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1. Continuous fentanyl infusion reduces intra-abdominal pressure, postoperative pain and normalizes lungs’ mechanical changes in newborn with viscera-abdominal disproportion in early post-operative period

Author

Konstantin Bercun, Oleksandr Nazarchuk, Oleksandr Dobrovanov, Denis Surkov, and Viktor Vidiščák

Subjects
fentanyl, gastroshisis, lungs function, newborns, postoperative pain, Anesthesiology, RD78.3-87.3
Abstract

We aimed to study the influence of prolonged administration of fentanyl on postoperative pain, intra­ab­dominal pressure and mechanical lungs’ changes that may happen in neonates in early post­operative period. 30 newborns (in the period from January 2017 to May 2021) with gastroschisis were divided into two groups ac­cordingly to the method of analgesia (14 – morphine hydrochloride; 16 – prolonged infusion of fentanyl). Lungs’ mechanical characteristics, effectiveness of post­operative analgesia, abdominal wall relaxation was studied by monitoring of dynamic compliance (Cdyn), pressure and flow­volume loops, capnography. Apprising analgesia sta­tus, we measured hemodynamic, SаO2, blood level of cortizol, C­reactive protein (CRP), glucose, analyzed post­operative pain syndrome using visual analogue scales (VAS). Intra­abdominal pressure (IAP) was controlled by Cron. For statistic analysis we used Student’s t­test. In the group with morphine, thete was the increase of IAP by 11–12 cm H2O, being stable during some period of time, and also variable levels of pain according to VAS, the in­creasing of CRP from 0.8 ± 0.25 mg/dl by 5 mg/dl, cortisol by 674.4 nmol/l, and blood glucosae rate – 7.4 mmol/l. Periods with high traumatic effects and poor analgesia (morphine group) reasoned the increasing IAP, step by step dynamic compliance decreasing in 3.4 times, resistance increasing in 2.42 times and PIP rising till 22 cm H2O. Di­rect correlation between IAP increase and lungs’ mechanical changes took place. The study has demonstrated that prolonged administration of fentanyl prevented high increase of IAP, CRP, levels of glucose and cortizol and changes of VAS data, lungs’ mechanical characteristics.

Published
2021
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3. Continuous fentanyl infusion reduces intra-abdominal pressure, postoperative pain and normalizes lungs’ mechanical changes in newborn with viscera-abdominal disproportion in early post-operative period

Author

Viktor Vidiščák, Oleksandr Nazarchuk, Konstantin Bercun, Denis Surkov, and Oleksandr Dobrovanov

Subjects
newborns, Postoperative pain, післяопераційний біль, Hemodynamics, lungs function, новорожденные, fentanyl, послеоперационная боль, Fentanyl, Abdominal wall, фентанил, Anesthesiology, medicine, RD78.3-87.3, гастрошизис, гастрошмзиш, Intra abdominal pressure, gastroshisis, Capnography, новонароджений, medicine.diagnostic_test, Gastroschisis, business.industry, medicine.disease, фентаніл, medicine.anatomical_structure, функция легких, Anesthesia, Morphine, функція легень, business, postoperative pain, medicine.drug
Abstract

