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)

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