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Anaesthesia Critical Care & Pain Medicine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le mardi 18 juin 2019
Doi : 10.1016/j.accpm.2019.06.001
Description of practices and complications in the French centres that participated to APRICOT: A secondary analysis
 

Souhayl Dahmani a, b, c, , Anne Laffargue d, Christophe Dadure e, f, Francis Veyckemans d

the French APRICOT trial group1

  The French APRICOT Trial Group. a American Memorial Hospital, Reims Univeristy Hospital, Catherine Amory, Hugues Ludot*. b Tourcoing General Hospital, Patricia Lambotte*. c Nantes University Hospital Centre, René Busche, Olivier Jacqmarcq, Corinne Lejus*. d Jeanne de Flandre Hospital, Regional University Hospital Centre, Julien Corouge, Christian Erb, Delphine Garrigue, Patricia Gillet, Anne Laffargue*, Veronique Lambelin, Hélène Le Freche, Daliana Peresbota, Pierre Richart. e Angers University Hospital, Jerome Berton, Catherine Chapotte, Laurent Colbus, Thierry Lehousse*, Jean Monrigal. f Bicetre, Catherine Baujard*, Philippe Roulleau, Giuseppe Staiti. g Bordeaux University Hospital, Hélène Batoz, Maryline Bordes, Anne Didier, Yann Hamonic, Sylvaine Lagarde, Karine Nouette-Gaulain, François Semjen, Brigitte Zaghet*. h Amiens University Hospital, Jacky Dekens, Axelle Delcuze, Hervé Dupont*, Aurélien Legrand, Celine Raffoflandreur. i Grenoble University Hospital, Noémie Audren*, Blandine Camus, Marielle Cartal, Chantal Chazelet, Isabelle Davin, Marion Guillier. j Hôpital des enfants, Toulouse University Hospital, Luc Desjeux, Claire Larcher*. k Nancy–Brabois University Hospital, Elodie Grein, Mickeal Leclercq, Roxana Levitchi, Lilica Rosu, Dominique Simon, Aurélien Zang*. l Femme-Mère-Enfant Hospital, Bron, Anne Migeon*, Anne-Charlotte Gagey, Nathalie Bourdaud, Anne-Charlotte Carre. m Clinique du Val d’Ouest, Frédéric Duflo*, Jean-Claude Riche, Philippe Robert. n Necker Enfants Malades University Hospital, Paris Descartes University, PRES Sorbonne Paris Cité, Emilie Druot, Olivier Maupain, Gilles Orliaguet*, Lucie Sabau, Hanna Taright, Lynn Uhrig, Juliette Verchere-Montmayeur. o Private Hospital of Villeneuve d’Ascq, Lise Debrabant, Clotaire Pilla*, Alexandre Podvin, Benjamin Roth. p Robert Debré Hospital. Paris Diderot University, PRES Sorbonne Paris Cité, Souhayl Dahmani*, Florence Julien-Marsollier. q Trousseau Hospital, Paris VI Pierre et Marie Curie University, Est Parisien University Hospitals: Nada Sabourdin*. r Nice Children Hospitals, Lenval University Hospital, Bogdan Alexandri, Gilles Brezac, Francois de la Brière*, Catherine Hayem, Elizabeth Lhubat, Jean Paul Mission, Charlotte Rémond. s Lapeyronie University Hospital, Christophe Dadure*, Maud Maniora, Anais Marie, Philippe Pirat, Anne-Charlotte Saour, Chrystelle Sola. t South Hospital-Univeristy of Rennes 1, Claude Ecoffey*, Eric Wodey. * site lead investigators.

a Department of Anaesthesia and Intensive care, Robert-Debré University Hospital, Assistance Publique Hôpitaux de Paris, Paris Diderot University, Paris Sorbonne Cité, 48, boulevard Serurier, Paris, France 
b Paris Diderot University (Paris VII), PRES Paris Sorbonne Cité, Paris, France 
c DHU PROTECT, Inserm U1141, Robert-Debré University Hospital, Paris, France 
d Department of Anaesthesia and Intensive care, Jeanne-de Flandre University Hospital, Lille, France 
e Department of Anaesthesia and Intensive care, Lapeyronie University Hospital, Montpellier, France 
f Institut de Neuroscience de Montpellier, Unité Inserm U1051 

Corresponding author at: Department of Anaesthesia and Intensive care, Paris Diderot University, Robert-Debré University Hospital. Assistance Publique Hôpitaux de Paris, 75019 Paris, France.Department of Anaesthesia and Intensive care, Paris Diderot University, Robert-Debré University Hospital. Assistance Publique Hôpitaux de ParisParis75019France
Highlights

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.