We aimed to study the influence of prolonged administration of fentanyl on postoperative pain, intra­ab­dominal pressure and mechanical lungs’ changes that may happen in neonates in early post­operative period. 30 newborns (in the period from January 2017 to May 2021) with gastroschisis were divided into two groups ac­cordingly to the method of analgesia (14 – morphine hydrochloride; 16 – prolonged infusion of fentanyl). Lungs’ mechanical characteristics, effectiveness of post­operative analgesia, abdominal wall relaxation was studied by monitoring of dynamic compliance (Cdyn), pressure and flow­volume loops, capnography. Apprising analgesia sta­tus, we measured hemodynamic, SаO2, blood level of cortizol, C­reactive protein (CRP), glucose, analyzed post­operative pain syndrome using visual analogue scales (VAS). Intra­abdominal pressure (IAP) was controlled by Cron. For statistic analysis we used Student’s t­test. In the group with morphine, thete was the increase of IAP by 11–12 cm H2O, being stable during some period of time, and also variable levels of pain according to VAS, the in­creasing of CRP from 0.8 ± 0.25 mg/dl by 5 mg/dl, cortisol by 674.4 nmol/l, and blood glucosae rate – 7.4 mmol/l. Periods with high traumatic effects and poor analgesia (morphine group) reasoned the increasing IAP, step by step dynamic compliance decreasing in 3.4 times, resistance increasing in 2.42 times and PIP rising till 22 cm H2O. Di­rect correlation between IAP increase and lungs’ mechanical changes took place. The study has demonstrated that prolonged administration of fentanyl prevented high increase of IAP, CRP, levels of glucose and cortizol and changes of VAS data, lungs’ mechanical characteristics., В исследовании изучается влияние контину­альной инфузии фентанила на послеоперационную боль, внутрибрюшное давление и механические изме­нения в легких, которые могут возникнуть у новоро­жденных в раннем послеоперационном периоде. По ме­тоду обезболивания 30 новорожденных (январь 2017 – май 2021 г.) с гастрошизисом были разделены на две группы (14­ти был назначен морфина гидро хлорид; 16­ти – континуальная инфузия фентанила). Ме­ханические характеристики легких, эффективность послеоперационной анальгезии, релаксации брюшной стенки изучались путем мониторинга динамического комплайенса, петель давления и потока­объема, кап­нографии. Для оценки качества обезболивания измеря­лись параметры гемодинамики, сатурация кислорода в крови, уровень кортизола, С­реактивного белка, глю­козы, проводилась оценка послеоперационного болево­го синдрома с помощью визуальных аналоговых шкал. Внутрибрюшное давление (IAP) контролировалось при помощи Cron. Для статистического анализа использо­вался t­критерий Стьюдента. В группе пациентов, по­лучавших морфин, отмечалось увеличение IAP на 11–12 см H2O, уровня кортизола и глюкозы в крови. Эти эффекты были связаны с травматичностью операции и недостаточной анальгезией, что стало причиной увеличения IAP, постепенного снижения динамическо­го комплайенса, увеличения резистентности легких. Отмечается прямая корреляция между увеличением IAP и механическими изменениями в легких. Исследова­ние показало, что применение континуальной инфузии фентанила предотвращает все вышеперечисленные нежелательные эффекты., У дослідженні вивчається вплив континуаль­ної інфузії фентанілу на післяопераційний біль, вну­трішньочеревний тиск і механічні зміни в легенях, які можуть виникнути у новонароджених у ранньому піс­ляопераційному періоді. За методом знеболення 30 но­вонароджених (січень 2017 – травень 2021 г.) з га­строшизисом були розділені на дві групи (14­ти було призначено морфіну гідрохлорид; 16­ти – континуаль­на інфузія фентанілу). Механічні характеристики ле­гень, ефективність післяопераційної аналгезії, релак­сації черевної стінки вивчалися шляхом моніторингу динамічного комплаєнсу, петель тиску і петель пото­ку­об’єму, капнографії. Для оцінки якості знеболюван­ня вимірювалися параметри гемодинаміки, сатурація кисню в крові, рівень кортизолу, С­реактивного білка, глюкози, проводилася оцінка післяопераційного больо­вого синдрому за допомогою візуальних аналогових шкал. Внутрішньочеревний тиск (IAP) контролювався за допомогою Cron. Для статистичного аналізу ви­користовувався t­критерій Стьюдента. У групі паці­єнтів, які отримували морфін, відзначалося збільшен­ня IAP на 11–12 см H2O, рівня кортизолу та глюкози в крові. Ці ефекти були пов’язані з травматичністю операції і недостатньою анальгезією, що стало при­чиною збільшення IAP, поступового зниження динаміч­ного комплаєнсу, підвищення резистентності легень. Відзначається пряма кореляція між збільшенням IAP та механічними змінами в легенях. Дослідження по­казало, що застосування континуальної інфузії фен­танілу запобігає всім перерахованим вище небажаним ефектам.

