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1. Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Author

Klimscha, Walter, Konecny, Regina, Luntzer, Robert, Morawk-Wintersperger, Ulrike, Neiger, Franz, Rustemeyer, Lydia, Breschan, Christian, Frey, Denise, Platzer, Manuela, Germann, Reinhard, Oeding, Joachim, Stoegermüller, Birgit, Ziegler, Bernhard, Brotatsch, Philipp, Gutmann, Anton, Mausser, Gerlinde, Messerer, Brigitte, Toller, Wolfgang, Vittinghoff, Maria, Zangl, Gregor, Seidel-Ahyai, Natascha, Hochhold, Christoph, Kroess, Ruth, Paal, Peter, Cnudde, Steven, Coucke, Patricia, Loveniers, Birgit, Mitchell, John, Kahn, David, Pirotte, Thierry, Pregardien, Caroline, Veyckemans, Francis, Coppens, Marc, De Hert, Stefan, Heyse, Björn, Neckebroek, Martine, Parashchanka, Aliaksandra, Van Limmen, Jurgen, Van Den Eynde, Nancy, Vanpeteghem, Caroline, Wyffels, Piet, Lalot, Michaël, Lechat, Jean-Paul, Stevens, France, Casaer, Sari, De Groote, Françoise, De Pooter, Françoise, De Villé, Andrée, Gerin, Marc, Magasich, Natalia, Sanchez Torres, Cristel, Van Deenen, Denise, Berghmans, Johan, Himpe, Dirk, Roofthooft, Eva, Joukes, Ellen, Smitz, Carine, Van Reeth, Veronique, Huygens, Christel, Lauweryns, Julie, De Smet, Karen, Najafi, Nadia, Poelaert, Jan, Van de Velde, Anne, Van Mossevelde, Veerle, Bekavac, Ivan, Butkovic, Diana, Heli Litvic, Dubravka, Kerovec Soric, Ivana, Maretic, Hrvoje, Moscatello, Djurdjica, Popovic, Ljiljana, Micici, Slobodan, Stuck Tus, Ivana, Kalagac Fabris, Lada, Simurina, Tatjana, Sulen, Nina, Kesic-Valpotic, Gordana, Djapic, Dajana, Žurek, Jirí, Jureckova, Lucie, Mackova, Iveta, Skacel, Monika, Weinlichova, Stanislava, Divák, Jan, Frelich, Michal, Urbanec, René, Biskupova, Vera, Mixa, Vladimir, Pavlickova, Jana, Afshari, Arash, Bøttger, Morten, Ellekvist, Marguerite B., Johansen, Mathias, Ingeborg Madsen, Birgitte, Christian Nilsson, Jens, Schousboe, Birgitte MB, Clausen, Nicola G., Hansen, Tom G., Phaff Steen, Nick, Ilmoja, Mari-Liis, Tonise, Virge, Karjagin, Juri, Kikas, Reet, Isohanni, Mika, Lyly, Anniina, Takala, Annika, Happo, Johanna, Kiviluoma, Kai, Martikainen, Kati, Aantaa, Riku, Manner, Tuula, Vilo, Sanna, Amory, Catherine, Ludot, Hugues, Lambotte, Patricia, Busche, René, Jacqmarcq, Olivier, Lejus, Corinne, Corouge, Julien, Erb, Christian, Garrigue, Delphine, Gillet, Patricia, Laffargue, Anne, Lambelin, Veronique, Le Freche, Hélène, Peresbota, Daliana, Richart, Pierre, Berton, Jerome, Chapotte, Catherine, Colbus, Laurent, Lehousse, Thierry, Monrigal, Jean, Baujard, Catherine, Roulleau, Philippe, Staiti, Giuseppe, Batoz, Hélène, Bordes, Maryline, Didier, Anne, Hamonic, Yann, Lagarde, Sylvaine, Nouette-Gaulain, Karine, Semjen, François, Zaghet, Brigitte, Dekens, Jacky, Delcuze, Axelle, Dupont, Hervé, Legrand, Aurélien, Raffoflandreur, Celine, Audren, Noémie, Camus, Blandine, Cartal, Marielle, Chazelet, Chantal, Davin, Isabelle, Guillier, Marion, Desjeux, Luc, Larcher, Claire, Grein, Elodie, Leclercq, Mickeal, Levitchi, Roxana, Rosu, Lilica, Simon, Dominique, Zang, Aurélien, Migeon, Anne, Gagey, Anne-Charlotte, Bourdaud, Nathalie, Carre, Anne-Charlotte, Duflo, Frédéric, Riche, Jean-Claude, Robert, Philippe, Druot, Emilie, Maupain, Olivier, Orliaguet, Gilles, Sabau, Lucie, Taright, Hanna, Uhrig, Lynn, Verchere-Montmayeur, Juliette, Debrabant, Lise, Pilla, Clotaire, Podvin, Alexandre, Roth, Benjamin, Dahmani, Souhayl, Julien-Marsollier, Florence, Sabourdin, Nada, Alexandri, Bogdan, Brezac, Gilles, de la Brière, Francois, Hayem, Catherine, Lhubat, Elizabeth, Paul Mission, Jean, Rémond, Charlotte, Dadure, Christophe, Maniora, Maud, Marie, Anais, Pirat, Philippe, Saour, Anne-Charlotte, Sola, Chrystelle, Ecoffey, Claude, Wodey, Eric, Adam, Christian, Standl, Thomas, Schindler, Ehrenfried, Yamamoto, Tomohiro, Brackhahn, Michael, Eich, Christoph Bernhard, Guericke, Holger, Kindermann, Petra, Laschat, Michael, Schink, Cornel, Wappler, Frank, Hoehne, Claudia, Skordou, Natalia, Ulrici, Johanna, Jetzek-Zader, Martin, Kienbaum, Peter, Meyer-Treschan, Tanja, Picker, Olaf, Schaefer, Maximilian S., Mielke, Golo, Baethge, Sabine, Ramminger, Axel, Bauer, Martin, Bollinger, Matthias, Hinz, José, Quintel, Michael, Russo, Sebastian G., Bauer, Michael, Geil, Dfominik, Kortgen, Andreas, Preussler, Niels-Peter, Hofmann, Ulrich, Raber, Manfred, Reindl, Doris, Becke, Karin, Oppenrieder, Karin, Schierlinger, Bettina, Roth, Jens, Funk, Wolfgang, Fischer, Thomas, Gernoth, Christian, Wiefelspütz, Christina, Volger, Hauke, Zederer, Nicole, Diers, Anja, Huber, Matthias, Schorer, Clemens, Weyland, Andreas, Schwarzkopf, Konrad, Grau, Catharina, Roth, Winfried, Holy, Rolf, Mader, Thomas, Peter, Laura, Supthut, Hauke, Kuehhirt, Thomas, Milde, Alexander, Fiedler, Fritz, Isselhorst, Carsten, Grundmann, Ulrich, Pattar, Alexander, Reinert, Jennifer, Ehm, Birgit, Fritzsche, Katrin, Gaebler, Ralf, Meybohm, Patrick, Hein, Maximilian, Guzman, Ines, Jokinen, Johanna, Kranke, Peter, Goebel, Ulrich, Harris, Sarah, Eisner, Christoph, Ochsenreiter, Miriam, Schoeler, Michael, Thil, Elke, Ellerkmann, Richard, Hoeft, Andreas, Neumann, Claudia, Weber, Stefan, Keilhauer, Julia, Kloessing, Jan, Schramm, Michael, Trieschmann, Uwe, Knauss, Kristina, Sinner, Barbara, Steinmann, Johannes, Koessler, Herbert, Kalliardou, Evagelia, Malisiova, Anna, Tsiotou, Adelais, Chloropoulou, Pelagia, Chrysi, Mpratzou, Iordanidou, Despoina, Ntavlis, Merkourios, Boda, Krisztina B, Guerin, Christilynn, Irwin, Janice, Magner, Claire, Nakhjavani, Solmaz, O'Hare, Brendan, Galvin, Deborah, Jamil, Yosry, Lesmes, Carlos, Barak, Yuri, Fisher, Haran, Kachko, Ludmyla, Katz, Jacob, Kirilov, Dmitry, Levinzon, Michael, Manevich, Yair, Nekrasov, Konstantin, Peled, Elia, Sanko, Elena, Schmain, Dmitri, Sheinkin, Olga, Simhi, Eliahu, Tarabikin, Alex, Trabkin, Evelina, Yagudaev, Irena, Zeitlin, Yelena, Zunser, Igor, Cerutti, Elisabetta, Maddalena