Abstract:
OBJECTIVE AND DESIGN:We conducted a systematic review and meta-analysis to evaluate the incidence of adverse events in the emergency department (ED) during procedural sedation in the paediatric population. Randomised controlled trials and observational studies from the past 10 years were included. We adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. SETTING:ED. PARTICIPANTS:Children. INTERVENTIONS:Procedural sedation. OUTCOMES:Adverse events like vomiting, agitation, hypoxia and apnoea. Meta-analysis was performed with random-effects model and reported as incidence rates with 95% CIs. RESULTS:A total of 1177 studies were retrieved for screening and 258 were selected for full-text review. 41 studies reporting on 13 883 procedural sedations in 13 876 children (≤18 years) were included. The most common adverse events (all reported per 1000 sedations) were: vomiting 55.5 (CI 45.2 to 65.8), agitation 17.9 (CI 12.2 to 23.7), hypoxia 14.8 (CI 10.2 to 19.3) and apnoea 7.1 (CI 3.2 to 11.0). The need to intervene with either bag valve mask, oral airway or positive pressure ventilation occurred in 5.0 per 1000 sedations (CI 2.3 to 7.6). The incidences of severe respiratory events were: 34 cases of laryngospasm among 8687 sedations (2.9 per 1000 sedations, CI 1.1 to 4.7; absolute rate 3.9 per 1000 sedations), 4 intubations among 9136 sedations and 0 cases of aspiration among 3326 sedations. 33 of the 34 cases of laryngospasm occurred in patients who received ketamine. CONCLUSIONS:Serious adverse respiratory events are very rare in paediatric procedural sedation in the ED. Emesis and agitation are the most frequent adverse events. Hypoxia, a late indicator of respiratory depression, occurs in 1.5% of sedations. Laryngospasm, though rare, happens most frequently with ketamine. The results of this study provide quantitative risk estimates to facilitate shared decision-making, risk communication, informed consent and resource allocation in children undergoing procedural sedation in the ED.
journal_name
BMJ Openjournal_title
BMJ openauthors
Bellolio MF,Puls HA,Anderson JL,Gilani WI,Murad MH,Barrionuevo P,Erwin PJ,Wang Z,Hess EPdoi
10.1136/bmjopen-2016-011384subject
Has Abstractpub_date
2016-06-15 00:00:00pages
e011384issue
6issn
2044-6055pii
bmjopen-2016-011384journal_volume
6pub_type
杂志文章,meta分析,评审相关文献
BMJ Open文献大全abstract:OBJECTIVES:Circulating 25-hydroxyvitamin D (25-OHD) is associated with improved cancer prognosis in some studies, yet it may be a surrogate marker for physical activity. We investigated the associations of leisure-time physical activity (LTPA) with circulating 25-OHD levels in cancer survivors, and determined whether a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-016064
更新日期:2017-07-10 00:00:00
abstract::Objectives To evaluate the adequacy of reporting of protocols for randomised trials on diseases of the digestive system registered in http://ClinicalTrials.gov and the consistency between primary outcomes, secondary outcomes and sample size specified in http://ClinicalTrials.gov and published trials. Methods Randomis...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2011-000309
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:This article summarises all the available evidence on the impact of introducing blood-based point-of-care panel testing (POCT) in ambulatory care on patient outcomes and healthcare processes. DESIGN:Systematic review and meta-analysis of randomised-controlled trials and before-after studies. DATA SOURCES:O...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032132
更新日期:2020-02-27 00:00:00
abstract:OBJECTIVES:The present study aimed to assess the level of knowledge on peripherally inserted central catheter (PICC) maintenance among nurses in China and to analyse the related factors influencing this variable. DESIGN:A cross-sectional survey. SETTING:Ninety-one hospitals at three different levels in Hunan Province...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033804
更新日期:2020-05-21 00:00:00
abstract:OBJECTIVE:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement has been developed as a guideline for reporting systematic reviews and meta-analyses. Despite the prevalent use of the PRISMA statement in medicine and nursing, no studies have examined authors' perception of it. The pur...