Published
2021

4. Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Author

Walid Habre, Nicola Disma, Katalin Virag, Karin Becke, Tom G Hansen, Martin Jöhr, Brigitte Leva, Neil S Morton, Petronella M Vermeulen, Marzena Zielinska, Krisztina Boda, Francis Veyckemans, Walter Klimscha, Regina Konecny, Robert Luntzer, Ulrike Morawk-Wintersperger, Franz Neiger, Lydia Rustemeyer, Christian Breschan, Denise Frey, Manuela Platzer, Reinhard Germann, Joachim Oeding, Birgit Stoegermüller, Bernhard Ziegler, Philipp Brotatsch, Anton Gutmann, Gerlinde Mausser, Brigitte Messerer, Wolfgang Toller, Maria Vittinghoff, Gregor Zangl, Natascha Seidel-Ahyai, Christoph Hochhold, Ruth Kroess, Peter Paal, Steven Cnudde, Patricia Coucke, Birgit Loveniers, John Mitchell, David Kahn, Thierry Pirotte, Caroline Pregardien, Marc Coppens, Stefan De Hert, Björn Heyse, Martine Neckebroek, Aliaksandra Parashchanka, Jurgen Van Limmen, Nancy Van Den Eynde, Caroline Vanpeteghem, Piet Wyffels, Michaël Lalot, Jean-Paul Lechat, France Stevens, Sari Casaer, Françoise De Groote, Françoise De Pooter, Andrée De Villé, Marc Gerin, Natalia Magasich, Cristel Sanchez Torres, Denise Van Deenen, Johan Berghmans, Dirk Himpe, Eva Roofthooft, Ellen Joukes, Carine Smitz, Veronique Van Reeth, Christel Huygens, Julie Lauweryns, Karen De Smet, Nadia Najafi, Jan Poelaert, Anne Van de Velde, Veerle Van Mossevelde, Ivan Bekavac, Diana Butkovic, Dubravka Heli Litvic, Ivana Kerovec Soric, Hrvoje Maretic, Djurdjica Moscatello, Ljiljana Popovic, Slobodan Micici, Ivana Stuck Tus, Lada Kalagac Fabris, Tatjana Simurina, Nina Sulen, Gordana Kesic-Valpotic, Dajana Djapic, Jirí Žurek, Lucie Jureckova, Iveta Mackova, Monika Skacel, Stanislava Weinlichova, Jan Divák, Michal Frelich, René Urbanec, Vera Biskupova, Vladimir Mixa, Jana Pavlickova, Arash Afshari, Morten Bøttger, Marguerite B. Ellekvist, Mathias Johansen, Birgitte Ingeborg Madsen, Jens Christian Nilsson, Birgitte MB Schousboe, Nicola G. Clausen, Tom G. Hansen, Nick Phaff Steen, Mari-Liis Ilmoja, Virge Tonise, Juri Karjagin, Reet Kikas, Mika Isohanni, Anniina Lyly, Annika Takala, Johanna Happo, Kai Kiviluoma, Kati Martikainen, Riku Aantaa, Tuula Manner, Sanna Vilo, Catherine Amory, Hugues Ludot, Patricia Lambotte, René Busche, Olivier Jacqmarcq, Corinne Lejus, Julien Corouge, Christian Erb, Delphine Garrigue, Patricia Gillet, Anne Laffargue, Veronique Lambelin, Hélène Le Freche, Daliana Peresbota, Pierre Richart, Jerome Berton, Catherine Chapotte, Laurent Colbus, Thierry Lehousse, Jean Monrigal, Catherine Baujard, Philippe Roulleau, Giuseppe Staiti, Hélène Batoz, Maryline Bordes, Anne Didier, Yann Hamonic, Sylvaine Lagarde, Karine Nouette-Gaulain, François Semjen, Brigitte Zaghet, Jacky Dekens, Axelle Delcuze, Hervé Dupont, Aurélien Legrand, Celine Raffoflandreur, Noémie Audren, Blandine Camus, Marielle Cartal, Chantal Chazelet, Isabelle Davin, Marion Guillier, Luc Desjeux, Claire Larcher, Elodie Grein, Mickeal Leclercq, Roxana Levitchi, Lilica Rosu, Dominique Simon, Aurélien Zang, Anne