Risk factors of hypoxemia during bronchoscopy under deep sedation in pediatric patients and establishment of a predictive model: a 2024 retrospective study

TL;DR

This study identifies risk factors for hypoxemia during bronchoscopy in children under deep sedation and creates a predictive model to help prevent it.

Contribution

The study establishes a predictive model for hypoxemia in pediatric bronchoscopy under deep sedation based on age and procedure duration.

Findings

Young age and longer examination duration are significant risk factors for hypoxemia during bronchoscopy under deep sedation in children.

The predictive model showed strong performance with an area under the curve of 0.96 in the modeling group and 0.89 in the validation group.

Calibration curves indicated good consistency between predicted and actual hypoxemia risks in both groups.

Abstract

Hypoxemia is a common complication of bronchoscopy performed under deep sedation in pediatric patients, seriously compromising the safety of surgery and the prognosis of children. Therefore, this study explored the risk factors and established a predictive model for hypoxia during bronchoscopy in pediatric patients under deep sedation.

365 pediatric patients who underwent bronchoscopy under deep sedation in our hospital from January to December 2024 were retrospectively selected with a random number table. After screening, 346 pediatric patients were finally included, and they were divided into a modeling group (n = 243) and a validation group (n = 103) in a ratio of 7:3. Data were analyzed.

The results of binary logistic regression analysis showed that age (6.39 ± 2.80) and examination duration were factors influencing hypoxemia during bronchoscopy under deep sedation (P < 0.05). A predictive model was developed. The calibration curves in both the modeling group and validation group showed lines close to a slope of 1, indicating good consistency between the predicted risks and the actual risks. The ROC (receiver operating characteristic) analysis results showed that the area under the curve in the modeling group was 0.96. In the validation group, the area under the curve was 0.89. The DCA (decision curve analysis) curve demonstrated a clear net benefit of the model.

Given that young age (6.39 ± 2.80) and long examination duration are important risk factors for hypoxia during bronchoscopy under deep sedation in pediatric patients, preoperative assessment of age and optimization of the procedure to reduce its duration are recommended. At the same time, based on the verified prediction model, high-risk children should take measures to prevent hypoxia in advance.

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