Complications associated with paediatric airway management during the COVID-19 pandemic: an international, multicentre, observational study.

Journal Article (Journal Article)

Respiratory adverse events in adults with COVID-19 undergoing general anaesthesia can be life-threatening. However, there remains a knowledge gap about respiratory adverse events in children with COVID-19. We created an international observational registry to collect airway management outcomes in children with COVID-19 who were having a general anaesthetic. We hypothesised that children with confirmed or suspected COVID-19 would experience more hypoxaemia and complications than those without. Between 3 April 2020 and 1 November 2020, 78 international centres participated. In phase 1, centres collected outcomes on all children (age ≤ 18 y) having a general anaesthetic for 2 consecutive weeks. In phase 2, centres recorded outcomes for children with test-confirmed or suspected COVID-19 (based on symptoms) having a general anaesthetic. We did not study children whose tracheas were already intubated. The primary outcome was the incidence of hypoxaemia during airway management. Secondary outcomes included: incidence of other complications; and first-pass success rate for tracheal intubation. In total, 7896 children were analysed (7567 COVID-19 negative and 329 confirmed or presumed COVID-19 positive). The incidence of hypoxaemia during airway management was greater in children who were COVID-19 positive (24 out of 329 (7%) vs. 214 out of 7567 (3%); OR 2.70 (95%CI 1.70-4.10)). Children who had symptoms of COVID-19 had a higher incidence of hypoxaemia compared with those who were asymptomatic (9 out of 51 (19%) vs. 14 out of 258 (5%), respectively; OR 3.7 (95%CI 1.5-9.1)). Children with confirmed or presumed COVID-19 have an increased risk of hypoxaemia during airway management in conjunction with general anaesthesia.

Full Text

Duke Authors

Cited Authors

  • Peterson, MB; Gurnaney, HG; Disma, N; Matava, C; Jagannathan, N; Stein, ML; Liu, H; Kovatsis, PG; von Ungern-Sternberg, BS; Fiadjoe, JE; PAWS-COVID-19 Group,

Published Date

  • March 23, 2022

Published In

Volume / Issue

  • 77 / 6

Start / End Page

  • 649 - 658

PubMed ID

  • 35319088

Pubmed Central ID

  • PMC9111470

Electronic International Standard Serial Number (EISSN)

  • 1365-2044

Digital Object Identifier (DOI)

  • 10.1111/anae.15716


  • eng

Conference Location

  • England