Migeon, Anne-Charlotte Gagey, Nathalie Bourdaud, Anne-Charlotte Carre, Frédéric Duflo, Jean-Claude Riche, Philippe Robert, Emilie Druot, Olivier Maupain, Gilles Orliaguet, Lucie Sabau, Hanna Taright, Lynn Uhrig, Juliette Verchere-Montmayeur, Lise Debrabant, Clotaire Pilla, Alexandre Podvin, Benjamin Roth, Souhayl Dahmani, Florence Julien-Marsollier, Nada Sabourdin, Bogdan Alexandri, Gilles Brezac, Francois de la Brière, Catherine Hayem, Elizabeth Lhubat, Jean Paul Mission, Charlotte Rémond, Christophe Dadure, Maud Maniora, Anais Marie, Philippe Pirat, Anne-Charlotte Saour, Chrystelle Sola, Claude Ecoffey, Eric Wodey, Christian Adam, Thomas Standl, Ehrenfried Schindler, Tomohiro Yamamoto, Michael Brackhahn, Christoph Bernhard Eich, Holger Guericke, Petra Kindermann, Michael Laschat, Cornel Schink, Frank Wappler, Claudia Hoehne, Natalia Skordou, Johanna Ulrici, Martin Jetzek-Zader, Peter Kienbaum, Tanja Meyer-Treschan, Olaf Picker, Maximilian S. Schaefer, Golo Mielke, Sabine Baethge, Axel Ramminger, Martin Bauer, Matthias Bollinger, José Hinz, Michael Quintel, Sebastian G. Russo, Michael Bauer, Dfominik Geil, Andreas Kortgen, Niels-Peter Preussler, Ulrich Hofmann, Manfred Raber, Doris Reindl, Karin Oppenrieder, Bettina Schierlinger, Jens Roth, Wolfgang Funk, Thomas Fischer, Christian Gernoth, Christina Wiefelspütz, Hauke Volger, Nicole Zederer, Anja Diers, Matthias Huber, Clemens Schorer, Andreas Weyland, Konrad Schwarzkopf, Catharina Grau, Winfried Roth, Rolf Holy, Thomas Mader, Laura Peter, Hauke Supthut, Thomas Kuehhirt, Alexander Milde, Fritz Fiedler, Carsten Isselhorst, Ulrich Grundmann, Alexander Pattar, Jennifer Reinert, Birgit Ehm, Katrin Fritzsche, Ralf Gaebler, Patrick Meybohm, Maximilian Hein, Ines Guzman, Johanna Jokinen, Peter Kranke, Ulrich Goebel, Sarah Harris, Christoph Eisner, Miriam Ochsenreiter, Michael Schoeler, Elke Thil, Richard Ellerkmann, Andreas Hoeft, Claudia Neumann, Stefan Weber, Julia Keilhauer, Jan Kloessing, Michael Schramm, Uwe Trieschmann, Kristina Knauss, Barbara Sinner, Johannes Steinmann, Herbert Koessler, Evagelia Kalliardou, Anna Malisiova, Adelais Tsiotou, Pelagia Chloropoulou, Mpratzou Chrysi, Despoina Iordanidou, Merkourios Ntavlis, Krisztina B Boda, Christilynn Guerin, Janice Irwin, Claire Magner, Solmaz Nakhjavani, Brendan O'Hare, Deborah Galvin, Yosry Jamil, Carlos Lesmes, Yuri Barak, Haran Fisher, Ludmyla Kachko, Jacob Katz, Dmitry Kirilov, Michael Levinzon, Yair Manevich, Konstantin Nekrasov, Elia Peled, Elena Sanko, Dmitri Schmain, Olga Sheinkin, Eliahu Simhi, Alex Tarabikin, Evelina Trabkin, Irena Yagudaev, Yelena Zeitlin, Igor Zunser, Elisabetta Cerutti, Maria Maddalena Schellino, Silvia Valzan, Rosa Lucia Pinciroli, Luciano Bortone, Giorgia Cerati, Fabiana Salici, Leonardo Bussolin, Giuliana Rizzo, Francesca Rossetti, Laura Marchesini, Simonetta Tesoro, Brita De Lorenzo, Fabio Guarracino, Beate Kuppers, Marinella Astuto, Sofia Pitino, Rita Scalisi, Lucia Scordo, Sandra D'Alessandro, Luigi Dei Giudici, Ivano Farinelli, Giuseppe