a Web-based tool.

Use of a pediatric observation unit for treatment of children with dehydration caused by gastroenteritis.

Objective: Observation units (OUs) have emerged as a cost-saving alternative to traditional ward admission for many pediatric illnesses. Dehydration caused by gastroenteritis is a common reason for admission to a pediatric OU. In this study, we describe characteristics of patients with presumed gastroenteritis admitted to a pediatric OU and seek to identify factors associated with unplanned inpatient admission, defined as the inability to discharge an OU patient within 24 hours.

Bronchiolitis management preferences and the influence of pulse oximetry and respiratory rate on the decision to admit.

Objective: High incidence, rising admission rates, and relatively ineffective therapies make the management of bronchiolitis controversial. Since 1980, the rate of hospitalization for children with bronchiolitis has increased by nearly 250%, whereas mortality rates for the disease have remained constant. It has been speculated that the increasing use of pulse oximetry has lowered the threshold for admission and may have contributed to the rise in bronchiolitis-related admissions.