title: Deep procedural sedation by a sedationist team for outpatient pediatric renal biopsies.
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.
authors: Children's Healthcare of Atlanta and Department of Pediatrics Emory University School of Medicine, Atlanta, GA, USA.|Division of Pediatric Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors: Pradip P
authors: PP
authors: Kamat
authors: Children's Healthcare of Atlanta and Department of Pediatrics Emory University School of Medicine, Atlanta, GA, USA.|Division of Pediatric Nephrology, Emory University School of Medicine, Atlanta, GA, USA.
authors: Frank W
authors: FW
authors: Ayestaran
authors: Children's Healthcare of Atlanta and Department of Pediatrics Emory University School of Medicine, Atlanta, GA, USA.|Division of Pediatric Infectious Disease, Emory University School of Medicine, Atlanta, GA, USA.
authors: Scott E
authors: SE
authors: Gillespie
authors: Children's Healthcare of Atlanta and Department of Pediatrics Emory University School of Medicine, Atlanta, GA, USA.
authors: Rebecca D
authors: RD
authors: Sanders
authors: Children's Healthcare of Atlanta and Department of Pediatrics Emory University School of Medicine, Atlanta, GA, USA.|Division of Pediatric Nephrology, Emory University School of Medicine, Atlanta, GA, USA.
authors: Larry A
authors: LA
authors: Greenbaum
authors: Children's Healthcare of Atlanta and Department of Pediatrics Emory University School of Medicine, Atlanta, GA, USA.|Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors: Harold K
authors: HK
authors: Simon
authors: Children's Healthcare of Atlanta and Department of Pediatrics Emory University School of Medicine, Atlanta, GA, USA.|Division of Pediatric Critical Care Medicine, Emory University School of Medicine, Atlanta, GA, USA.
authors: Jana A
authors: JA
authors: Stockwell
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000379:methods*; D000777:Anesthetics / Q000008:administration & dosage; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007668:Kidney / Q000601:surgery; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010045:Outpatients; D010100:Oxygen; D010343:Patient Admission; D010351:Patient Discharge; D010372:Pediatrics / Q000379:methods; D015742:Propofol / Q000008:administration & dosage; D012044:Regression Analysis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000777:Anesthetics; D010100:Oxygen; D005283:Fentanyl; D015742:Propofol
keywords: adverse events; native; outpatient; pediatric; renal biopsy; sedation; transplant