Schellino, Maria, Valzan, Silvia, Lucia Pinciroli, Rosa, Bortone, Luciano, Cerati, Giorgia, Salici, Fabiana, Bussolin, Leonardo, Rizzo, Giuliana, Rossetti, Francesca, Marchesini, Laura, Tesoro, Simonetta, De Lorenzo, Brita, Guarracino, Fabio, Kuppers, Beate, Astuto, Marinella, Pitino, Sofia, Scalisi, Rita, Scordo, Lucia, D'Alessandro, Sandra, Dei Giudici, Luigi, Farinelli, Ivano, Lofino, Giuseppe, Marchetti, Giuliano, Giuseppe Picardo, Sergio, Reali, Simone, Vittori, Alessandro, Antonio Idone, Francesco, Sammartino, Maria, Sbaraglia, Fabio, Barbera, Cinzia, Bevilacqua, Michela, Cento, Valeria, Disma, Nicola, Kotzeva, Svetlana, Mameli, Leila, Montobbio, Giovanni, Passariello, Leandro, Punzo, Cinzia, Sileo, Rosanna, Viacava, Rosanna, Volpe, Claudia, Zanaboni, Clelia, Calderini, Edoardo, Genco, Daniele, Neri, Simona, Ottolina, Davide, Camporesi, Anna, Izzo, Francesca, Salvo, Ida, Wolfler, Andrea, Sanna, Andrea, Sciascia, Angela, Stoia, Paolo, Guddo, Annamaria, Lapi, Maria, Ivani, Giorgio, Longobardo, Annalisa, Mossetti, Valeria, Pedrotti, Dino, Grazzini, Maurizia, Meneghini, Luisa, Metrangolo, Salvatore, Michelon, Stefania, Minardi, Carmelo, Tognon, Costanza, Zadra, Nicola, Busi, Ilaria, Khotcholava, Magda, Guido Locatelli, Bruno, Sonzogni, Valter, Starita, Giusi, Almenrader, Nicole, Aurilio, Caterina, Sansone, Pasquale, Albarello, Raffaella, Bracci, Paolo, Cecini, Mariateresa, Cristina Mondardini, Maria, Pasini, Lorena, Vason, Milo, Zani, Gianluca, Zoppellari, Roberto, Pistidda, Laura, Cortegiani, Andrea, Maurizio Raineri, Santi, Hasani, Antigona, Hashimi, Medita, Ancupans, Agris, Barzdina, Arta, Straume, Zane, Zundane, Anda, Chlopin, Mikhail, Gestautaite, Dalia, Lukosiene, Laura, Paliokaite, Evelina, Razlevice, Ilona, Armoniene, Inesa, Bernotiene, Aurelija, Daugelavicius, Vidunas, Dockiene, Ilona, Gaidelyte, Lina, Saviciene, Nijole, Krikstaponiene, Jolita, Sidlovskaite-Baltake, Dominika, Stasevski, Vladyslav, Vaitoskaite, Agne, Gatt, David, Mifsud, Stephanie, Zammit, Simone, Allison, Celia, Aslami, Hamid, Eberl, Susanne, van Stijn, Mireille F M, Stevens, Markus F, Punt, Kees, van Osch, Rob, Bauwman, Arthur, Scholten, Harm, Svircevic, Vesna, Adriaens, Veronique, Dirckx, Maaike, Dogger, Jaap, Dons-Sinke, Ilse, Machotta, Andreas, Moors, Xavier, Rad, Mandana, Staals, Lonneke, van der Knijff - van Dortmont, Anouk, van der Marel, Caroline, Sieben, Anne, van der Zwan, Tim, Veldhuizen, Marianne, Alders, David, Buhre, Wolfgang, Vermeulen, Petronella M, Engel, Nicole, Vossen, Carine, Mahadewsing, Ravin, Meijer, Patrick, Gerling, Volker, van der Schatte Olivier, Roelof, van Doorn, Thea, Vons Mark Hendriks, Kristy, Lako, Sandra, jan Scheffer, Gert, Tielens, Luc, Voet, Marieke, Absalom, Anthony, Bergsma, Margot, Spanjer, Vera, Spanjersberg, Rob, van de Riet, Yvette, Volkers, Martin, de Graaff, Jurgen C., Hopman, Geranne A.J., Kappen, Teus H., Hannie, J., Megens, A.M., Numan, Sandra C., Schouten, Anton N.J., Turner, Nigel M., Van Der Werff, Désirée B.M., Wensing, Renee T.M., Ephraim, Erik, Nolte, Claire, Reikvam, Tore, Fredrik Lund, Ole, Skaaden, Lene, Marthe Ballovarre, Kari, Bakken Boerke, Wenche, Grindheim, Guro, Lindenskov, Pal H H, Beate Solas, Anne, Sponheim, Sjur, Ullensvang, Kyrre, Viken, Oddbjorn, Marie Drage, Inger, Gymoese Berthelsen, Kasper, Anders Kroken, Bjørn, Bergland, Unni, Pryzmont, Miroslaw, Talalaj, Mariola, Wasiluk, Malgorzata, Zalewska, Dorota, Damps, Maria, Siemek-Mitela, Jadzia, Wieczorek, Pawel, Juzwa, Magdalena, Rosada-Kurasinska, Jowita, Bartkowska-Sniatkowska, Alicja, Cettler, Maciej, Kopycinska, Renata, Rudewicz, Iwona, Sobczyk, Jaek, Wojciechowski, Dariusz, Baranowski, Artur, Basiewicz, Ewa, Mierzewska-Schmidt, Magdalena, Retka, Wlodzimierz, Sawicki, Piotr, Checinska, Magdalena, Zielinska, Marzena, Zurawska, Magdalena, Leal, Teresa, Mascarenhas, Catia, Pedro Pina, António, Joao Susano, Maria, Moniz, Antonio, Teresa Rocha, Maria, Calvao Santos, Carolina, Domingas Patuleia, M, Pereira, Ricardo, Roxo, Helena, Amaral, Rosa, Guedes, Isabel, Gomes, Cristina, Gonçalves, Marta, Salgado, Helena, Santos, Maria, Rodrigues, Sara, Sa, Angela, Machado, Elvira, Pé d'Arca, Sandra, Seabra, Manuel, Mihaela Gheorghe, Ligia, Ivascu, Constantin, Moraru-Draghici, Lucia, Suvejan, Mirela, Babici, Remus, Eniko, Kovacs, Hogea, Cristiana, Mihaela, Dubau, Nicoleta, Daraban, Barbunc, Danut, Maria Nistor, Alina, Stefan, Violeta, Catalina Ionescu, Gabriela, Davidescu, Irina, Teodora Nastase, Alina, Dumitru Rusu, Florin, Badarau, Victoria, Cindea, Iulia, Moscaliuc, Melania, Olteanu, Dana, Petrescu, Luxita, Ceuca, Daniela, Galinescu, Irena, Badeti, Rodica, Capusan, Alin, Cucui-Cozma, Cosmina, Popescu, Barbura, Cimpeanu, Luminita, Birliba, Mihaela-Petronela, Miulescu, Magdalena, Balamat, Stefania, Gurita, Adriana, Ilie, Luminita, Mocioiu, Gabriel, Pick, Darina, Sirghie, Rodica, Tabacaru, Radu, Trante, Irinel, Horhota, Lucian, Bandrabur, Daniela, Ciobanu, Tudor, Cuciuc, Veaceslav, Munteanu, Valentin, Olaru, Valentin, Paiu, Corneliu, Savu, Anca, Trifan, Oana, Elena Malos, Anca, Glazunov, Anton, Ivanov, Alexander, Poduskov, Evgeny, Popov, Alexander, Guskov, Igor, Lugovoy, Alexander, Nechaev, Vladislav, Ovezov, Alexey, Basov, Mikhail, Kochkin, Vladimir, Lazarev, Vladimir, Chizhov, Dmitri, Ostreikov, Ivan, Tolasov, Konstantin, Budic, Ivana, Marjanovic, Vesna, Draskovic, Biljana, Pandurov, Marina, Simin, Jovana, Dolinaj, Vladimir, Janjevic, Dusanka, Mandras, Ana, Mircetic, Maja, Petrovic, Sladjana, Rebac, Vlatka, Slavkovic, Bojana, Stevanovic, Vesna, Velcev, Ana, Knezevic, Mirjana, Milojevic, Irina, Puric, Selena, Simic, Irena, Stevic, Marija, Stranjanac, Vladimir, Simic, Dusica, Cabanova, Barbora, Hanula, Miloslav, Grynyuk, Andry, Berger, Jelena, Cerne, Uros, Nastran, Andraz, Pirc, Dejan, Popic, Rok, Stupnik, Spela, Rubio, Paloma, del