Lofino, Giuliano Marchetti, Sergio Giuseppe Picardo, Simone Reali, Alessandro Vittori, Francesco Antonio Idone, Maria Sammartino, Fabio Sbaraglia, Cinzia Barbera, Michela Bevilacqua, Valeria Cento, Svetlana Kotzeva, Leila Mameli, Giovanni Montobbio, Leandro Passariello, Cinzia Punzo, Rosanna Sileo, Rosanna Viacava, Claudia Volpe, Clelia Zanaboni, Edoardo Calderini, Daniele Genco, Simona Neri, Davide Ottolina, Anna Camporesi, Francesca Izzo, Ida Salvo, Andrea Wolfler, Andrea Sanna, Angela Sciascia, Paolo Stoia, Annamaria Guddo, Maria Lapi, Giorgio Ivani, Annalisa Longobardo, Valeria Mossetti, Dino Pedrotti, Maurizia Grazzini, Luisa Meneghini, Salvatore Metrangolo, Stefania Michelon, Carmelo Minardi, Costanza Tognon, Nicola Zadra, Ilaria Busi, Magda Khotcholava, Bruno Guido Locatelli, Valter Sonzogni, Giusi Starita, Nicole Almenrader, Caterina Aurilio, Pasquale Sansone, Raffaella Albarello, Paolo Bracci, Mariateresa Cecini, Maria Cristina Mondardini, Lorena Pasini, Milo Vason, Gianluca Zani, Roberto Zoppellari, Laura Pistidda, Andrea Cortegiani, Santi Maurizio Raineri, Antigona Hasani, Medita Hashimi, Agris Ancupans, Arta Barzdina, Zane Straume, Anda Zundane, Mikhail Chlopin, Dalia Gestautaite, Laura Lukosiene, Evelina Paliokaite, Ilona Razlevice, Inesa Armoniene, Aurelija Bernotiene, Vidunas Daugelavicius, Ilona Dockiene, Lina Gaidelyte, Nijole Saviciene, Jolita Krikstaponiene, Dominika Sidlovskaite-Baltake, Vladyslav Stasevski, Agne Vaitoskaite, David Gatt, Stephanie Mifsud, Simone Zammit, Celia Allison, Hamid Aslami, Susanne Eberl, Mireille F M van Stijn, Markus F Stevens, Kees Punt, Rob van Osch, Arthur Bauwman, Harm Scholten, Vesna Svircevic, Veronique Adriaens, Maaike Dirckx, Jaap Dogger, Ilse Dons-Sinke, Andreas Machotta, Xavier Moors, Mandana Rad, Lonneke Staals, Anouk van der Knijff - van Dortmont, Caroline van der Marel, Anne Sieben, Tim van der Zwan, Marianne Veldhuizen, David Alders, Wolfgang Buhre, Nicole Engel, Carine Vossen, Ravin Mahadewsing, Patrick Meijer, Volker Gerling, Roelof van der Schatte Olivier, Thea van Doorn, Kristy Vons Mark Hendriks, Sandra Lako, Gert jan Scheffer, Luc Tielens, Marieke Voet, Anthony Absalom, Margot Bergsma, Vera Spanjer, Rob Spanjersberg, Yvette van de Riet, Martin Volkers, Jurgen C. de Graaff, Geranne A.J. Hopman, Teus H. Kappen, J. Hannie, A.M. Megens, Sandra C. Numan, Anton N.J. Schouten, Nigel M. Turner, Désirée B.M. Van Der Werff, Renee T.M. Wensing, Erik Ephraim, Claire Nolte, Tore Reikvam, Ole Fredrik Lund, Lene Skaaden, Kari Marthe Ballovarre, Wenche Bakken Boerke, Guro Grindheim, Pal H H Lindenskov, Anne Beate Solas, Sjur Sponheim, Kyrre Ullensvang, Oddbjorn Viken, Inger Marie Drage, Kasper Gymoese Berthelsen, Bjørn Anders Kroken, Unni Bergland, Miroslaw Pryzmont, Mariola Talalaj, Malgorzata Wasiluk, Dorota Zalewska, Maria Damps, Jadzia Siemek-Mitela, Pawel Wieczorek, Magdalena Juzwa, Jowita Rosada-Kurasinska, Alicja Bartkowska-Sniatkowska, Maciej Cettler, Renata Kopycinska, Iwona Rudewicz, Jaek Sobczyk, Dariusz