French NECTARINE Trial Group, France; Paris Diderot University (Paris VII), Paris, France; Department of Anaesthesia and Intensive Care, Robert Debré University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; FHU I2-D2, INSERM U1141, Robert Debré University Hospital, Paris, France.
Department of Anaesthesia and Intensive Care, Jeanne de Flandre University Hospital, Lille, France.
Anaesth Crit Care Pain Med. 2022 Apr;41(2):101036. doi: 10.1016/j.accpm.2022.101036. Epub 2022 Feb 16.
Neonatal and infant anaesthesia are associated with a high risk of perioperative complications. The aim of the current study was to describe those risks in France using the French data from the NECTARINE study.
Data from the French centres that participated to the NECTARINE study were analysed. The primary goal of the study was the description of patients' characteristics, procedures and perioperative management and their comparison with the results of the European NECTARINE study. Secondary outcomes were the description of major perioperative complications and death.
Overall, 926 procedures collected in 15 centres (all teaching hospitals) were analysed. Comparison between the French and European NECTARINE cohorts found few differences related to patients' characteristics and procedures. The rate of interventions for critical events (respiratory, haemodynamic, and metabolic) was similar between the two cohorts. Near-infrared spectroscopy monitoring was used in 12% of procedures. Nearly none of the thresholds for these interventions met the published standards. By day 30, complications (respiratory, haemodynamic, metabolic, renal, and liver failure) and death were observed in 14.4% [95% CI 11.6-16.4]% and 1.8% [95% CI 1.1-2.9] of cases, respectively.
Although the health status of the patients in the French cohort was less severe, procedures, management and postoperative complications and mortality rates were similar to the European cohort. However, thresholds for interventions were often inadequate in both cohorts. Efforts should be undertaken to improve the knowledge and use of new monitoring devices in this population.
新生儿和婴儿麻醉与围手术期并发症的高风险相关。本研究的目的是使用 NECTARINE 研究的法国数据描述法国的这些风险。
分析了参与 NECTARINE 研究的法国中心的数据。该研究的主要目标是描述患者的特征、手术和围手术期管理，并将其与欧洲 NECTARINE 研究的结果进行比较。次要结局是描述主要围手术期并发症和死亡。
总体而言，15 个中心（均为教学医院）共收集了 926 例手术。法国和欧洲 NECTARINE 队列之间的比较发现，患者特征和手术方面的差异很小。两组之间的危急事件（呼吸、血流动力学和代谢）干预率相似。近红外光谱监测在 12%的手术中使用。这些干预措施的阈值几乎没有一个符合已发表的标准。在第 30 天，观察到并发症（呼吸、血流动力学、代谢、肾功能和肝功能衰竭）和死亡分别为 14.4%[95%CI 11.6-16.4]%和 1.8%[95%CI 1.1-2.9]。
尽管法国队列患者的健康状况较轻，但手术、管理以及术后并发症和死亡率与欧洲队列相似。然而，在两个队列中，干预的阈值往往都不足。应努力提高该人群对新监测设备的知识和使用。
