Harmonising paediatric anaesthesia training in Europe

Hansen, Tom Giedsing; Vutskits, László; Disma, Nicola; Becke‐Jakob, Karin; Elfgren, Jochen; Frykholm, Peter; Machotta, Andreas; Weiß, Markus; Engelhardt, Thomas

doi:10.1097/eja.0000000000001694

Cited by 8 publications

(6 citation statements)

References 24 publications

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“…However, we believe that defining the minimum amount of education, competencies and training required for pediatric anesthesia under the umbrella of the European Society of Anaesthesiology and Intensive Care and the European Society for Pediatric Anaesthesiology is necessary. 5 In turn, these recommendations may influence training and certification processes at the national level in each country. There is clearly space for improvement and we owe this to the future generations.…”

Section: Discussionmentioning

confidence: 99%

Pediatric anesthesia in Europe: Variations within uniformity

de Graaff,

Frykholm,

Engelhardt

et al. 2024

Pediatric Anesthesia

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Organization of healthcare strongly differs between European countries and results in country‐specific requirements in postgraduate medical training. Within the European Union (EU), the European Board of Anaesthesiology has set recommendations of training for the Specialty of Anaesthesiology including standards for Postgraduate Medical Specialist training including a description for providing service in pediatric anesthesia. However, these standards are advisory and not mandatory. Here we aimed to review the current state and associated challenges of pediatric anesthesia training in Europe. We report an important country‐specific variability both in training and regulations of practice of pediatric anesthesia in the EU and in the United Kingdom. The requirements for training in pediatric anesthesia varies between nothing specified (Belgium) or providing anesthesia with direct supervision to a minimum of 50 cases below 5 years of age (Germany) to 3–6 month clinical practice in a specialized pediatric hospital (France). Likewise, the regulations for providing anesthesia to children varies from no regulations at all (Belgium) to age specific requirements and centralization of all children below 4 years of age to specified centers (United Kingdom). Officially recognized pediatric anesthesia fellowship programs are not available in most countries of Europe. It remains unclear if and how country‐specific differences in pediatric anesthesia training are associated with clinical outcomes in pediatric perioperative care. There is converging interest and support for the establishment of a European pediatric anesthesia curriculum.

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Section: Discussionmentioning

confidence: 99%

Pediatric anesthesia in Europe: Variations within uniformity

de Graaff,

Frykholm,

Engelhardt

et al. 2024

Pediatric Anesthesia

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“…But it must be stressed that these data should be interpreted with caution. Importantly, the NECTARINE study has drawn attention to the difficulties associated with endotracheal intubation in newborns and tiny infants, 7,10 and recommendations for how to enhance the procedure's success in this particular population have been made 11–13 . A total of 236/530 children (44.5%) were admitted to the postoperative ICU.…”

Section: Discussionmentioning

confidence: 99%

Outcome following anaesthesia in infancy in the Nordic countries: Subgroup analysis of the NECTARINE study

Hansen

Vieri

Børke

et al. 2023

Acta Anaesthesiol Scand

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Introduction 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. Methods 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. Results 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%). Conclusions 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.

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“…National societies have made concerted efforts to incorporate these findings into local clinical practice, introducing specific training programs to maintain clinician skills. 4,5 Despite these collaborative efforts, the attainment of educational goals remains elusive. Even in high-resource countries, the implementation of these resolutions is challenging.…”

Section: Pediatric Anesthesia Skills: Black and White Or Shades Of Gray?mentioning

confidence: 99%

Pediatric anesthesia skills: Black and white or shades of gray?

Sbaraglia

2024

Pediatric Anesthesia

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Harmonising paediatric anaesthesia training in Europe

Cited by 8 publications

References 24 publications

Pediatric anesthesia in Europe: Variations within uniformity

Pediatric anesthesia in Europe: Variations within uniformity

Outcome following anaesthesia in infancy in the Nordic countries: Subgroup analysis of the NECTARINE study

Pediatric anesthesia skills: Black and white or shades of gray?

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