journal_title:BMJ open
pub_type: 杂志文章,meta分析
doi:10.1136/bmjopen-2018-026271
更新日期:2019-04-20 00:00:00
abstract:OBJECTIVES:To investigate short-term and long-term effectiveness of simulation training to acquire a structured Airway Breathing Circulation Disability Exposure (ABCDE) approach for medical emergencies; and to examine which skills were learnt and maintained best. DESIGN:An observational study with a 3-4 months follow-...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032023
更新日期:2020-07-06 00:00:00
abstract:OBJECTIVES:Different studies have been conducted on the role of curcumin in health since having multiple properties, including antioxidant and anti-inflammatory effects. Due to the lack of studies regarding curcumin effects on obese patients with non-alcoholic fatty liver disease (NAFLD), our protocol was designed to a...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-016914
更新日期:2017-07-10 00:00:00
abstract:OBJECTIVE:Nearly 100 000 primary total knee replacements (TKR) are performed in the UK annually. The primary aim of TKR is pain relief, but 10%-34% of patients report chronic pain. The aim of this systematic review was to evaluate the effectiveness of presurgical interventions in preventing chronic pain after TKR. DES...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-033248
更新日期:2020-01-20 00:00:00
abstract:OBJECTIVES:To estimate the incidence and epidemiology of catheter-related bloodstream infections (CRBSIs) on a national scale by using prospective epidemiological data from the Swiss Antibiotic Resistance Surveillance System (ANRESIS). DESIGN:Observational study. SETTING:National surveillance from 2008 to 2015 of acu...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-023824
更新日期:2018-12-22 00:00:00
abstract:INTRODUCTION:An ageing population has become an urgent concern for Asia in recent times. In nursing homes, polypharmacy has also become a compounding issue. Deprescribing practice is an evidence-based strategy to provide a better outcome in this group of patients; however, its implementation in nursing homes is often c...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2016-015293
更新日期:2017-05-09 00:00:00
abstract:INTRODUCTION:Holistic healthcare considers the whole person-their body, mind, spirit and emotions-and has been associated with narrative medicine practice. Narrative medicine is medicine performed with narrative skill and has been offered as a model for humanism and effective medical practice. Narrative medicine interv...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029588
更新日期:2019-08-02 00:00:00
abstract:INTRODUCTION:Auditory verbal hallucinations (AVH) are prevalent experiences that can induce distress and impede social functioning. While most voice hearers benefit from antipsychotic medication or cognitive-behavioural therapy, additional effective interventions are needed to reduce the burden of experiencing AVH. 'Te...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2017-020537
更新日期:2018-03-06 00:00:00
abstract:INTRODUCTION:Sub-Saharan Africa remains the epicentre of the HIV pandemic, yet enormous knowledge gaps still exist to elicit a comprehensive portrait of multimorbidity and HIV linkage. This study aims to conduct a systematic meta-analysis of peer-reviewed literature to investigate the current status of multimorbidity e...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-036988
更新日期:2020-12-12 00:00:00
abstract:INTRODUCTION:Opioids prescribed after surgery accounted for 5% of the 191 million opioid prescriptions filled in 2017. Approximately 80% of the opioid pills prescribed by surgical care providers remain unused, leaving a substantial number of opioids available for non-medical use. We developed a multi-component interven...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030404
更新日期:2019-06-03 00:00:00
abstract:OBJECTIVES:(1) Investigate and explore whether different classes of associative stigma (the process by which a person experiences stigmatisation as a result of an association with another stigmatised person) could be identified using latent class analysis; (2) determine the sociodemographic and employment-related corre...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-028179
更新日期:2019-07-11 00:00:00
abstract:OBJECTIVES:To derive priority weights for access to bariatric surgery for obese adults, from the perspective of the public. SETTING:Australian public hospital system. PARTICIPANTS:Adults (N=1994), reflecting the age and gender distribution of Queensland and South Australia. PRIMARY AND SECONDARY OUTCOME MEASURES:A d...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008919
更新日期:2015-10-15 00:00:00
abstract:OBJECTIVE:To determine the feasibility of therapy-based, risk-stratified follow-up guidelines for childhood and teenage cancer survivors by evaluating adverse health outcomes in a survivor cohort retrospectively assigned a risk category. DESIGN:Retrospective cohort study. SETTING:Tertiary level, single centre, paedia...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-002451
更新日期:2013-08-02 00:00:00