Wojciechowski, Artur Baranowski, Ewa Basiewicz, Magdalena Mierzewska-Schmidt, Wlodzimierz Retka, Piotr Sawicki, Magdalena Checinska, Magdalena Zurawska, Teresa Leal, Catia Mascarenhas, António Pedro Pina, Maria Joao Susano, Antonio Moniz, Maria Teresa Rocha, Carolina Calvao Santos, M Domingas Patuleia, Ricardo Pereira, Helena Roxo, Rosa Amaral, Isabel Guedes, Cristina Gomes, Marta Gonçalves, Helena Salgado, Maria Santos, Sara Rodrigues, Angela Sa, Elvira Machado, Sandra Pé d'Arca, Manuel Seabra, Ligia Mihaela Gheorghe, Constantin Ivascu, Lucia Moraru-Draghici, Mirela Suvejan, Remus Babici, Kovacs Eniko, Cristiana Hogea, Dubau Mihaela, Daraban Nicoleta, Danut Barbunc, Alina Maria Nistor, Violeta Stefan, Gabriela Catalina Ionescu, Irina Davidescu, Alina Teodora Nastase, Florin Dumitru Rusu, Victoria Badarau, Iulia Cindea, Melania Moscaliuc, Dana Olteanu, Luxita Petrescu, Daniela Ceuca, Irena Galinescu, Rodica Badeti, Alin Capusan, Cosmina Cucui-Cozma, Barbura Popescu, Luminita Cimpeanu, Mihaela-Petronela Birliba, Magdalena Miulescu, Stefania Balamat, Adriana Gurita, Luminita Ilie, Gabriel Mocioiu, Darina Pick, Rodica Sirghie, Radu Tabacaru, Irinel Trante, Lucian Horhota, Daniela Bandrabur, Tudor Ciobanu, Veaceslav Cuciuc, Valentin Munteanu, Valentin Olaru, Corneliu Paiu, Anca Savu, Oana Trifan, Anca Elena Malos, Anton Glazunov, Alexander Ivanov, Evgeny Poduskov, Alexander Popov, Igor Guskov, Alexander Lugovoy, Vladislav Nechaev, Alexey Ovezov, Mikhail Basov, Vladimir Kochkin, Vladimir Lazarev, Dmitri Chizhov, Ivan Ostreikov, Konstantin Tolasov, Ivana Budic, Vesna Marjanovic, Biljana Draskovic, Marina Pandurov, Jovana Simin, Vladimir Dolinaj, Dusanka Janjevic, Ana Mandras, Maja Mircetic, Sladjana Petrovic, Vlatka Rebac, Bojana Slavkovic, Vesna Stevanovic, Ana Velcev, Mirjana Knezevic, Irina Milojevic, Selena Puric, Irena Simic, Marija Stevic, Vladimir Stranjanac, Dusica Simic, Barbora Cabanova, Miloslav Hanula, Andry Grynyuk, Jelena Berger, Uros Cerne, Andraz Nastran, Dejan Pirc, Rok Popic, Spela Stupnik, Paloma Rubio, Cristina del Río, Pilar Benito, Gema Pino, Ignacio Gutierrez, Andrea Gutierrez Valcarcel, Irene León Carsi, Anibal Perez Garcia, Sílvia López Galera, Joan Marco Valls, Laura Ricol Lainez, Andrea Vallejo Tarrat, David Artes, Ester Banus, Luca Chirichiello, Leidy De Abreu, Belen De Josemaria, M Helena Gaitan, Antonio Garces, Juan J Lazaro, Ferran Manen Berga, Dolors Molies, Enric Monclus, Montserrat Navaro, Carmen Pamies, Marina Perelló, Mar Prat, Laura Ribo, M Angeles Sanz, Silvia Serrano, Eva Sola Ruiz, Blanca Anuncia Escontrela Rodríguez, Andrea Maria Gago Martinez, Alberto Martínez Ruiz, Fausto De La Cruz Benito, Gustavo Gabilondo Garcia, Ever Martinez Maldonado, Bryant Noriega, Lara Oller Duque, Alberto Olmos Mendez, Antonio Perez- Ferrer, Francisco Reinoso Barbero, Ismael Acevedo Bambaren, Fernando Domínguez, Teresa Franco, Anabel Jiménez, Alicia Melero, Montserrat Feliu, Irene García, Núria Montferrer, Francisca Munar, Cristina Muro, Rosario Nuño, Remel Perera, Erika