Catré Dora, Lopes Maria Francelina, Viana Joaquim Silva, Cabrita António Silvério
Centro Hospitalar Tondela-Viseu, Viseu, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal.
Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal; Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Rev Bras Anestesiol. 2015 Sep-Oct;65(5):384-94. doi: 10.1016/j.bjan.2013.03.025. Epub 2014 Sep 30.
Although many recognize that the first year of life and specifically the neonatal period are associated with increased risk of anesthetic morbidity and mortality, there are no studies directed to these pediatric subpopulations. This systematic review of the scientific literature including the last 15 years aimed to analyze the epidemiology of morbidity and mortality associated with general anesthesia and surgery in the first year of life and particularly in the neonatal (first month) period.
The review was conducted by searching publications in Medline/PubMed databases, and the following outcomes were evaluated: early mortality in the first year of life (<1 Yr) and in subgroups of different vulnerability in this age group (0-30 days and 1-12 months) and the prevalence of cardiac arrest and perioperative critical/adverse events of various types in the same subgroups.
The current literature indicates great variability in mortality and morbidity in the age group under consideration and in its subgroups. However, despite the obvious methodological heterogeneity and absence of specific studies, epidemiological profiles of morbidity and mortality related to anesthesia in children in the first year of life show higher frequency of morbidity and mortality in this age group, with the highest peaks of incidence in the neonates' anesthesia.
尽管许多人认识到生命的第一年,尤其是新生儿期,与麻醉相关的发病率和死亡率风险增加有关,但尚无针对这些儿科亚人群的研究。这项对过去15年科学文献的系统综述旨在分析生命第一年,特别是新生儿期(第一个月)与全身麻醉和手术相关的发病率和死亡率的流行病学情况。
通过检索Medline/PubMed数据库中的出版物进行综述,并评估以下结果:生命第一年(<1岁)以及该年龄组不同脆弱性亚组(0 - 30天和1 - 12个月)的早期死亡率,以及同一亚组中心脏骤停和各种类型围手术期危急/不良事件的发生率。
当前文献表明,所考虑的年龄组及其亚组中的死亡率和发病率存在很大差异。然而,尽管存在明显的方法学异质性且缺乏具体研究,但生命第一年儿童麻醉相关的发病率和死亡率的流行病学概况显示,该年龄组的发病率和死亡率较高,其中新生儿麻醉的发病率峰值最高。