Deep procedural sedation by a sedationist team for outpatient pediatric renal biopsies

Pediatr Transplant. 2016 May;20(3):372-7. doi: 10.1111/petr.12680. Epub 2016 Feb 12.

Abstract

To date, no study has analyzed the use of deep PS for pediatric renal biopsies by a dedicated sedation team in an outpatient setting. Retrospective analysis of renal biopsies performed at CHOA from 2009 to 2013. Patient demographics, procedure success, and sedation-related events were analyzed. Logistic regression techniques were applied to identify characteristics associated with procedure safety and success. A total of 174 biopsies from 136 patients, aged 2-21 yr, were reviewed. Of the 174 biopsies, 63 of 174 (36%) were from native, and 111 of 174 (64%) were from transplanted kidneys, respectively. No deaths, allograft losses, or unanticipated hospital admissions occurred. The most commonly utilized interventions during sedation were blow-by oxygen (29.9%) and CPAP (12.1%). Children receiving the combination of F + P had significantly higher biopsy success rates vs. other drug combinations (96.1% vs. 79%; p = 0.014). There was no difference in complication rates regardless of drug combination or biopsy type (transplanted vs. native). The combination of F + P yields a high procedural success rate for outpatient native and transplanted kidney biopsies. We identified a number of sedation-related events that can be easily managed by a well-trained sedationist team.

Keywords: adverse events; native; outpatient; pediatric; renal biopsy; sedation; transplant.

MeSH terms

  • Adolescent
  • Anesthesia / methods*
  • Anesthetics / administration & dosage
  • Biopsy
  • Child
  • Child, Preschool
  • Continuous Positive Airway Pressure
  • Female
  • Fentanyl / administration & dosage
  • Humans
  • Kidney / surgery
  • Kidney Transplantation / methods*
  • Male
  • Monitoring, Physiologic / methods
  • Outpatients
  • Oxygen
  • Patient Admission
  • Patient Discharge
  • Pediatrics / methods
  • Propofol / administration & dosage
  • Regression Analysis
  • Retrospective Studies
  • Young Adult

Substances

  • Anesthetics
  • Oxygen
  • Fentanyl
  • Propofol