Río, Cristina, Benito, Pilar, Pino, Gema, Gutierrez, Ignacio, Gutierrez Valcarcel, Andrea, León Carsi, Irene, Perez Garcia, Anibal, López Galera, Sílvia, Marco Valls, Joan, Ricol Lainez, Laura, Vallejo Tarrat, Andrea, Artes, David, Banus, Ester, Chirichiello, Luca, De Abreu, Leidy, De Josemaria, Belen, Helena Gaitan, M, Garces, Antonio, Lazaro, Juan J, Manen Berga, Ferran, Molies, Dolors, Monclus, Enric, Navaro, Montserrat, Pamies, Carmen, Perelló, Marina, Prat, Mar, Ribo, Laura, Angeles Sanz, M, Serrano, Silvia, Sola Ruiz, Eva, Anuncia Escontrela Rodríguez, Blanca, Maria Gago Martinez, Andrea, Martínez Ruiz, Alberto, De La Cruz Benito, Fausto, Gabilondo Garcia, Gustavo, Martinez Maldonado, Ever, Noriega, Bryant, Oller Duque, Lara, Olmos Mendez, Alberto, Perez- Ferrer, Antonio, Reinoso Barbero, Francisco, Acevedo Bambaren, Ismael, Domínguez, Fernando, Franco, Teresa, Jiménez, Anabel, Melero, Alicia, Feliu, Montserrat, García, Irene, Montferrer, Núria, Munar, Francisca, Muro, Cristina, Nuño, Rosario, Perera, Remel, Schmucker, Erika, Börjesson, Glenda, Gillberg, Lars, Castellheim, Albert, Sandström, Kerstin, Bauer, Annette, Roos, Torbjörn, Hedlund, Lars, Boegli, Yann, Dolci, Mirko, Marcucci, Carine, Spahr-Schopfer, Isabelle, Habre, Walid, Pellegrini, Michel, Book, Malte, Errass, Loreen, Riggenbach, Christine, Casutt, Mattias, Hölzle, Martin, Hurni, Thomas, Jöhr, Martin, Mauch, Jacqueline, Anselmi, Luciano, Anselmi, Irene, Jacomet, Alfred, Oberhauser, Markus, Wossner, Stephanie, Zettl, Angelika, Erb, Thomas, Mackiewicz, Tomasz, Simitzes, Helena, Ozer, Yetkin, Takil, Arzu, Alanoglu, Zekeriyya, Bermede, Onat, Cakar Turhan, K.Sanem, Alkis, Neslihan, Yildirim Guclu, Cigdem, Ceyda Meco, Basak, Hatipoglu, Zehra, Ozcengiz, Dilek, Begec, Zekine, Ilksen Toprak, Huseyin, Kendigelen, Pinar, Cigdem Tütüncü, Ayse, Karadeniz, Meltem Savran, Seyhan Ozkan, Tulay, Sivrikoz, Nuket, Kemal Arslantas, Mustafa, Hizal, Ayse, Tore Altun, Gülbin, Umuroglu, Tumay, Baris, Sibel, Kazak Bengisun, Zuleyha, Goncharenko, Galyna, Khrapak, Maksym, Klymenko, Tetyana, Pavlenko, Vitaliy, Prysiazhniuk, Dmytro, Rudio, Olga, Varyvoda, Mykhailo, Vodianytskyi, Sergii, Boryshkevych, Ivanna, Kyselova, Iryna, Trikash, Nikolay, Albokrinov, Andrew, Perova-Sharonova, Valentina, Sklyar, Vitaliy, Surkov, Denis, Abdelaal, Amr, Barber, Nicola, Checuti, Sarah, Godsiff, Leisha, Johanne, Lynch, Simpson, Joanna, Underhill, Helen, Diwan, Rishi, Kelgeri, Nivedita, Masip, Nuria, Ravi, Radha, Roberts, Steve, Cillis, Annagrazia, Marcus, Ritchie, Merella, Federica, Love, David, Baraggia, Paolo, Bird, Victoria, Hussey, Joseph, Alderson, Peter, Bartholomew, Karen, Moncreiff, Michael, Davidson, Sarah, Hare, Alison, Kotecha, Ami, Lee, Corina, Liyanage, Ganga, Patel, Shivali, Samani, Amee, Abou-Samra, Mark, Boyd, Matthew, Hullatt, Laurence, Levy, David, Pauling, Mark, Sharman, Sarah-Jane, Smith, Natalie, Rutherford, John, Cavalier, Alison, Locke, Christie, Sage, Frederic, Bapat, Smita, Hammerschlag, Jacinda, Ioannou, Ioannis, King, Stephanie, Pegg, Rachel, Salota, Vishal, Sketcher, Jonathan, Thadsad, Muthu, Zeitlin, Deborah, Jack, Ewan, Lang, Colin, Ahmed, Samira, Ayyash, Reema, Bari, Francoise, Bell, Sarah J, Elizabeth Biercamp, Claire, Briggs, Sandra, Gabriella Elena Clement, Maria, Dalton, Mark, Ali Eissa Eid, Mohamed, Gandhi, Monica, Harmen Herrema, Idse, Khaffaf, Ranj, Jeng Min Law, Savio, McClintock, Joanna, Ireland, Nicholas, Majid Saleem, Mohammed, Smith, Fiona, Cohen, Marc, Lee, Clover-Ann, O'Donahue, Lizanne, Powell, Alex, Rawlinson, Ellen, Snoek, Aarjan, Weiss, Katja, Wellesley, Hugo, Crawford, Michael, Abdel-Hafiz, Mostafa, Day, Alexandra, Rajamani, Balaji, Saha, Rita, Wright, Dave, Chee, Lew-Chin, Bew, Stephanie, Homer, Rachel, Malarkkan, Nalini, Wolfe Barry, Juliet, Angadi, Pradeep, Cagney, Brid, De Melo, Eric, Dekker, Elsa, Helm, Emma, Jones, Gareth, Peiris, Kawshala, Russell, William, Slater, Patricia, Sodhi, Puja, Browning, Mike, Phillips, Trudie, Van Hecke, Rachel, Muir, Vimty, Singh, Piyush, Soskova, Tereza, Cumming, Craig, Farquharson, Pamela, Pearson, Karen, Shaw, Neil, Whiteside, Jonathan, Whyte, Emma, Byers, Gordon, Davies, Kay, Engelhardt, Thomas, Faliszewski, Isabella, Johnston, Graham, Kaufmann, Nils, Kusnirikova, Zuzana, Wilson, Graham, Carachi, Peter, Makin, Andrew, Foster, Brian, Lipczynski, Dariusz, Mawer, Rebecca, Rutherford, William, Rogerson, David, Rushman, Sarah, Taylor, Christopher, Tomlinson, William, Dix, Philippa, Woodward, Tom, Bell, Graham, Boyle, David, Cloherty, Marianne, Cullen, Julia, Cullen, Pauline, Fairgrieve, Ross, Ghent, Robert, Glasgow, Russell, Gordeeva, Elena, Harden, Alison, Hivey, Sarah, Jerome, Kevin, McKee, Lesley, Morton, Neil, Pribul, Vicky, Sinclair, John, Steiner, Maria, Steward, Heather, Sweeney, Lorraine, Thomson, Wendy, Whiteside, Jeanette, Dalton, Andrew, Ross, Mark, Smith, Carolyn, Allen, Claire, Anders, Nicola, Barlow, Victoria, Bassett, Mike, Darwin, Leanne, Davison, Rachel, Diacono, Jacques, Hobbs, Amy, Hutchinson, Adel, Lomas, Bernadette, Lonsdale, Hannah, Nasser, Leila, Oshan, Vimmi, Patel, Pradip, Raistrick, Christopher, Scott-Warren, Victoria, Talbot, Laura, Wai, Carolynn, Childs, Sophie, Dickinson, Matthew, Bloomfield, Tom, Garrioch, Sweyn, Watson, Karen, Gaynor, James, Harrison, Richard, Lee, Juliette, Blythe, Elizabeth, Dorman, Teresa, Eissa, Ayman, Ellwood, James, Gooch, Ingrid, Hearn, Robert, Hodgetts, Vanessa, John, Robert, Kirton, Christine, Ladak, Nadia, Morgan, Judith, Plant, Nina, Shepherd, Elizabeth, Short, Judith, Stack, Charles, Steel, Simon, Taylor, Matthew, Thomas, Deborah, Wilson, Catharine, Wilson-Smith, Elaine, Bradbury, Carol L., Hussain, Nageena, Mayell, Antonia, Mesbah, Ahmed, Qureshi, Arif, Vaidyanath, Chandra, Geary, Tim, Hawksworth, Chris, Parasuraman, Tamaraichelvi, Perry, Nicole, Banerjee, Indrani, Barr, Katharine, Butler, Patrick, Davies, Jack, Flewin, Lisa, Gande, Richard, Montague, James, Plumb, James, Pratt, Thomas, Sutherland, Paul, Vail, Hannah, Wilkins, Andrew, Hunter, Catherine, Russell, Susan, Thomas, Alun, Mifsud, Mark, Strachan, Dominic, Leva, Brigitte, Plichon, Benoit, Harlet, Pierre, Virag, Katalin, Hansen, Tom G, Morton, Neil S, and Boda, Krisztina

