{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:31:42Z","timestamp":1777937502792,"version":"3.51.4"},"reference-count":10,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"\n BACKGROUND AND OBJECTIVES:<\/jats:title>\n Anaphylaxis is rare but life-threatening. Its incidence during pediatric procedural sedation outside of the operating room is unknown. We used data from the Pediatric Sedation Research Consortium (PSRC) to determine the incidence and nature of allergic and anaphylactic reactions in this practice.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n A retrospective observational study of prospectively collected information in the PSRC\u2019s multicenter database was performed. Cases of allergic reaction were identified. Because anaphylaxis is not a listed complication in the PSRC database, all cases for which allergic reaction was noted were reviewed for the occurrence of other complications or interventions that would suggest at least 2 organ system derangements consistent with anaphylaxis as well as for practitioner commentary stating the occurrence of anaphylaxis. Descriptive analyses of demographic information and summary statistics were performed, and multiple logistic regression analysis was used to evaluate associations between the occurrence of allergic reactions and medications.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n During the study period, 227\u2009833 cases were entered into the PSRC database. There were 54 cases of allergic reaction (incidence 1:4219); 6 were consistent with anaphylaxis (incidence 1:37\u2009972). A significant association between the development of allergic reaction and 4 sedative and\/or analgesic medications was noted: midazolam (odds ratio [OR] 2.2; confidence interval [CI] 1.2\u20133.9), ketamine (OR 3.8; CI 2.1\u20137.1), methohexital (OR 48.8; CI 14.9\u2013159.9), and morphine (OR 4.4; CI 1.04\u201318.2). There were no mortalities.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Allergic reactions and anaphylaxis during pediatric procedural sedation are rare. In this study, the development of allergic reactions was significantly associated with the use of midazolam, ketamine, methohexital, and morphine.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/hpeds.2018-0089","type":"journal-article","created":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T14:25:18Z","timestamp":1546352718000},"page":"16-23","source":"Crossref","is-referenced-by-count":20,"title":["The Incidence and Nature of Allergic and Anaphylactic Reactions During Pediatric Procedural Sedation: A Report From the Pediatric Sedation Research Consortium"],"prefix":"10.1542","volume":"9","author":[{"given":"James H.","family":"Hertzog","sequence":"first","affiliation":[{"name":"Division of Critical Care Medicine, Department of Pediatrics, Nemours Alfred I. duPont Hospital for Children, Wilmington, Delaware;"},{"name":"Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krista","family":"Preisberga","sequence":"additional","affiliation":[{"name":"Departments of Hospital Medicine and Anesthesiology, Texas Children\u2019s Hospital and Baylor College of Medicine, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Penfil","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Herman and Walter Samuelson Children\u2019s Hospital at Sinai, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2019,1,1]]},"reference":[{"issue":"2","key":"2021120817315704100_B1","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.iac.2015.01.006","article-title":"Recognition, treatment, and prevention of anaphylaxis","volume":"35","author":"Moore","year":"2015","journal-title":"Immunol Allergy Clin North Am"},{"issue":"5","key":"2021120817315704100_B2","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.anai.2015.07.019","article-title":"Anaphylaxis\u2013a practice parameter update 2015","volume":"115","author":"Lieberman","year":"2015","journal-title":"Ann Allergy Asthma Immunol"},{"issue":"3","key":"2021120817315704100_B3","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1542\/peds.2006-0313","article-title":"Incidence and nature of adverse events during pediatric sedation\/anesthesia for procedures outside the operating room: report from the Pediatric Sedation Research Consortium","volume":"118","author":"Cravero","year":"2006","journal-title":"Pediatrics"},{"issue":"3","key":"2021120817315704100_B4","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1213\/ane.0b013e31818fc334","article-title":"The incidence and nature of adverse events during pediatric sedation\/anesthesia with propofol for procedures outside the operating room: a report from the Pediatric Sedation Research Consortium","volume":"108","author":"Cravero","year":"2009","journal-title":"Anesth Analg"},{"issue":"1","key":"2021120817315704100_B5","doi-asserted-by":"crossref","first-page":"e2017009","DOI":"10.1542\/peds.2017-0009","article-title":"Upper respiratory infections and airway adverse events in pediatric procedural sedation","volume":"140","author":"Mallory","year":"2017","journal-title":"Pediatrics"},{"issue":"2","key":"2021120817315704100_B6","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.jaci.2005.12.1303","article-title":"Second symposium on the definition and management of anaphylaxis: summary report\u2013Second National Institute of Allergy and Infectious Disease\/Food Allergy and Anaphylaxis Network symposium","volume":"117","author":"Sampson","year":"2006","journal-title":"J Allergy Clin Immunol"},{"issue":"5","key":"2021120817315704100_B7","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11882-015-0522-4","article-title":"Perioperative anaphylaxis: what should be known?","volume":"15","author":"Dewachter","year":"2015","journal-title":"Curr Allergy Asthma Rep"},{"issue":"6","key":"2021120817315704100_B8","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/j.1460-9592.1993.tb00101.x","article-title":"Anaphylactic reactions during paediatric anaesthesia; results of the survey of the French Society of Paediatric Anaesthesists (ADARPEF) 1991-1992","volume":"3","author":"Murat","year":"1993","journal-title":"Paediatr Anaesth"},{"issue":"3","key":"2021120817315704100_B9","doi-asserted-by":"crossref","first-page":"144","DOI":"10.2344\/anpr-64-04-05","article-title":"Office-based anesthesia: safety and outcomes in pediatric dental patients","volume":"64","author":"Spera","year":"2017","journal-title":"Anesth Prog"},{"issue":"1","key":"2021120817315704100_B10","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1093\/bja\/aev360","article-title":"No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut","volume":"116","author":"Asserh\u00f8j","year":"2016","journal-title":"Br J Anaesth"}],"container-title":["Hospital Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/9\/1\/16\/1146806\/hpeds_2018-0089.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/9\/1\/16\/1146806\/hpeds_2018-0089.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T18:08:24Z","timestamp":1638986904000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article\/9\/1\/16\/26664\/The-Incidence-and-Nature-of-Allergic-and"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,1]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,1,1]]},"published-print":{"date-parts":[[2019,1,1]]}},"URL":"https:\/\/doi.org\/10.1542\/hpeds.2018-0089","relation":{},"ISSN":["2154-1663","2154-1671"],"issn-type":[{"value":"2154-1663","type":"print"},{"value":"2154-1671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,1]]}}}