Association of Lower Age and Cardiorespiratory Events during Intra-Arterial Chemotherapy for Retinoblastoma: A Prospective Observational Study

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FIG 1.
Predicted risk of a cardiorespiratory event based on age.
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FIG 2.
Vital signs and respiratory parameters measured before (immediately before femoral puncture) and during the cardiorespiratory event. BPM indicates beats per minute.

Table 1:

Clinical and demographic characteristics

Characteristic	Overall (n = 175)^{^a}	No Cardiorespiratory Event (n = 153)^{^a}	Cardiorespiratory Event (n = 22)^{^a}	P Value^{^b}
Female sex	96 (55%)	82 (54%)	14 (64%)	.376
Age (m)	28.93 (23.21)	30.11 (24.17)	20.43 (11.76)	.004
Weight (kg)	13.00 (10.00–15.65)	13.00 (9.90–16.00)	11.30 (10.00–14.50)	.228
Bronchial hyperreactivity	19 (11%)	19 (12%)	0 (0%)	.136
Rhinitis	1 (1%)	1 (1%)	0 (0%)	>.999
Previous bronchiolitis	5 (3%)	5 (3%)	0 (0%)	>.999
Upper respiratory tract infections <15 days	8 (5%)	8 (5%)	0 (0%)	.598
Parental smoking	9 (5%)	7 (5%)	2 (9%)	.315
No clinical history	137 (78%)	117 (76%)	20 (91%)	.169

↵a Data are No. (%), mean (SD), median (25th–75th percentiles).
↵b Determined by the Pearson χ² test; Welch 2-sample t test; Fisher exact test; Wilcoxon rank-sum test.

Table 2:

Adverse cardiorespiratory events and treatment during intra-arterial chemotherapy

Events and Treatment
Characteristic (n = 175)^{^a}
Uneventful	153 (87%)
Reduced tidal volume (>10% from baseline)	16 (9%)
SpO₂ drop (>10% or below 90% even if transient)	7 (4%)
Change in the capnography curve to an ascending pattern	3 (2%)
Hypotension	5 (3%)
Bradycardia	2 (1%)
Cardiorespiratory arrest	0 (0%)
Treatment (n = 22)^{^a}
Manual ventilation	13 (59%)
Increased inspiratory pressure	8 (36%)
Increase in FiO₂	12 (55%)
Crystalloid bolus	5 (23%)
Atropine	0 (0%)
Epinephrine	4 (18%)
Propofol bolus	2 (9%)
Increased sevoflurane	0 (0%)
Interruption of the procedure	1 (5%)
Neuromuscular blocker administration	0 (0%)
Spontaneous resolution	2 (9%)