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2017
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5. Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Author

Habre, Walid, Disma, Nicola, Virag, Katalin, Becke, Karin, Hansen, Tom G., Joehr, Martin, Leva, Brigitte, Morton, Neil S., Vermeulen, Petronella M., Zielinska, Marzena, Boda, Krisztina, Veyckemans, Francis, Klimscha, Walter, Konecny, Regina, Luntzer, Robert, Morawk-Wintersperger, Ulrike, Neiger, Franz, Rustemeyer, Lydia, Breschan, Christian, Frey, Denise, Platzer, Manuela, Germann, Reinhard, Oeding, Joachim, Stoegermuller, Birgit, Ziegler, Bernhard, Brotatsch, Philipp, Gutmann, Anton, Mausser, Gerlinde, Messerer, Brigitte, Toller, Wolfgang, Vittinghoff, Maria, Zangl, Gregor, Seidel-Ahyai, Natascha, Hochhold, Christoph, Kroess, Ruth, Paal, Peter, Cnudde, Steven, Coucke, Patricia, Loveniers, Birgit, Mitchell, John, Kahn, David, Pirotte, Thierry, Pregardien, Caroline, Coppens, Marc, De Baerdemaeker, Luc, De Hert, Stefan, Heyse, Bjorn, Neckebroek, Martine, Parashchanka, Aliaksandra, Van Limmen, Jurgen, Van Den Eynde, Nancy, Vanpeteghem, Caroline, Wyffels, Piet, Lalot, Michael, Lechat, Jean-Paul, Stevens, France, Casaer, Sari, De Groote, Francoise, De Pooter, Francoise, De Ville, Andree, Gerin, Marc, Magasich, Natalia, Torres, Cristel Sanchez, Van Deenen, Denise, Berghmans, Johan, Himpe, Dirk, Roofthooft, Eva, Joukes, Ellen, Smitz, Carine, Van Reeth, Veronique, Huygens, Christel, Lauweryns, Julie, De Smet, Karen, Najafi, Nadia, Poelaert, Jan, Van de Velde, Anne, Van Mossevelde, Veerle, Bekavac, Ivan, Butkovic, Diana, Litvic, Dubravka Heli, Soric, Ivana Kerovec, Maretic, Hrvoje, Moscatello, Djurdjica, Popovic, Ljiljana, Micic, Slobodan, Tus, Ivana Stuck, Fabris, Lada Kalagac, Simurina, Tatjana, Sulen, Nina, Kesi-Valpotic, Gordana, Djapic, Dajana, Zurek, Jiri, Jureckova, Lucie, Mackova, Iveta, Skacel, Monika, Weinlichova, Stanislava, Divak, Jan, Frelich, Michal, Urbanec, Rene, Biskupova, Vera, Mixa, Vladimir, Pavlickova, Jana, Afshari, Arash, Bottger, Morten, Ellekvist, Marguerite B., Johansen, Mathias, Madsen, Birgitte Ingeborg, Nilsson, Jens Christian, Schousboe, Birgitte M. B., Clausen, Nicola G., Steen, Nick Phaff, Ilmoja, Mari-Liis, Tonise, Virge, Karjagin, Juri, Kikas, Reet, Isohanni, Mika, Lyly, Anniina, Takala, Annika, Happo, Johanna, Kiviluoma, Kai, Martikainen, Kati, Aantaa, Riku, Manner, Tuula, Vilo, Sanna, Amory, Catherine, Ludot, Hugues, Lambotte, Patricia, Busche, Rene, Jacqmarcq, Olivier, Lejus, Corinne, Corouge, Julien, Erb, Christian, Garrigue, Delphine, Gillet, Patricia, Laffargue, Anne, Lambelin, Veronique, Le Freche, Helene, Peresbota, Daliana, Richart, Pierre, Berton, Jerome, Chapotte, Catherine, Colbus, Laurent, Lehousse, Thierry, Monrigal, Jean, Baujard, Catherine, Roulleau, Philippe, Staiti, Giuseppe, Batoz, Helene, Bordes, Maryline, Didier, Anne, Hamonic, Yann, Lagarde, Sylvaine, Nouette-Gaulain, Karine, Semjen, Francois, Zaghet, Brigitte, Dekens, Jacky, Delcuze, Axelle, Dupont, Herve, Legrand, Aurelien, Raffoflandreur, Celine, Audren, Noemie, Camus, Blandine, Cartal, Marielle, Chazelet, Chantal, Davin, Isabelle, Guillier, Marion, Desjeux, Luc, Larcher, Claire, Grein, Elodie, Leclercq, Mickeal, Levitchi, Roxana, Rosu, Lilica, Simon, Dominique, Zang, Aurelien, Migeon, Anne, Gagey, Anne-Charlotte, Bourdaud, Nathalie, Carre, Anne-Charlotte, Duflo, Frederic, Riche, Jean-Claude, Robert, Philippe, Druot, Emilie, Maupain, Olivier, Orliaguet, Gilles, Sabau, Lucie, Taright, Hanna, Uhrig, Lynn, Verchere-Montmayeur, Juliette, Debrabant, Lise, Pilla, Clotaire, Podvin, Alexandre, Roth, Benjamin, Dahmani, Souhayl, Julien-Marsollier, Florence, Sabourdin, Nada, Alexandri, Bogdan, Brezac, Gilles, de la Briere, Francois, Hayem, Catherine, Lhubat, Elizabeth, Mission, Jean Paul, Remond, Charlotte, Dadure, Christophe, Maniora, Maud, Marie, Anais, Pirat, Philippe, Saour, Anne-Charlotte, Sola, Chrystelle, Ecoffey, Claude, Wodey, Eric, Adam, Christian, Standl, Thomas, Schindler, Ehrenfried, Yamamoto, Tomohiro, Brackhahn, Michael, Eich, Christoph Bernhard, Guericke, Holger, Kindermann, Petra, Laschat, Michael, Schink, Cornel, Wappler, Frank, Hoehne, Claudia, Skordou, Natalia, Ulrici, Johanna, Jetzek-Zader, Martin, Kienbaum, Peter, Meyer-Treschan, Tanja, Picker, Olaf, Schaefer, Maximilian S., Mielke, Golo, Baethge, Sabine, Ramminger, Axel, Bauer, Martin, Bollinger, Matthias, Hinz, Jose, Quintel, Michael, Russo, Sebastian G., Bauer, Michael, Geil, Dfominik, Kortgen, Andreas, Preussler, Niels-Peter, Hofmann, Ulrich, Raber, Manfred, Reindl, Doris, Oppenrieder, Karin, Schierlinger, Bettina, Roth, Jens, Funk, Wolfgang, Fischer, Thomas, Gernoth, Christian, Wiefelsputz, Christina, Volger, Hauke, Zederer, Nicole, Diers, Anja, Huber, Matthias, Schorer, Clemens, Weyland, Andreas, Schwarzkopf, Konrad, Grau, Catharina, Roth, Winfried, Holy, Rolf, Mader, Thomas, Peter, Laura, Supthut, Hauke, Kuehhirt, Thomas, Milde, Alexander, Fiedler, Fritz, Isselhorst, Carsten, Grundmann, Ulrich, Pattar, Alexander, Reinert, Jennifer, Ehm, Birgit, Fritzsche, Katrin, Gaebler, Ralf, Meybohm, Patrick, Hein, Maximilian, Guzman, Ines, Jokinen, Johanna, Kranke, Peter, Goebel, Ulrich, Harris, Sarah, Eisner, Christoph, Ochsenreiter, Miriam, Schoeler, Michael, Thil, Elke, Ellerkmann, Richard, Hoeft, Andreas, Neumann, Claudia, Weber, Stefan, Keilhauer, Julia, Kloessing, Jan, Schramm, Michael, Trieschmann, Uwe, Knauss, Kristina, Sinner, Barbara, Steinmann, Johannes, Koessler, Herbert, Kalliardou, Evagelia, Malisiova, Anna, Tsiotou, Adelais, Chloropoulou, Pelagia, Chrysi, Mpratzou, Iordanidou, Despoina, Ntavlis, Merkourios, Rarosi, Ferenc, Boda, Krisztina