Department of Anaesthesiology and Intensive Care - Paediatrics, Odense University Hospital, Odense, Denmark.
Department of Clinical Research - Anaesthesiology, University of Southern Denmark, Odense, Denmark.
Acta Anaesthesiol Scand. 2023 Jul;67(6):714-723. doi: 10.1111/aas.14236. Epub 2023 Mar 27.
The neonate and children audit of anaesthesia practice in Europe (NECTARINE) prospective observational study reported an incidence of 35.2% of critical events requiring intervention during 6542 anaesthetics in 5609 infants up to 60 weeks postmenstrual age (PMA) from 165 centres in 31 European countries.
Sub-analysis of the cohort from the Nordic countries (8% of the entire cohort) was conducted. Secondary aims were to describe the Nordic countries' anaesthetic practices and compare morbidity and mortality with the overall European cohort.
Eleven Nordic centres recruited 447 infants (66% males, 37.3% born preterm and 45% had congenital anomalies) undergoing anaesthesia for 530 surgical or non-surgical procedures at 25-60 weeks PMA. Perioperative critical events triggered interventions in 228/530 (43%) cases. Hypotension (12.6%) or hypoxaemia (11.7%) were more common in younger patients and those with co-morbidities. Hypo/hypercapnia occurred in 1.5%/4.7% of cases. More than two attempts for intubation were required in 13 (2.9%) infants (max three attempts). Distribution of ASA-Physical Status Scores was similar to the total European cohort (40% was ASA > 2). A total of 236/530 (44.5%) patients were admitted to the postoperative intensive care unit. Thirty-day morbidity (complications in 87/447 = 19.5%) and mortality (8/447, 1.8%) did not differ from the overall European cohort. Hospital re-admissions were significant up to 90 days (98/447 = 21.9%).
In Nordic countries, anaesthesia in young infant children is resource-demanding, and perioperative critical events and co-morbidities are common. Thirty-day morbidity and mortality data in the Nordic countries did not differ from the overall European cohort.
在欧洲麻醉实践新生儿和儿童审核（NECTARINE）前瞻性观察研究中，报告了在 31 个欧洲国家的 165 个中心的 6542 例麻醉中，5609 例胎龄（PMA）60 周以下婴儿中需要干预的关键事件发生率为 35.2%。
对来自北欧国家的队列进行了亚组分析（整个队列的 8%）。次要目的是描述北欧国家的麻醉实践，并将发病率和死亡率与整个欧洲队列进行比较。
11 个北欧中心招募了 447 名婴儿（男性占 66%，早产儿占 37.3%，45%有先天性异常），在 25-60 周 PMA 时接受 530 例手术或非手术程序的麻醉。530 例手术中，228 例（43%）出现围手术期关键事件触发干预。低血压（12.6%）或低氧血症（11.7%）在年龄较小的患者和合并症患者中更为常见。低/高碳酸血症发生率分别为 1.5%/4.7%。13 名（2.9%）婴儿需要进行两次以上的插管尝试（最大三次尝试）。ASA 身体状况评分的分布与整个欧洲队列相似（40%为 ASA>2）。共有 236 名（44.5%）患者被收入术后重症监护病房。30 天发病率（447 例中的 87 例并发症=19.5%）和死亡率（447 例中的 8 例=1.8%）与整个欧洲队列无差异。90 天内再次住院的情况显著增加（447 例中的 98 例=21.9%）。
在北欧国家，幼儿麻醉需要大量资源，围手术期关键事件和合并症很常见。北欧国家的 30 天发病率和死亡率数据与整个欧洲队列无差异。