Schmucker, Glenda Börjesson, Lars Gillberg, Albert Castellheim, Kerstin Sandström, Annette Bauer, Torbjörn Roos, Lars Hedlund, Yann Boegli, Mirko Dolci, Carine Marcucci, Isabelle Spahr-Schopfer, Michel Pellegrini, Malte Book, Loreen Errass, Christine Riggenbach, Mattias Casutt, Martin Hölzle, Thomas Hurni, Jacqueline Mauch, Luciano Anselmi, Irene Anselmi, Alfred Jacomet, Markus Oberhauser, Stephanie Wossner, Angelika Zettl, Thomas Erb, Tomasz Mackiewicz, Helena Simitzes, Yetkin Ozer, Arzu Takil, Zekeriyya Alanoglu, Onat Bermede, K.Sanem Cakar Turhan, Neslihan Alkis, Cigdem Yildirim Guclu, Basak Ceyda Meco, Zehra Hatipoglu, Dilek Ozcengiz, Zekine Begec, Huseyin Ilksen Toprak, Pinar Kendigelen, Ayse Cigdem Tütüncü, Meltem Savran Karadeniz, Tulay Seyhan Ozkan, Nuket Sivrikoz, Mustafa Kemal Arslantas, Ayse Hizal, Gülbin Tore Altun, Tumay Umuroglu, Sibel Baris, Zuleyha Kazak Bengisun, Galyna Goncharenko, Maksym Khrapak, Tetyana Klymenko, Vitaliy Pavlenko, Dmytro Prysiazhniuk, Olga Rudio, Mykhailo Varyvoda, Sergii Vodianytskyi, Ivanna Boryshkevych, Iryna Kyselova, Nikolay Trikash, Andrew Albokrinov, Valentina Perova-Sharonova, Vitaliy Sklyar, Denis Surkov, Amr Abdelaal, Nicola Barber, Sarah Checuti, Leisha Godsiff, Lynch Johanne, Joanna Simpson, Helen Underhill, Rishi Diwan, Nivedita Kelgeri, Nuria Masip, Radha Ravi, Steve Roberts, Annagrazia Cillis, Ritchie Marcus, Federica Merella, David Love, Paolo Baraggia, Victoria Bird, Joseph Hussey, Peter Alderson, Karen Bartholomew, Michael Moncreiff, Sarah Davidson, Alison Hare, Ami Kotecha, Corina Lee, Ganga Liyanage, Shivali Patel, Amee Samani, Mark Abou-Samra, Matthew Boyd, Laurence Hullatt, David Levy, Mark Pauling, Sarah-Jane Sharman, Natalie Smith, John Rutherford, Alison Cavalier, Christie Locke, Frederic Sage, Smita Bapat, Jacinda Hammerschlag, Ioannis Ioannou, Stephanie King, Rachel Pegg, Vishal Salota, Jonathan Sketcher, Muthu Thadsad, Deborah Zeitlin, Ewan Jack, Colin Lang, Samira Ahmed, Reema Ayyash, Francoise Bari, Sarah J Bell, Claire Elizabeth Biercamp, Sandra Briggs, Maria Gabriella Elena Clement, Mark Dalton, Mohamed Ali Eissa Eid, Monica Gandhi, Idse Harmen Herrema, Ranj Khaffaf, Savio Jeng Min Law, Joanna McClintock, Nicholas Ireland, Mohammed Majid Saleem, Fiona Smith, Marc Cohen, Clover-Ann Lee, Lizanne O'Donahue, Alex Powell, Ellen Rawlinson, Aarjan Snoek, 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van Dortmont, Anouk, Hopman, Geranne A.J., Megens, A.M., Schouten, Anton N.J., Van Der Werff, Désirée B.M., Wensing, Renee T.M., Lindenskov, Pal H H, Siemek-Mitela, Jadzia, Rosada-Kurasinska, Jowita, Bartkowska-Sniatkowska, Alicja, Mierzewska-Schmidt, Magdalena, Moraru-Draghici, Lucia, Cucui-Cozma, Cosmina, Birliba, Mihaela-Petronela, Perez- Ferrer, Antonio, Spahr-Schopfer, Isabelle, Cakar Turhan, K.Sanem, Perova-Sharonova, Valentina, Abou-Samra, Mark, Sharman, Sarah-Jane, McClintock, Joanna, Lee, Clover-Ann, Abdel-Hafiz, Mostafa, Chee, Lew-Chin, McKee, Lesley, Scott-Warren, Victoria, and Wilson-Smith, Elaine