B., Guerin, Christilynn, Irwin, Janice, Magner, Claire, Nakhjavani, Solmaz, O'Hare, Brendan, Galvin, Deborah, Jamil, Yosry, Lesmes, Carlos, Barak, Yuri, Fisher, Haran, Kachko, Ludmyla, Katz, Jacob, Kirilov, Dmitry, Levinzon, Michael, Manevich, Yair, Nekrasov, Konstantin, Peled, Elia, Sanko, Elena, Schmain, Dmitri, Sheinkin, Olga, Simhi, Eliahu, Tarabikin, Alex, Trabkin, Evelina, Yagudaev, Irena, Zeitlin, Yelena, Zunser, Igor, Habre, Walid, Disma, Nicola, Virag, Katalin, Becke, Karin, Hansen, Tom G., Joehr, Martin, Leva, Brigitte, Morton, Neil S., Vermeulen, Petronella M., Zielinska, Marzena, Boda, Krisztina, Veyckemans, Francis, Klimscha, Walter, Konecny, Regina, Luntzer, Robert, Morawk-Wintersperger, Ulrike, Neiger, Franz, Rustemeyer, Lydia, Breschan, Christian, Frey, Denise, Platzer, Manuela, Germann, Reinhard, Oeding, Joachim, Stoegermuller, Birgit, Ziegler, Bernhard, Brotatsch, Philipp, Gutmann, Anton, Mausser, Gerlinde, Messerer, Brigitte, Toller, Wolfgang, Vittinghoff, Maria, Zangl, Gregor, Seidel-Ahyai, Natascha, Hochhold, Christoph, Kroess, Ruth, Paal, Peter, Cnudde, Steven, Coucke, Patricia, Loveniers, Birgit, Mitchell, John, Kahn, David, Pirotte, Thierry, Pregardien, Caroline, Coppens, Marc, De Baerdemaeker, Luc, De Hert, Stefan, Heyse, Bjorn, Neckebroek, Martine, Parashchanka, Aliaksandra, Van Limmen, Jurgen, Van Den Eynde, Nancy, Vanpeteghem, Caroline, Wyffels, Piet, Lalot, Michael, Lechat, Jean-Paul, Stevens, France, Casaer, Sari, De Groote, Francoise, De Pooter, Francoise, De Ville, Andree, Gerin, Marc, Magasich, Natalia, Torres, Cristel Sanchez, Van Deenen, Denise, Berghmans, Johan, Himpe, Dirk, Roofthooft, Eva, Joukes, Ellen, Smitz, Carine, Van Reeth, Veronique, Huygens, Christel, Lauweryns, Julie, De Smet, Karen, Najafi, Nadia, Poelaert, Jan, Van de Velde, Anne, Van Mossevelde, Veerle, Bekavac, Ivan, Butkovic, Diana, Litvic, Dubravka Heli, Soric, Ivana Kerovec, Maretic, Hrvoje, Moscatello, Djurdjica, Popovic, Ljiljana, Micic, Slobodan, Tus, Ivana Stuck, Fabris, Lada Kalagac, Simurina, Tatjana, Sulen, Nina, Kesi-Valpotic, Gordana, Djapic, Dajana, Zurek, Jiri, Jureckova, Lucie, Mackova, Iveta, Skacel, Monika, Weinlichova, Stanislava, Divak, Jan, Frelich, Michal, Urbanec, Rene, Biskupova, Vera, Mixa, Vladimir, Pavlickova, Jana, Afshari, Arash, Bottger, Morten, Ellekvist, Marguerite B., Johansen, Mathias, Madsen, Birgitte Ingeborg, Nilsson, Jens Christian, Schousboe, Birgitte M. B., Clausen, Nicola G., Steen, Nick Phaff, Ilmoja, Mari-Liis, Tonise, Virge, Karjagin, Juri, Kikas, Reet, Isohanni, Mika, Lyly, Anniina, Takala, Annika, Happo, Johanna, Kiviluoma, Kai, Martikainen, Kati, Aantaa, Riku, Manner, Tuula, Vilo, Sanna, Amory, Catherine, Ludot, Hugues, Lambotte, Patricia, Busche, Rene, Jacqmarcq, Olivier, Lejus, Corinne, Corouge, Julien, Erb, Christian, Garrigue, Delphine, Gillet, Patricia, Laffargue, Anne, Lambelin, Veronique, Le Freche, Helene, Peresbota, Daliana, Richart, Pierre, Berton, Jerome, Chapotte, Catherine, Colbus, Laurent, Lehousse, Thierry, Monrigal, Jean, Baujard, Catherine, Roulleau, Philippe, Staiti, Giuseppe, Batoz, Helene, Bordes, Maryline, Didier, Anne, Hamonic, Yann, Lagarde, Sylvaine, Nouette-Gaulain, Karine, Semjen, Francois, Zaghet, Brigitte, Dekens, Jacky, Delcuze, Axelle, Dupont, Herve, Legrand, Aurelien, Raffoflandreur, Celine, Audren, Noemie, Camus, Blandine, Cartal, Marielle, Chazelet, Chantal, Davin, Isabelle, Guillier, Marion, Desjeux, Luc, Larcher, Claire, Grein, Elodie, Leclercq, Mickeal, Levitchi, Roxana, Rosu, Lilica, Simon, Dominique, Zang, Aurelien, Migeon, Anne, Gagey, Anne-Charlotte, Bourdaud, Nathalie, Carre, Anne-Charlotte, Duflo, Frederic, Riche, Jean-Claude, Robert, Philippe, Druot, Emilie, Maupain, Olivier, Orliaguet, Gilles, Sabau, Lucie, Taright, Hanna, Uhrig, Lynn, Verchere-Montmayeur, Juliette, Debrabant, Lise, Pilla, Clotaire, Podvin, Alexandre, Roth, Benjamin, Dahmani, Souhayl, Julien-Marsollier, Florence, Sabourdin, Nada, Alexandri, Bogdan, Brezac, Gilles, de la Briere, Francois, Hayem, Catherine, Lhubat, Elizabeth, Mission, Jean Paul, Remond, Charlotte, Dadure, Christophe, Maniora, Maud, Marie, Anais, Pirat, Philippe, Saour, Anne-Charlotte, Sola, Chrystelle, Ecoffey, Claude, Wodey, Eric, Adam, Christian, Standl, Thomas, Schindler, Ehrenfried, Yamamoto, Tomohiro, Brackhahn, Michael, Eich, Christoph Bernhard, Guericke, Holger, Kindermann, Petra, Laschat, Michael, Schink, Cornel, Wappler, Frank, Hoehne, Claudia, Skordou, Natalia, Ulrici, Johanna, Jetzek-Zader, Martin, Kienbaum, Peter, Meyer-Treschan, Tanja, Picker, Olaf, Schaefer, Maximilian S., Mielke, Golo, Baethge, Sabine, Ramminger, Axel, Bauer, Martin, Bollinger, Matthias, Hinz, Jose, Quintel, Michael, Russo, Sebastian G., Bauer, Michael, Geil, Dfominik, Kortgen, Andreas, Preussler, Niels-Peter, Hofmann, Ulrich, Raber, Manfred, Reindl, Doris, Oppenrieder, Karin, Schierlinger, Bettina, Roth, Jens, Funk, Wolfgang, Fischer, Thomas, Gernoth, Christian, Wiefelsputz, Christina, Volger, Hauke, Zederer, Nicole, Diers, Anja, Huber, Matthias, Schorer, Clemens, Weyland, Andreas, Schwarzkopf, Konrad, Grau, Catharina, Roth, Winfried, Holy, Rolf, Mader, Thomas, Peter, Laura, Supthut, Hauke, Kuehhirt, Thomas, Milde, Alexander, Fiedler, Fritz, Isselhorst, Carsten, Grundmann, Ulrich, Pattar, Alexander, Reinert, Jennifer, Ehm, Birgit, Fritzsche, Katrin, Gaebler, Ralf, Meybohm, Patrick, Hein, Maximilian, Guzman, Ines, Jokinen, Johanna, Kranke, Peter, Goebel, Ulrich, Harris, Sarah, Eisner, Christoph, Ochsenreiter, Miriam, Schoeler, Michael, Thil, Elke, Ellerkmann, Richard, Hoeft, Andreas, Neumann, Claudia, Weber, Stefan, Keilhauer, Julia, Kloessing, Jan, Schramm, Michael, Trieschmann, Uwe, Knauss, Kristina, Sinner, Barbara, Steinmann, Johannes, Koessler, Herbert, Kalliardou, Evagelia, Malisiova, Anna, Tsiotou, Adelais, Chloropoulou, Pelagia, Chrysi, Mpratzou, Iordanidou, Despoina, Ntavlis, Merkourios, Rarosi, Ferenc, Boda, Krisztina B., Guerin, Christilynn, Irwin, Janice, Magner, Claire, Nakhjavani, Solmaz, O'Hare, Brendan, Galvin, Deborah, Jamil, Yosry, Lesmes, Carlos, Barak, Yuri, Fisher, Haran, Kachko, Ludmyla, Katz, Jacob, Kirilov, Dmitry, Levinzon, Michael, Manevich, Yair, Nekrasov, Konstantin, Peled, Elia, Sanko, Elena, Schmain, Dmitri, Sheinkin, Olga, Simhi, Eliahu, Tarabikin, Alex, Trabkin, Evelina, Yagudaev, Irena, Zeitlin, Yelena, and Zunser, Igor

