In Reply We thank our colleagues for their interest in our study.1 We agree that many respiratory adverse events are common and minor and may have little effect on the patient’s immediate clinical care. However, bronchospasm and laryngospasm are known to be a major cause of perioperative cardiac arrests, unplanned intensive care unit admissions, and neurological damage following anesthesia. The composite of these respiratory adverse events allows a standardized approach to clinical trials and minimizes the potential for operator bias across treatment arms. We do acknowledge that different approaches to these composite events are used and that careful consideration should be given when comparing outcomes from different clinical trials. However, this does not invalidate the outcomes within any one research study.
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von Ungern-Sternberg BS, Sommerfield D, Hall GL. Albuterol and Pediatric Perioperative Respiratory Complications—Reply. JAMA Pediatr. Published online September 16, 2019. doi:10.1001/jamapediatrics.2019.3188
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