Airway management in paediatric anaesthesia in Europe—insights from APRICOT (Anaesthesia Practice In Children Observational Trial): a prospective multicentre observational study in 261 hospitals in Europe

Engelhardt, Thomas; Virág, Katalin; Veyckemans, Francis; Habre, Walid

doi:10.1016/j.bja.2018.04.013

Cited by 108 publications

(94 citation statements)

References 28 publications

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“…Pediatric tracheal intubation is generally easy in healthy (ASA‐PS 1 or 2) children but can be more challenging in infants (particularly syndromic patients) . There is no best equipment or technique for all tracheal intubations.…”

Section: Framework For the Approach To The Pediatric Airwaymentioning

confidence: 99%

“…Repeated tracheal intubation attempts may traumatize the pediatric airway and can render a difficult tracheal intubation impossible or result in the inability to oxygenate and ventilate the patient. An alternative airway technique should be used early …”

Section: Framework For the Approach To The Pediatric Airwaymentioning

confidence: 99%

“…Delayed management of airway obstruction can quickly lead to serious complications due to the short apnea tolerance in children. A simple, time critical, and pediatric‐specific airway management approach combined with dedicated teaching, training, and frequent practice will help to reduce airway‐related pediatric morbidity and mortality . There is currently no pediatric‐specific universal framework available to guide practice.…”

Section: Introductionmentioning

confidence: 99%

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A framework for the management of the pediatric airway

Engelhardt

Fiadjoe

Weiß

et al. 2019

Pediatric Anesthesia

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Summary Critical airway incidents in children are a frequent problem in pediatric anesthesia and remain a significant cause of morbidity and mortality. Young children are at particular risk in the perioperative period. Delayed management of airway obstruction can quickly lead to serious complications due to the short apnea tolerance in children. A simple, time critical, and pediatric‐specific airway management approach combined with dedicated teaching, training, and frequent practice will help to reduce airway‐related pediatric morbidity and mortality. There is currently no pediatric‐specific universal framework available to guide practice. Current algorithms are modifications of adult approaches which are often inappropriate because of differences in age‐related anatomy, physiology, and neurodevelopment. A universal and pragmatic approach is required to achieve acceptance across diverse pediatric clinicians, societies, and groups. Such a framework will also help to establish minimum standards for pediatric airway equipment, personnel, and medications whenever pediatric airway management is required.

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Section: Framework For the Approach To The Pediatric Airwaymentioning

confidence: 99%

Section: Framework For the Approach To The Pediatric Airwaymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A framework for the management of the pediatric airway

Engelhardt

Fiadjoe

Weiß

et al. 2019

Pediatric Anesthesia

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“…As shown in the European APRICOT study, tracheal extubation following general anesthesia is associated with a risk of respiratory complications that appears to be greater than during induction of anesthesia (Table ). This compares with the greater risk of aviation accidents during landing than during takeoff .…”

Section: Introductionmentioning

confidence: 99%

Tracheal extubation in children: Planning, technique, and complications

Veyckemans

2020

Pediatric Anesthesia

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Although poorly described in textbooks and rarely a topic of lecture, tracheal extubation is a critical phase of anesthetic care. It should therefore be carefully planned taking into account simple physiology‐based principles to maintain the upper airway patent and avoid lung de‐recruitment, but also the pharmacology of all anesthetic agents used. Although the management of most of its complications can be learned in a clinical simulation environment, the basic techniques can so far only be taught at the bedside, in the operating room. In this paper, the process of extubation is described in successive steps: preparation, return to adequate spontaneous ventilation, awake versus deep extubation, timing according to the child's breathing cycle, extubation in the operating room or in the Postanesthesia Care unit, child's management immediately after extubation, diagnosis and treatment of the early complications, and finally, how to prepare for a difficult reintubation.

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“…In addition, comprehension of anesthesia requirements and ventilation strategies differ substantially between neonatologists and anesthetists. For example, neonatologists are more likely to use pressure‐regulated volume control modes and other protective ventilation modalities than anesthesiologists who prefer pressure‐ or volume‐controlled modes . Therefore, maintaining a neonate on the same ventilation regimen to and from the neonatal intensive care unit for surgery in operating room is contended.…”

mentioning

confidence: 99%