Abstract

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6.35 years (SD 4.50) were included. The incidence of perioperative severe critical events was 5.2% (95% CI 5.0-5.5) with an incidence of respiratory critical events of 3.1% (2.9-3.3). Cardiovascular instability occurred in 1.9% (1.7-2.1), with an immediate poor outcome in 5.4% (3.7-7.5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0.88, 95% CI 0.86-0.90; p<0.0001), medical history, and physical condition (1.60, 1.40-1.82; p<0.0001) were the major risk factors for a serious critical event. Multivariate analysis revealed evidence for the beneficial effect of years of experience of the most senior anaesthesia team member (0.99, 0.981-0.997; p<0.0048 for respiratory critical events, and 0.98, 0.97-0.99; p=0.0039 for

Published
2017

6. Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Author

Habre, Walid, primary, Disma, Nicola, additional, Virag, Katalin, additional, Becke, Karin, additional, Hansen, Tom G, additional, Jöhr, Martin, additional, Leva, Brigitte, additional, Morton, Neil S, additional, Vermeulen, Petronella M, additional, Zielinska, Marzena, additional, Boda, Krisztina, additional, Veyckemans, Francis, additional, Klimscha, Walter, additional, Konecny, Regina, additional, Luntzer, Robert, additional, Morawk-Wintersperger, Ulrike, additional, Neiger, Franz, additional, Rustemeyer, Lydia, additional, Breschan, Christian, additional, Frey, Denise, additional, Platzer, Manuela, additional, Germann, Reinhard, additional, Oeding, Joachim, additional, Stoegermüller, Birgit, additional, Ziegler, Bernhard, additional, Brotatsch, Philipp, additional, Gutmann, Anton, additional, Mausser, Gerlinde, additional, Messerer, Brigitte, additional, Toller, Wolfgang, additional, Vittinghoff, Maria, additional, Zangl, Gregor, additional, Seidel-Ahyai, Natascha, additional, Hochhold, Christoph, additional, Kroess, Ruth, additional, Paal, Peter, additional, Cnudde, Steven, additional, Coucke, Patricia, additional, Loveniers, Birgit, additional, Mitchell, John, additional, Kahn, David, additional, Pirotte, Thierry, additional, Pregardien, Caroline, additional, Coppens, Marc, additional, De Hert, Stefan, additional, Heyse, Björn, additional, Neckebroek, Martine, additional, Parashchanka, Aliaksandra, additional, Van Limmen, Jurgen, additional, Van Den Eynde, Nancy, additional, Vanpeteghem, Caroline, additional, Wyffels, Piet, additional, Lalot, Michaël, additional, Lechat, Jean-Paul, additional, Stevens, France, additional, Casaer, Sari, additional, De Groote, Françoise, additional, De Pooter, Françoise, additional, De Villé, Andrée, additional, Gerin, Marc, additional, Magasich, Natalia, additional, Sanchez Torres, Cristel, additional, Van Deenen, Denise, additional, Berghmans, Johan, additional, Himpe, Dirk, additional, Roofthooft, Eva, additional, Joukes, Ellen, additional, Smitz, Carine, additional, Van Reeth, Veronique, additional, Huygens, Christel, additional, Lauweryns, Julie, additional, De Smet, Karen, additional, Najafi, Nadia, additional, Poelaert, Jan, additional, Van de Velde, Anne, additional, Van Mossevelde, Veerle, additional, Bekavac, Ivan, additional, Butkovic, Diana, additional, Heli Litvic, Dubravka, additional, Kerovec Soric, Ivana, additional, Maretic, Hrvoje, additional, Moscatello, Djurdjica, additional, Popovic, Ljiljana, additional, Micici, Slobodan, additional, Stuck Tus, Ivana, additional, Kalagac Fabris, Lada, additional, Simurina, Tatjana, additional, Sulen, Nina, additional, Kesic-Valpotic, Gordana, additional, Djapic, Dajana, additional, Žurek, Jirí, additional, Jureckova, Lucie, additional, Mackova, Iveta, additional, Skacel, Monika, additional, Weinlichova, Stanislava, additional, Divák, Jan, additional, Frelich, Michal, additional, Urbanec, René, additional, Biskupova, Vera, additional, Mixa, Vladimir, additional, Pavlickova, Jana, additional, Afshari, Arash, additional, Bøttger, Morten, additional, Ellekvist, Marguerite B., additional, Johansen, Mathias, additional, Ingeborg Madsen, Birgitte, additional, Christian Nilsson, Jens, additional, Schousboe, Birgitte MB, additional, Clausen, Nicola G., additional, Hansen, Tom G., additional, Phaff Steen, Nick, additional, Ilmoja, Mari-Liis, additional, Tonise, Virge, additional, Karjagin, Juri, additional, Kikas, Reet, additional, Isohanni, Mika, additional, Lyly, Anniina, additional, Takala, Annika, additional, Happo, Johanna, additional, Kiviluoma, Kai, additional, Martikainen, Kati, additional, Aantaa, Riku, additional, Manner, Tuula, additional, Vilo, Sanna, additional, Amory, Catherine, additional, Ludot, Hugues, additional, Lambotte, Patricia, additional, Busche, René, additional, Jacqmarcq, Olivier, additional, Lejus, Corinne, additional, Corouge, Julien, additional, Erb, Christian, additional, Garrigue, Delphine, additional, Gillet, Patricia, additional, Laffargue, Anne, additional, Lambelin, Veronique, additional, Le