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February 13, 2018Current Opinion in Anaesthesiology23 citationsOpen Access

Pediatric anesthesia after APRICOT (Anaesthesia PRactice In Children Observational Trial)

WHWalid Habre

Key Result

The experience of the anesthesiologist in charge reduces respiratory and cardiovascular severe critical events by 1% and 2% for each year of experience, respectively.

Structured PICO

P
Population
Children undergoing anesthesia (based on the APRICOT study across 33 European countries)
I
Intervention
Harmonization of training, certification, continuous professional development, and implementation of incident-reporting systems
O
Outcome
Incidence of perioperative severe critical events and quality of anesthesia care

Standardized training, competency-based curricula, and incident-reporting systems are needed to reduce the high incidence of severe critical events and variability in pediatric anesthesia practice across Europe.

Limitations

  • Variability in training, available resources, equipment, and facilities limit the generalization of some of the APRICOT results.
  • Sociocultural factors, such as fear of blame or incompetence, may influence the self-reporting of critical events.
  • Variability in training, available resources, equipment, and facilities limit the generalization of some of the APRICOT results

Abstract

PURPOSE OF REVIEW: This review highlights the requirements for harmonization of training, certification and continuous professional development and discusses the implications for anesthesia management of children in Europe. RECENT FINDINGS: A large prospective cohort study, Anaesthesia PRactice In Children Observational Trial (APRICOT), revealed a high incidence of perioperative severe critical events and a large variability of anesthesia practice across 33 European countries. Relevantly, quality improvement programs have been implemented in North America, which precisely define the requirements to manage anesthesia care for children. These programs, with the introduction of an incident-reporting system at local and national levels, could contribute to the improvement of anesthesia care for children in Europe. SUMMARY: The main factors that likely contributed to the APRICOT study results are discussed with the goal of defining clear requirement guidelines for anesthetizing children. Emphasis is placed on the importance of an incident-reporting system that can be used for both competency-based curriculum for postgraduate training as well as for continuous professional development. Variability in training as well as in available resources, equipment and facilities limit the generalization of some of the APRICOT results. Finally, the impact on case outcome of the total number of pediatric cases attended by the anesthesiologist should be taken into consideration along with the level of expertise of the anesthesiologist for complex pediatric anesthesia cases.

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Cite This Study

Walid Habre (2018) conducted a review in Perioperative severe critical events in pediatric anesthesia. Pediatric anesthesia training and continuous professional development was evaluated. The experience of the anesthesiologist in charge reduces respiratory and cardiovascular severe critical events by 1% and 2% for each year of experience, respectively.

synapsesocial.com/papers/6a10ee3bb21a4e8c150b097chttps://doi.org/10.1097/aco.0000000000000580
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