Pulmonary aspiration during procedural sedation: a comprehensive systematic review - PubMed (original) (raw)

Review

. 2017 Mar 1;118(3):344-354.

doi: 10.1093/bja/aex004.

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• PMID: 28186265
• DOI: 10.1093/bja/aex004

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Review

Pulmonary aspiration during procedural sedation: a comprehensive systematic review

S M Green et al. Br J Anaesth. 2017.

Free article

Abstract

Background: Although pulmonary aspiration complicating operative general anaesthesia has been extensively studied, little is known regarding aspiration during procedural sedation.

Methods: We performed a comprehensive, systematic review to identify and catalogue published instances of aspiration involving procedural sedation in patients of all ages. We sought to report descriptively the circumstances, nature, and outcomes of these events.

Results: Of 1249 records identified by our search, we found 35 articles describing one or more occurrences of pulmonary aspiration during procedural sedation. Of the 292 occurrences during gastrointestinal endoscopy, there were eight deaths. Of the 34 unique occurrences for procedures other than endoscopy, there was a single death in a moribund patient, full recovery in 31, and unknown recovery status in two. We found no occurrences of aspiration in non-fasted patients receiving procedures other than endoscopy.

Conclusions: This first systematic review of pulmonary aspiration during procedural sedation identified few occurrences outside of gastrointestinal endoscopy, with full recovery typical. Although diligent caution remains warranted, our data indicate that aspiration during procedural sedation appears rare, idiosyncratic, and typically benign.

Keywords: adverse events; propofol; pulmonary aspiration; sedation.

© The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com

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Comment in

• A Review of Scientific Literature of Interest to Office-Based Anesthesiology Practice.
  Green SA, Saxen MA, Urman RD. Green SA, et al. Anesth Prog. 2017 Summer;64(2):119-121. doi: 10.2344/anpr-64-02-14. Anesth Prog. 2017. PMID: 28604092 Free PMC article. No abstract available.

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