Background:
Post-bronchoscopy fever in children is a commonly described complication (14.2%-48%). Risk factors for fever were well described and include young age and abnormal BAL findings. However, anesthetic choice as a risk factor for fever not yet been reported.
Objectives:
The aim of our study was to explore the role of sedative agents as a risk factor for fever during the 24 hours after the procedure. additional risk factors were investigated as well.
Methods:
A retrospective analysis files of immunocompetent children that underwent elective bronchoscopies during the period of 2013-2018 in Safra`s children`s Hospital was conducted, statistical analysis was performed.
Results:
130 children were enrolled. 56.15% of patients were treated with Sevoflurane. Post-bronchoscopy fever occurred in 23.85% of cases, 1 child identified with bacteremia. The average of CRP in the children who developed fever was 7.28mg/l, and the average of neutrophil absolute was 13.09k/ul.
35.62% of patients receiving Sevoflurane developed post-bronchoscopy fever compared to 8.77 in the non-Sevoflurane group (RR=4.06, CI [1.66-9.91], p=0.05).
Multivariate analysis of the data (comorbidities, sedation choice, age, indication for doing the procedure, BAL performed and its findings, post-prematurity, FTT, and medications) suggested only Sevoflurane and young age were statistically significant risk factors for fever. Antibiotic treatment was found to be a protective factor against fever when used long term.
Conclusions:
We conclude that Sevoflurane is a significant risk factor for developing post-bronchoscopy fever. A potential mechanism for this finding is an irritation of the over-stimulated bronchus by the anesthetic and therefore generating inflammatory reaction.
