Operator-Managed Sedation for Pediatric Cardiac Catheterization: Experience and Safety in a Single-Center Cohort.
Adverse events occurred in 7.0% of pediatric catheterizations under operator-managed sedation.
Operator-Managed Sedation for Pediatric Cardiac Catheterization: Experience and Safety in a Single-Center Cohort.
While the 2024 international expert consensus acknowledges that operator-managed sedation (operator-managed sedation) may provide equal safety to anesthesiologist-directed care, it emphasizes clinical judgment over numerical risk scores alone, yet supporting institutional data remain limited.
We retrospectively reviewed 342 cardiac catheterization procedures in pediatric patients under six years of age performed under operator-managed sedation between 2020 and 2022.
In the univariate analysis, neonatal age (OR = 13.5, p < 0.001), body weight ≤ 10 kg (OR = 3.04, p = 0.01), and genetic abnormalities (OR = 3.92, p = 0.023) were identified as significant risk factors.
Neonatal age and genetic abnormalities remained significant in the multivariate analysis.
The incidence of adverse events increased with higher Catheterization Risk Score for Pediatrics (Catheterization Risk Score for Pediatrics) scores, showing a significant linear trend ( p < 0.001), whereas no sedation-related adverse events occurred in patients with scores below 2.
Operator-managed sedation can be performed safely across a wide Catheterization Risk Score for Pediatrics score range in experienced centers.
Neonatal age and genetic abnormalities were associated with increased adverse events risk; however, case selection should be guided by each patient's overall clinical picture rather than any single risk factor alone.