The full text of this article is available in PDF format.
Abstract
Introduction

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.

Results

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.

Discussion

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.

The full text of this article is available in PDF format.

Keywords : Paediatric anaesthesia, Safety, Practice of anaesthesia, Preoperative risks


1  The French APRICOT Trial Group. a American Memorial Hospital, Reims Univeristy Hospital, Catherine Amory, Hugues Ludot*. b Tourcoing General Hospital, Patricia Lambotte*. c Nantes University Hospital Centre, René Busche, Olivier Jacqmarcq, Corinne Lejus*. d Jeanne de Flandre Hospital, Regional University Hospital Centre, Julien Corouge, Christian Erb, Delphine Garrigue, Patricia Gillet, Anne Laffargue*, Veronique Lambelin, Hélène Le Freche, Daliana Peresbota, Pierre Richart. e Angers University Hospital, Jerome Berton, Catherine Chapotte, Laurent Colbus, Thierry Lehousse*, Jean Monrigal. f Bicetre, Catherine Baujard*, Philippe Roulleau, Giuseppe Staiti. g Bordeaux University Hospital, Hélène Batoz, Maryline Bordes, Anne Didier, Yann Hamonic, Sylvaine Lagarde, Karine Nouette-Gaulain, François Semjen, Brigitte Zaghet*. h Amiens University Hospital, Jacky Dekens, Axelle Delcuze, Hervé Dupont*, Aurélien Legrand, Celine Raffoflandreur. i Grenoble University Hospital, Noémie Audren*, Blandine Camus, Marielle Cartal, Chantal Chazelet, Isabelle Davin, Marion Guillier. j Hôpital des enfants, Toulouse University Hospital, Luc Desjeux, Claire Larcher*. k Nancy–Brabois University Hospital, Elodie Grein, Mickeal Leclercq, Roxana Levitchi, Lilica Rosu, Dominique Simon, Aurélien Zang*. l Femme-Mère-Enfant Hospital, Bron, Anne Migeon*, Anne-Charlotte Gagey, Nathalie Bourdaud, Anne-Charlotte Carre. m Clinique du Val d’Ouest, Frédéric Duflo*, Jean-Claude Riche, Philippe Robert. n Necker Enfants Malades University Hospital, Paris Descartes University, PRES Sorbonne Paris Cité, Emilie Druot, Olivier Maupain, Gilles Orliaguet*, Lucie Sabau, Hanna Taright, Lynn Uhrig, Juliette Verchere-Montmayeur. o Private Hospital of Villeneuve d’Ascq, Lise Debrabant, Clotaire Pilla*, Alexandre Podvin, Benjamin Roth. p Robert Debré Hospital. Paris Diderot University, PRES Sorbonne Paris Cité, Souhayl Dahmani*, Florence Julien-Marsollier. q Trousseau Hospital, Paris VI Pierre et Marie Curie University, Est Parisien University Hospitals: Nada Sabourdin*. r Nice Children Hospitals, Lenval University Hospital, Bogdan Alexandri, Gilles Brezac, Francois de la Brière*, Catherine Hayem, Elizabeth Lhubat, Jean Paul Mission, Charlotte Rémond. s Lapeyronie University Hospital, Christophe Dadure*, Maud Maniora, Anais Marie, Philippe Pirat, Anne-Charlotte Saour, Chrystelle Sola. t South Hospital-Univeristy of Rennes 1, Claude Ecoffey*, Eric Wodey. * site lead investigators.


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