abstract:BACKGROUND:Conflicts of interest may bias the findings of systematic reviews. The objective of this methodological survey was to assess the frequency and different types of conflicts of interest that authors of Cochrane and non-Cochrane systematic reviews report. METHODS:We searched for systematic reviews using the Co...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011997
更新日期:2016-08-10 00:00:00
abstract:INTRODUCTION:Placebo effects (true biopsychological effects not attributable to the active ingredients of medical technical interventions) can be attributed to several mechanisms, such as expectancy manipulation and empathy manipulation elicited by a provider's communication. So far, effects have primarily been shown i...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2016-015505
更新日期:2017-11-03 00:00:00
abstract:OBJECTIVE:American Indians (AI) have a high prevalence of electronic nicotine delivery system (ENDS) use. However, little information exists on (ENDS) use, either alone or in combination with cigarettes (dual use), among AI. The objective of this small-scaled study was to examine use behaviours and dependence among exc...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-018469
更新日期:2017-12-19 00:00:00
abstract:INTRODUCTION:A large proportion of malaria-infected individuals in endemic areas do not experience symptoms that prompt treatment-seeking. These asymptomatically infected individuals may retain their infections for many months during which sexual-stage parasites (gametocytes) are produced that may be transmissible to m...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030598
更新日期:2019-09-13 00:00:00
abstract:INTRODUCTION:Tobacco smoking is one of the leading causes of preventable death. This is not inevitable as tobacco control tools have become more powerful and more effective. Among these, warnings on cigarette packs have proven to be somewhat effective. Our objective is to increase the efficacy of antismoking warnings b...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036166
更新日期:2020-06-28 00:00:00
abstract:OBJECTIVES:To explore prescribing practitioners' perspectives on prescribed codeine use, their ability to identify dependence and their options for treatment in the UK. DESIGN:Cross-sectional design using a questionnaire containing closed-ended and open-ended items. SETTING:A nationally representative sample of presc...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-011725
更新日期:2016-07-14 00:00:00
abstract:OBJECTIVES:Physical activity is widely recommended in the treatment and management of cystic fibrosis (CF). Despite the numerous physical and psychological benefits, many young people with CF are not achieving the recommended levels of physical activity. The aim of this systematic review was to identify and synthesise ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-035261
更新日期:2020-02-20 00:00:00
abstract:INTRODUCTION:Reducing length of hospital stay for stroke survivors often creates a shift in the responsibility of care towards informal carers. Adjustment to the caregiving process is experienced by many carers as overwhelming, complex and demanding and can have a detrimental impact on mental and physical health and we...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-018309
更新日期:2017-10-22 00:00:00
abstract:OBJECTIVE:Little is known about the potential health effects of eating organic food either in the general population or during pregnancy. The aim of this study was to examine associations between organic food consumption during pregnancy and the risk of pre-eclampsia among nulliparous Norwegian women. DESIGN:Prospecti...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006143
更新日期:2014-09-10 00:00:00
abstract:INTRODUCTION:Controlled trials support the efficacy of exercise as a treatment modality for chronic conditions, yet effectiveness of real-world Exercise Physiology services is yet to be determined. This study will investigate the efficacy and cost-effectiveness of services provided by Accredited Exercise Physiologists ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-027610
更新日期:2019-08-21 00:00:00
abstract:OBJECTIVE:To investigate sex differences in survival of primary care treated patients with type 2 diabetes (T2D) in the Netherlands. SETTING:Primary care. PARTICIPANTS:A total of 1815 patients who participated in a prospective observational cohort study (Zwolle Outpatient Diabetes Project Integrating Available Care (...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-015870
更新日期:2017-10-25 00:00:00
abstract:OBJECTIVES:Examine the relationship between maternal alcohol use disorder and child school attendance outcomes for non-Indigenous and Indigenous children in Western Australia. DESIGN:Population cohort study. SETTING:Routinely collected linked administrative health, education and child protection data. PARTICIPANTS:T...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-015650
更新日期:2017-07-11 00:00:00
abstract:INTRODUCTION:Circulating prostaglandin E2 levels are elevated in acutely decompensated cirrhosis and have been shown to contribute to immune suppression. Albumin binds to and inactivates this immune-suppressive lipid mediator. Human albumin solution (HAS) could thus be repurposed as an immune-restorative drug in these ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-023754
更新日期:2018-10-21 00:00:00