{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T08:35:20Z","timestamp":1790757320936,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,4,23]],"date-time":"2018-04-23T00:00:00Z","timestamp":1524441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Complications are common during anesthesia for patients with mucopolysaccharidoses. San Gerardo Hospital (Italy) is a reference center for mucopolysaccharidoses with a dedicated pediatric anesthesia service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aims to evaluate the safety of anesthesia for mucopolysaccharidoses patients, describe their anesthetic management at our institution, and assess risk factors for complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The anesthetic charts of mucopolysaccharidoses patients admitted from\u00a0January 1999 to December 2014 were retrospectively analyzed. We retrieved patients' demographics; location and type of the procedure; anesthetic approach airway management and occurrence of difficult intubation and complications and outcome at hospital discharge. A generalized linear mixed model was performed to assess risk factors for complications and difficult intubation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010four consecutive children were included. The anesthetic charts of 232 procedures (52% radio\u2010diagnostics, 15% orthopedics, 15% ear\u2010nose\u2010throat surgery, 10% neurosurgery, and 8% general surgery) were analyzed. Each patient underwent a median of 4 (1\u20106) procedures. The median age at the first procedure was 2 (1\u20105), and overall age was 5 (2\u20108) years old. One hundred and twenty\u2010five (54%) procedures were performed in remote locations. General anesthesia was utilized for 100 (43%) procedures. No death was recorded. Twenty\u2010one (9%) procedures had respiratory complications. Remote location anesthesia was associated with increased risk for complications (odds ratio 5.405 [1.355\u201028.571], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.016). All planned intubations (n\u00a0=\u00a065) were successful. Nineteen (29%) of those were defined difficult. All emergency intubations (n\u00a0=\u00a03) failed and were rescued by laryngeal mask airways. Older age was associated with an increased risk of difficult intubation (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.200 [1.019\u20101.436], <jats:italic>P<\/jats:italic>\u00a0=\u00a0.028).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with mucopolysaccharidoses are at high risk for anesthesia\u2010related complications. Remote location anesthesia is associated with increased risk for complications, and older age is associated with increased risk for difficult intubation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.13379","type":"journal-article","created":{"date-parts":[[2018,4,24]],"date-time":"2018-04-24T04:05:40Z","timestamp":1524542740000},"page":"436-442","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Safety of anesthesia for children with mucopolysaccharidoses: A retrospective analysis of 54 patients"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0877-7626","authenticated-orcid":false,"given":"Vittorio","family":"Scaravilli","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Critical Care Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Zanella","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy"},{"name":"Department of Medical Physiopathology and Transplants University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Ciceri","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery University of Milan\u2010Bicocca Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariagrazia","family":"Bosatra","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Intensive Care San Gerardo Hospital Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Flandoli","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Intensive Care San Gerardo Hospital Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"La Bruna","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Ospedale San Raffaele Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Sosio","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery University of Milan\u2010Bicocca Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossella","family":"Parini","sequence":"additional","affiliation":[{"name":"Pediatric Unit Fondazione MBBM San Gerardo Hospital Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Gasperini","sequence":"additional","affiliation":[{"name":"Pediatric Unit Fondazione MBBM San Gerardo Hospital Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Pesenti","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy"},{"name":"Department of Medical Physiopathology and Transplants University of Milan Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Moretto","sequence":"additional","affiliation":[{"name":"Department of Perioperative Medicine and Intensive Care San Gerardo Hospital Monza Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,4,23]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1172-6-72"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.12.024"},{"key":"e_1_2_10_4_1","first-page":"243","article-title":"Mucopolysaccharidoses: anesthetic 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A rare case of adult patient","volume":"69","author":"Ingrosso M","year":"2003","journal-title":"Minerva Anestesiol"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1213\/XAA.0000000000000031"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)91046-1"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2004.01.046"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpan.13379","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.13379","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T14:20:12Z","timestamp":1695478812000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.13379"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,23]]},"references-count":23,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1111\/pan.13379"],"URL":"https:\/\/doi.org\/10.1111\/pan.13379","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4,23]]},"assertion":[{"value":"2018-03-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-04-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}