Second-hand smoking and carboxyhemoglobin levels in children: A prospective observational study

Branden E. Yee, Mohammed I. Ahmed, Doug Brugge, Maureen Farrell, Gustavo Lozada, Raghu Idupaganthi, Roman Schumann

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Aim: To establish baseline noninvasive carboxyhemoglobin (COHb) levels in children and determine the influence of exposure to environmental sources of carbon monoxide (CO), especially environmental tobacco smoke, on such levels. Background: Second-hand smoking may be a risk factor for adverse outcomes following anesthesia and surgery in children (1) and may potentially be preventable. Patients and Methods: Parents and their children between the ages of 1-12 were enrolled on the day of elective surgery. The preoperative COHb levels of the children were assessed noninvasively using a CO-Oximeter (Radical-7 Rainbow SET Pulse CO-Oximeter; Masimo, Irvine, CA, USA). The parents were asked to complete an environmental air-quality questionnaire. The COHb levels were tabulated and correlated with responses to the survey in aggregate analysis. Statistical analyses were performed using the nonparametric Mann-Whitney and Kruskal-Wallis tests. P < 0.05 was statistically significant. Results: Two hundred children with their parents were enrolled. Children exposed to parental smoking had higher COHb levels than the children of nonsmoking controls. Higher COHb values were seen in the youngest children, ages 1-2, exposed to parental cigarette smoke. However, these trends did not reach statistical significance, and confidence intervals were wide. Conclusions: This study revealed interesting trends of COHb levels in children presenting for anesthesia and surgery. However, the COHb levels measured in our patients were close to the error margin of the device used in our study. An expected improvement in measurement technology may allow screening children for potential pulmonary perioperative risk factors in the future.

Original languageEnglish (US)
Pages (from-to)82-89
Number of pages8
JournalPaediatric Anaesthesia
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2010

Fingerprint

Carboxyhemoglobin
Observational Studies
Hand
Smoking
Prospective Studies
Carbon Monoxide
Parents
Smoke
Anesthesia
Environmental Exposure
Ambulatory Surgical Procedures
Tobacco Products
Tobacco
Air
Confidence Intervals
Technology

Keywords

  • Air pollution
  • Carbon monoxide
  • Carboxyhemoglobin
  • Environmental tobacco smoke exposure

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Second-hand smoking and carboxyhemoglobin levels in children : A prospective observational study. / Yee, Branden E.; Ahmed, Mohammed I.; Brugge, Doug; Farrell, Maureen; Lozada, Gustavo; Idupaganthi, Raghu; Schumann, Roman.

In: Paediatric Anaesthesia, Vol. 20, No. 1, 01.01.2010, p. 82-89.

Research output: Contribution to journalArticle

Yee, Branden E. ; Ahmed, Mohammed I. ; Brugge, Doug ; Farrell, Maureen ; Lozada, Gustavo ; Idupaganthi, Raghu ; Schumann, Roman. / Second-hand smoking and carboxyhemoglobin levels in children : A prospective observational study. In: Paediatric Anaesthesia. 2010 ; Vol. 20, No. 1. pp. 82-89.
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AB - Aim: To establish baseline noninvasive carboxyhemoglobin (COHb) levels in children and determine the influence of exposure to environmental sources of carbon monoxide (CO), especially environmental tobacco smoke, on such levels. Background: Second-hand smoking may be a risk factor for adverse outcomes following anesthesia and surgery in children (1) and may potentially be preventable. Patients and Methods: Parents and their children between the ages of 1-12 were enrolled on the day of elective surgery. The preoperative COHb levels of the children were assessed noninvasively using a CO-Oximeter (Radical-7 Rainbow SET Pulse CO-Oximeter; Masimo, Irvine, CA, USA). The parents were asked to complete an environmental air-quality questionnaire. The COHb levels were tabulated and correlated with responses to the survey in aggregate analysis. Statistical analyses were performed using the nonparametric Mann-Whitney and Kruskal-Wallis tests. P < 0.05 was statistically significant. Results: Two hundred children with their parents were enrolled. Children exposed to parental smoking had higher COHb levels than the children of nonsmoking controls. Higher COHb values were seen in the youngest children, ages 1-2, exposed to parental cigarette smoke. However, these trends did not reach statistical significance, and confidence intervals were wide. Conclusions: This study revealed interesting trends of COHb levels in children presenting for anesthesia and surgery. However, the COHb levels measured in our patients were close to the error margin of the device used in our study. An expected improvement in measurement technology may allow screening children for potential pulmonary perioperative risk factors in the future.

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