Perioperative critical events and morbidity associated with anesthesia in early life: Subgroup analysis of United Kingdom participation in the NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) prospective multicenter observational study. Issue 7 (1st May 2022)

• Record Type: Journal Article
• Authors: Walker, Suellen M.; Engelhardt, Thomas; Ahmad, Nargis; Dobby, Nadine
• Editors: Anderson, Brian
• Other Names: Kuchi Sridevi investigator.; Masip Nuria investigator.; Brooks Peter investigator.; Hare Alison investigator.; Casey Michelle investigator.; Silva Sam De investigator.; Krishnan Prakash investigator.; Sogbodjor L Amaki investigator.; Walker Ellie investigator.; King Stephanie investigator.; Nicholson Katy investigator.; Quinney Michelle investigator.; Stevens Paul investigator.; Blevin Andrew investigator.; Giombini Mariangela investigator.; Goonasekera Chulananda investigator.; Adil Sadia investigator.; Bew Stephanie investigator.; Bodlani Carol investigator.; Gilpin Dan investigator.; Jinks Stephanie investigator.; Malarkkan Nalini investigator.; Miskovic Alice investigator.; Pad Rebecca investigator.; Barry Juliet W. investigator.; Abbott Joy investigator.; Armstrong James investigator.; Cooper Natalie investigator.; Crate Lindsay investigator.; Emery John investigator.; James Kathryn investigator.; King Hannah investigator.; Martin Paul investigator.; Catenacci Stefano S. investigator.; Bomont Rob investigator.; Smith Paul investigator.; Mele Sara investigator.; Verzelloni Alessandra investigator.; Dix Philippa investigator.; Bell Graham investigator.; Gordeva Elena investigator.; McKee Lesley investigator.; Ngan Esther investigator.; Scheffczik Jutta investigator.; Tan Li‐En investigator.; Worrall Mark investigator.; Cassar Carmel investigator.; Goddard Kevin investigator.; Barlow Victoria investigator.; Oshan Vimmi investigator.; Shah Khairi investigator.; Bell Sarah investigator.; Daniels Lisa investigator.; Gandhi Monica investigator.; Pachter David investigator.; Perry Chris investigator.; Robertson Andrew investigator.; Scott Carmen investigator.; Waring Lynne investigator.; Barnes David investigator.; Childs Sophie investigator.; Norman Joanne investigator.; Sunderland Robin investigator.; Disma Nicola investigator.; Veyckemans Francis investigator.; Virag Katalin investigator.; Hansen Tom G. investigator.; Becke Karin investigator.; Harlet Pierre investigator.; Vutskits Laszlo investigator.; Walker Suellen M. investigator.; Graaff Jurgen C. de investigator.; Zielinska Marzena investigator.; Simic Dusica investigator.; Engelhardt Thomas investigator.; Habre Walid investigator.;
• Is Part Of: Paediatric anaesthesia. Volume 32:Issue 7(2022)
• Page Start: 801
• Page End: 814
• Publication Date: 2022-05-01
• Subjects: anesthesia, adverse effects -- anesthesia, mortality -- infant, newborn -- patient‐relevant outcome; Pediatric anesthesia -- Periodicals; 617.96798
• DOI: 10.1111/pan.14457
• Languages: English
• ISSNs: 1155-5645

Abstract

Abstract: Background: The NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) prospective observational study reported critical events requiring intervention during 35.2% of 6542 anesthetic episodes in 5609 infants up to 60 weeks postmenstrual age. The United Kingdom (UK) was one of 31 participating countries. Methods: Subgroup analysis of UK NECTARINE cases (12.8% of cohort) to identify perioperative critical events that triggered medical interventions. Secondary aims were to describe UK practice, identify factors more commonly associated with critical events, and compare 30‐day morbidity and mortality between participating UK and nonUK centers. Results: Seventeen UK centers recruited 722 patients (68.7% male, 36.1% born preterm, and 48.1% congenital anomalies) undergoing anesthesia for 876 surgical or diagnostic procedures at 25–60 weeks postmenstrual age. Repeat anesthesia/surgery was common: 17.6% patients prior to and 14.4% during the recruitment period. Perioperative critical events triggered interventions in 300/876 (34.3%) cases. Cardiovascular instability (16.9% of cases) and/or reduced oxygenation (11.4%) were more common in younger patients and those with co‐morbidities or requiring preoperative intensive support. A higher proportion of UK than nonUK cases were graded as ASA‐Physical Status scores >2 or requiring urgent or emergency procedures, and 39% required postoperative intensive care. Thirty‐day morbidity (complications in 17.2%) and mortality (8/715, 1.1%) did not differ from nonUK participants. Conclusions: Perioperative critical events and co‐morbidities are common in neonates and young infants. Thirty‐day morbidity and mortality data did not demonstrate national differences in outcome. Identifying factors associated with increased risk informs preoperative assessment, resource allocation, and discussions between clinicians and families.