An ADARPEF survey on respiratory management in pediatric anesthesia. Issue 10 (20th August 2014)

• Record Type: Journal Article
• Authors: Fesseau, Roselyne; Alacoque, Xavier; Larcher, Claire; Morel, Lydia; Lepage, Benoît; Kern, Delphine; Anderson, Brian
• Is Part Of: Paediatric anaesthesia. Volume 24:Issue 10(2014)
• Page Start: 1099
• Page End: 1105
• Publication Date: 2014-08-20
• Subjects: Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.12499
• Languages: English
• ISSNs: 1155-5645

Abstract

<abstract abstract-type="main" id="pan12499-abs-0001"> <title>Summary</title> <sec id="pan12499-sec-0001" sec-type="section"> <title>Background</title> <p>There have been recent changes with regard to tools and concepts for respiratory management of children undergoing general anesthesia.</p> </sec> <sec id="pan12499-sec-0002" sec-type="section"> <title>Objectives</title> <p>To determine the practice of pediatric anesthetists concerning: preoxygenation, breathing systems, ventilation modes, anesthetic agent and airway device, strategies for a general anaesthetic of less than 30 min using spontaneous respiration, and opinion about technical aspects of ventilation.</p> </sec> <sec id="pan12499-sec-0003" sec-type="section"> <title>Methods</title> <p>Online questionnaire sent by e‐mail to all the anesthetists registered on the mailing list of the French‐speaking Pediatric Anesthetists and Intensivists Association (ADARPEF).</p> </sec> <sec id="pan12499-sec-0004" sec-type="section"> <title>Results</title> <p>232 questionnaires (46%) were returned. More than 25% of anesthetists surveyed declared that they do not perform preoxygenation before induction for children <15 years old, apart from neonates and clinical specific situations. When performed, <65% chose a FiO<sub>2</sub> higher than 80%. Inhalational induction with sevoflurane is the preferred mode of induction set at 6% or 8%, respectively, 69% [62–75] vs 25% [18–31]. For induction, the circle system was the most popular circuit used in all ages. The accessory breathing system—Mapleson B type—was predominantly used for neonates (44% [37–54]). For maintenance of an anesthesia lasting <30 min in spontaneous breathing, the use of laryngeal mask increased with age, and the endotracheal tube was reserved for neonates (40% [33–48]). Pressure support ventilation was rarely used from the beginning of induction but was widely used for maintenance, whatever the age‐group. Results differed according to the type of institution.</p> </sec> <sec id="pan12499-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Ventilation management depends on the age and institutions in terms of circuit, airway device or ventilation mode, and specific differences exist for neonates.</p> </sec> </abstract>