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More Anesthesia-Related Death in Children With Heart Disease

Anesthesia-related mortality is higher in children with heart disease and pulmonary hypertension

TUESDAY, June 7 (HealthDay News) -- Anesthesia increases the risk of mortality in children with heart disease, especially pulmonary hypertension, but it is safe for healthy children, according to a study published in the June issue of Anesthesia & Analgesia.

Benjamin F. van der Griend, M.B.B.S., from Christchurch Hospital in New Zealand, and colleagues examined the incidence of 24-hour and 30-day pediatric mortality after anesthesia at a large tertiary institution. A total of 101,885 anesthetics were administered to 56,263 children aged 18 years or younger, between January 2003 and August 2008. Cases of death where a panel of anesthesiologists agreed that anesthesia or factors under the control of the anesthesiologist most likely influenced the timing of death were defined as anesthesia-related death.

The investigators found that there were 13.4 cases of overall 24-hour mortality from any cause following anesthesia per 10,000 anesthetics administered, and 34.5 cases of 30-day mortality per 10,000 anesthetics. Infants aged 30 days or younger had the highest incidence of death. Compared to patients undergoing noncardiac surgery, children undergoing cardiac surgery had a higher incidence of 24-hour and 30-day mortality. In total, there were 10 anesthesia-related deaths, with an incidence of anesthesia-related death of one in 10,188 or 0.98 cases per 10,000 anesthetics. In all of these cases, a significant factor contributing to death was the presence of pre-existing medical conditions, which for five patients was pulmonary hypertension.

"All anesthesia-related deaths were in children with highly complex medical problems, including congenital heart disease and in particular pulmonary hypertension; and no anesthesia-related deaths were identified in children with no or minor medical problems," the authors write.

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