Pediatric anesthesia & critical care
Adverse Events Associated with Airway Management in Pediatric Anesthesia: A Prospective, Multicenter, Observational Japan Pediatric Difficult Airway in Anesthesia (J-PEDIA) Study
Authors' conclusion
The Japan Pediatric Difficult Airway in Anesthesia (J-PEDIA) study demonstrated adverse event and desaturation incidences and the impact of clinically relevant risk factors during airway-securing procedures in Asian children.
Study context
- Population
- Children undergoing airway-securing procedures under GA in 10 tertiary care hospitals in Japan, June 2022–January 2024
- Participants
- 16,695 children · 17,007 procedures
- Outcome
- Adverse events associated with airway-securing procedures
Methodological detailsmulticentre, 10 tertiary care hospitals
- Multicentre
- 10 tertiary care hospitals
Main finding
As reported in the abstract
Any adverse events
- Any adverse events, 346 of 17,007
- 2.0% (95% CI, 1.8 to 2.3)
- Respiratory adverse events, 189 of 17,007 (0.96 to 1.3)
- 1.1%
- Risk factor: younger age, aOR
- 0.92 (95% CI, 0.90 to 0.95; P < 0.001)
- Risk factor: airway management in radiation diagnostic/therapy rooms, aOR (1.64 to 19.9; P = 0.006)
- 5.7
- Risk factor: airway sensitivity, aOR (1.09 to 1.94; P = 0.010)
- 1.46
- Risk factor: craniocervical surgery, aOR (1.09 to 1.83; P = 0.009)
- 1.41
- Risk factor: one anatomical difficult airway feature, aOR (1.02 to 2.95; P = 0.042)
- 1.74
- Risk factor: two or more anatomic difficult airway features, aOR (1.21 to 6.6; P = 0.017)
- 2.82
- Beneficial: supraglottic airway device at first attempt, aOR (0.288 to 0.62; P < 0.001)
- 0.42
- Beneficial: muscle relaxant administration, aOR (0.43 to 0.89; P = 0.009)
- 0.62
Observational data: associations, not effects.
Secondary outcomes
Desaturation (≥10% drop in oxygen saturation)
- All procedures, 395 of 17,007 (2.1 to 2.6)
- 2.3%
- Neonates, 66 of 308 (17.0 to 26.4)
- 21.4%
- Infants, 210 of 2,298 (8.0 to 10.4)
- 9.1%
Original publication
Adverse Events Associated with Airway Management in Pediatric Anesthesia: A Prospective, Multicenter, Observational Japan Pediatric Difficult Airway in Anesthesia (J-PEDIA) Study. Anesthesiology. Published 7 July 2025. doi:10.
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