Desaturation in procedural sedation for children with long bone fractures: Does weight status matter?
INTRODUCTION
Childhood obesity remains a serious problem in the United States. Significant associated adverse incidents have been reported with sedation of children with obesity, namely hypoxemia. The objective of our study was to determine if overweight and obesity were associated with increased desaturations during procedural sedation compared with patients of healthy weight.


METHODS
This was a single-center retrospective chart review of data from a three-year period of patient's age 2-17years. Of the 1700 charts reviewed 823 of these patients received procedural sedation and met the study inclusion criteria. Weight status was classified based on age and gender specific body mass index (BMI) percentiles: underweight, healthy weight, overweight, obese.


RESULTS
Among all weight categories there was no statistical significance, however children with obesity had greater desaturation rates (9.9%) compared with children of underweight, healthy weight, or overweight combined (5.4%), χ2=4.46, p=0.035.


DISCUSSION
The results indicate that children with obesity are almost twice as likely to have a desaturation related to procedural sedation compared with children of other weight status. Providers should be aware that children with obesity may be more likely to desaturate than other children, and therefore be skilled at recognizing this.
['Hirsch|Danielle G|DG|', 'Tyo|John|J|', 'Wrotniak|Brian H|BH|']
D000293:Adolescent D017677:Age Distribution D015992:Body Mass Index D019296:Capnography D002648:Child D002675:Child, Preschool D016292:Conscious Sedation D004305:Dose-Response Relationship, Drug D004636:Emergency Service, Hospital D005260:Female D005264:Femoral Fractures D006801:Humans D006810:Humeral Fractures D000860:Hypoxia D008297:Male D063766:Pediatric Obesity D017410:Practice Guidelines as Topic D012189:Retrospective Studies D013978:Tibial Fractures D014481:United States
Sedation Bone fracture Obesity Pediatrics