Freche, Hélène, additional, Peresbota, Daliana, additional, Richart, Pierre, additional, Berton, Jerome, additional, Chapotte, Catherine, additional, Colbus, Laurent, additional, Lehousse, Thierry, additional, Monrigal, Jean, additional, Baujard, Catherine, additional, Roulleau, Philippe, additional, Staiti, Giuseppe, additional, Batoz, Hélène, additional, Bordes, Maryline, additional, Didier, Anne, additional, Hamonic, Yann, additional, Lagarde, Sylvaine, additional, Nouette-Gaulain, Karine, additional, Semjen, François, additional, Zaghet, Brigitte, additional, Dekens, Jacky, additional, Delcuze, Axelle, additional, Dupont, Hervé, additional, Legrand, Aurélien, additional, Raffoflandreur, Celine, additional, Audren, Noémie, additional, Camus, Blandine, additional, Cartal, Marielle, additional, Chazelet, Chantal, additional, Davin, Isabelle, additional, Guillier, Marion, additional, Desjeux, Luc, additional, Larcher, Claire, additional, Grein, Elodie, additional, Leclercq, Mickeal, additional, Levitchi, Roxana, additional, Rosu, Lilica, additional, Simon, Dominique, additional, Zang, Aurélien, additional, Migeon, Anne, additional, Gagey, Anne-Charlotte, additional, Bourdaud, Nathalie, additional, Carre, Anne-Charlotte, additional, Duflo, Frédéric, additional, Riche, Jean-Claude, additional, Robert, Philippe, additional, Druot, Emilie, additional, Maupain, Olivier, additional, Orliaguet, Gilles, additional, Sabau, Lucie, additional, Taright, Hanna, additional, Uhrig, Lynn, additional, Verchere-Montmayeur, Juliette, additional, Debrabant, Lise, additional, Pilla, Clotaire, additional, Podvin, Alexandre, additional, Roth, Benjamin, additional, Dahmani, Souhayl, additional, Julien-Marsollier, Florence, additional, Sabourdin, Nada, additional, Alexandri, Bogdan, additional, Brezac, Gilles, additional, de la Brière, Francois, additional, Hayem, Catherine, additional, Lhubat, Elizabeth, additional, Paul Mission, Jean, additional, Rémond, Charlotte, additional, Dadure, Christophe, additional, Maniora, Maud, additional, Marie, Anais, additional, Pirat, Philippe, additional, Saour, Anne-Charlotte, additional, Sola, Chrystelle, additional, Ecoffey, Claude, additional, Wodey, Eric, additional, Adam, Christian, additional, Standl, Thomas, additional, Schindler, Ehrenfried, additional, Yamamoto, Tomohiro, additional, Brackhahn, Michael, additional, Eich, Christoph Bernhard, additional, Guericke, Holger, additional, Kindermann, Petra, additional, Laschat, Michael, additional, Schink, Cornel, additional, Wappler, Frank, additional, Hoehne, Claudia, additional, Skordou, Natalia, additional, Ulrici, Johanna, additional, Jetzek-Zader, Martin, additional, Kienbaum, Peter, additional, Meyer-Treschan, Tanja, additional, Picker, Olaf, additional, Schaefer, Maximilian S., additional, Mielke, Golo, additional, Baethge, Sabine, additional, Ramminger, Axel, additional, Bauer, Martin, additional, Bollinger, Matthias, additional, Hinz, José, additional, Quintel, Michael, additional, Russo, Sebastian G., additional, Bauer, Michael, additional, Geil, Dfominik, additional, Kortgen, Andreas, additional, Preussler, Niels-Peter, additional, Hofmann, Ulrich, additional, Raber, Manfred, additional, Reindl, Doris, additional, Oppenrieder, Karin, additional, Schierlinger, Bettina, additional, Roth, Jens, additional, Funk, Wolfgang, additional, Fischer, Thomas, additional, Gernoth, Christian, additional, Wiefelspütz, Christina, additional, Volger, Hauke, additional, Zederer, Nicole, additional, Diers, Anja, additional, Huber, Matthias, additional, Schorer, Clemens, additional, Weyland, Andreas, additional, Schwarzkopf, Konrad, additional, Grau, Catharina, additional, Roth, Winfried, additional, Holy, Rolf, additional, Mader, Thomas, additional, Peter, Laura, additional, Supthut, Hauke, additional, Kuehhirt, Thomas, additional, Milde, Alexander, additional, Fiedler, Fritz, additional, Isselhorst, Carsten, additional, Grundmann, Ulrich, additional, Pattar, Alexander, additional, Reinert, Jennifer, additional, Ehm, Birgit, additional, Fritzsche, Katrin, additional, Gaebler, Ralf, additional, Meybohm, Patrick, additional, Hein, Maximilian, additional, Guzman, Ines, additional, Jokinen, Johanna, additional, Kranke, Peter, additional, Goebel, Ulrich, additional, Harris, Sarah, additional, Eisner, Christoph, additional, Ochsenreiter, Miriam, additional, Schoeler, Michael, additional, Thil, Elke, additional, Ellerkmann, Richard, additional, Hoeft, Andreas, additional, Neumann, Claudia, additional, Weber, Stefan, additional, Keilhauer, Julia, additional, Kloessing, Jan, additional, Schramm, Michael, additional, Trieschmann, Uwe, additional, Knauss, Kristina, additional, Sinner, Barbara, additional, Steinmann, Johannes, additional, Koessler, Herbert, additional, Kalliardou, Evagelia, additional, Malisiova, Anna, additional, Tsiotou, Adelais, additional, Chloropoulou, Pelagia, additional, Chrysi, Mpratzou, additional, Iordanidou, Despoina, additional, Ntavlis, Merkourios, additional, Boda, Krisztina B, additional, Guerin, Christilynn, additional, Irwin, Janice, additional, Magner, Claire, additional, Nakhjavani, Solmaz, additional, O'Hare, Brendan, additional, Galvin, Deborah, additional, Jamil, Yosry, additional, Lesmes, Carlos, additional, Barak, Yuri, additional, Fisher, Haran, additional, Kachko, Ludmyla, additional, Katz, Jacob, additional, Kirilov, Dmitry, additional, Levinzon, Michael, additional, Manevich, Yair, additional, Nekrasov, Konstantin, additional, Peled, Elia, additional, Sanko, Elena, additional, Schmain, Dmitri, additional, Sheinkin, Olga, additional, Simhi, Eliahu, additional, Tarabikin, Alex, additional, Trabkin, Evelina, additional, Yagudaev, Irena, additional, Zeitlin, Yelena, additional, Zunser, Igor, additional, Cerutti, Elisabetta, additional, Maddalena Schellino, Maria, additional, Valzan, Silvia, additional, Lucia