What is already known: The practice of paediatric anaesthesia is highly variable in Europe. The participation of French centres to the APRICOT study allows comparison with other practices in Europe.
What this article adds: The current study describes the epidemiologic and perianaesthetic data of the population of children anaesthetised in the French centres that participated to APRICOT and determine some key points for improving perioperative safety.
Implications for translation: a wider spread of some key elements about safety during perioperative management in children has to be undertaken.
Analysing national patients’ profile and organisation of human resources are important for improving the perioperative quality of care. The aim of the current study was to achieve these goals using the French data from the APRICOT study.
Material and methods
Data from the French centres that participated to the APRICOT study were extracted and analysed. The primary goal of the study was to describe patients’ characteristics, procedures and perioperative anaesthetic management in France, and compare them to the results of the European APRICOT trial. Secondary outcomes were the description of major perioperative complications and the determination of human resources organisation possibly associated with these perioperative complications.
Overall 3535 procedures collected in 20 facilities (17 teaching hospitals, one community hospital and two private institutions) were analysed. Comparison between the French and European APRICOT cohorts found differences related to the more specialised French centres participating to the study. Overall complications (respiratory complications, haemodynamic instability, cardiac arrest, drug errors, and anaphylactic reactions) were observed in 6.4% [95% CI: 5.6; 6.3] of cases. Multivariate analysis identified the anaesthesiologist's experience of<15 years and the absence of an anaesthetic nurse as human factors independently associated with an increased risk for perioperative complications.
The current study identified some important differences between the French and the whole APRICOT cohort in terms of preoperative evaluation, surgical specialties involved, and monitoring of neuromuscular blockade. It confirms that, in France, the presence of an anaesthetic nurse and an experienced anaesthesiologist prevents anaesthetic complications.Le texte complet de cet article est disponible en PDF.
Keywords : Paediatric anaesthesia, Safety, Practice of anaesthesia, Preoperative risks