Subjects
Male, Pediatrics, Health Status, OPERATING-ROOM, Respiratory Tract Diseases, CHILDREN, 0302 clinical medicine, REGIONAL ANESTHESIA, Postoperative Complications, 030202 anesthesiology, CARDIAC-ARREST, Medicine, General anaesthesia, Prospective Studies, Prospective cohort study, Child, Intraoperative Complications, COMPLICATIONS, ddc:617, Incidence (epidemiology), Mortality rate, musculoskeletal, neural, and ocular physiology, Incidence, Age Factors, Hospitals, Europe, Cardiovascular Diseases, Child, Preschool, RESPIRATORY ADVERSE EVENTS, Female, Clinical Competence, Cohort study, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, macromolecular substances, Anesthesia, General, Drug Hypersensitivity, 03 medical and health sciences, MORBIDITY, Journal Article, Humans, business.industry, Infant, Newborn, Infant, 030208 emergency & critical care medicine, Perioperative, nervous system, PROSPECTIVE COHORT, Relative risk, RISK-FACTORS, Observational study, Human medicine, Nervous System Diseases, business, SYSTEM
Abstract

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0–5·5) with an incidence of respiratory critical events of 3·1% (2·9–3·3). Cardiovascular instability occurred in 1·9% (1·7–2·1), with an immediate poor outcome in 5·4% (3·7–7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86–0·90; p

Published
2017
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