Pinciroli, Rosa, additional, Bortone, Luciano, additional, Cerati, Giorgia, additional, Salici, Fabiana, additional, Bussolin, Leonardo, additional, Rizzo, Giuliana, additional, Rossetti, Francesca, additional, Marchesini, Laura, additional, Tesoro, Simonetta, additional, De Lorenzo, Brita, additional, Guarracino, Fabio, additional, Kuppers, Beate, additional, Astuto, Marinella, additional, Pitino, Sofia, additional, Scalisi, Rita, additional, Scordo, Lucia, additional, D'Alessandro, Sandra, additional, Dei Giudici, Luigi, additional, Farinelli, Ivano, additional, Lofino, Giuseppe, additional, Marchetti, Giuliano, additional, Giuseppe Picardo, Sergio, additional, Reali, Simone, additional, Vittori, Alessandro, additional, Antonio Idone, Francesco, additional, Sammartino, Maria, additional, Sbaraglia, Fabio, additional, Barbera, Cinzia, additional, Bevilacqua, Michela, additional, Cento, Valeria, additional, Kotzeva, Svetlana, additional, Mameli, Leila, additional, Montobbio, Giovanni, additional, Passariello, Leandro, additional, Punzo, Cinzia, additional, Sileo, Rosanna, additional, Viacava, Rosanna, additional, Volpe, Claudia, additional, Zanaboni, Clelia, additional, Calderini, Edoardo, additional, Genco, Daniele, additional, Neri, Simona, additional, Ottolina, Davide, additional, Camporesi, Anna, additional, Izzo, Francesca, additional, Salvo, Ida, additional, Wolfler, Andrea, additional, Sanna, Andrea, additional, Sciascia, Angela, additional, Stoia, Paolo, additional, Guddo, Annamaria, additional, Lapi, Maria, additional, Ivani, Giorgio, additional, Longobardo, Annalisa, additional, Mossetti, Valeria, additional, Pedrotti, Dino, additional, Grazzini, Maurizia, additional, Meneghini, Luisa, additional, Metrangolo, Salvatore, additional, Michelon, Stefania, additional, Minardi, Carmelo, additional, Tognon, Costanza, additional, Zadra, Nicola, additional, Busi, Ilaria, additional, Khotcholava, Magda, additional, Guido Locatelli, Bruno, 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Wlodzimierz, additional, Sawicki, Piotr, additional, Checinska, Magdalena, additional, Zurawska, Magdalena, additional, Leal, Teresa, additional, Mascarenhas, Catia, additional, Pedro Pina, António, additional, Joao Susano, Maria, additional, Moniz, Antonio, additional, Teresa Rocha, Maria, additional, Calvao Santos, Carolina, additional, Domingas Patuleia, M, additional, Pereira, Ricardo, additional, Roxo, Helena, additional, Amaral, Rosa, additional, Guedes, Isabel, additional, Gomes, Cristina, additional, Gonçalves, Marta, additional, Salgado, Helena, additional, Santos, Maria, additional, Rodrigues, Sara, additional, Sa, Angela, additional, Machado, Elvira, additional, Pé d'Arca, Sandra, additional, Seabra, Manuel, additional, Mihaela Gheorghe, Ligia, additional, Ivascu, Constantin, additional, Moraru-Draghici, Lucia, additional, Suvejan, Mirela, additional, Babici, Remus, additional, Eniko, Kovacs, additional, Hogea, Cristiana, additional, Mihaela, Dubau, additional, Nicoleta, Daraban, additional, Barbunc, Danut, additional, Maria Nistor, Alina, additional, Stefan, Violeta, additional, Catalina Ionescu, Gabriela, additional, Davidescu, Irina, additional, Teodora Nastase, Alina, additional, Dumitru Rusu, Florin, additional, Badarau, Victoria, additional, Cindea, Iulia, additional, Moscaliuc, Melania, additional, Olteanu, Dana, additional, Petrescu, Luxita, additional, Ceuca, Daniela, additional, Galinescu, Irena, additional, Badeti, Rodica, additional, Capusan, Alin, additional, Cucui-Cozma, Cosmina, additional, Popescu, Barbura, additional, Cimpeanu, Luminita, additional, Birliba, Mihaela-Petronela, additional, Miulescu, Magdalena, additional, Balamat, Stefania, additional, Gurita, Adriana, additional, Ilie, Luminita, additional, Mocioiu, Gabriel, additional, Pick, Darina, additional, Sirghie, Rodica, additional, Tabacaru, Radu, additional, Trante, Irinel, additional, Horhota, Lucian, additional, Bandrabur, Daniela, additional, Ciobanu, Tudor, additional, 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additional, Velcev, Ana, additional, Knezevic, Mirjana, additional, Milojevic, Irina, additional, Puric, Selena, additional, Simic, Irena, additional, Stevic, Marija, additional, Stranjanac, Vladimir, additional, Simic, Dusica, additional, Cabanova, Barbora, additional, Hanula, Miloslav, additional, Grynyuk, Andry, additional, Berger, Jelena, additional, Cerne, Uros, additional, Nastran, Andraz, additional, Pirc, Dejan, additional, Popic, Rok, additional, Stupnik, Spela, additional, Rubio, Paloma, additional, del Río, Cristina, additional, Benito, Pilar, additional, Pino, Gema, additional, Gutierrez, Ignacio, additional, Gutierrez Valcarcel, Andrea, additional, León Carsi, Irene, additional, Perez Garcia, Anibal, additional, López Galera, Sílvia, additional, Marco Valls, Joan, additional, Ricol Lainez, Laura, additional, Vallejo Tarrat, Andrea, additional, Artes, David, additional, Banus, Ester, additional, Chirichiello, Luca, additional, De Abreu, Leidy, additional, De Josemaria, Belen, additional, Helena Gaitan, M, additional, Garces, Antonio, additional, Lazaro, Juan J, additional, Manen Berga, Ferran, additional, Molies, Dolors, additional, Monclus, Enric, additional, Navaro, Montserrat, additional, Pamies, Carmen, additional, Perelló, Marina, additional, Prat, Mar, additional, Ribo, Laura, additional, Angeles Sanz, M, additional, Serrano, Silvia, additional, Sola Ruiz, Eva, additional, Anuncia Escontrela Rodríguez, Blanca, additional, Maria Gago Martinez, Andrea, additional, Martínez Ruiz, Alberto, additional, De La Cruz Benito, Fausto, additional, Gabilondo Garcia, Gustavo, additional, Martinez Maldonado, Ever, additional, Noriega, Bryant, additional, Oller Duque, Lara, additional, Olmos Mendez, Alberto, additional, Perez- Ferrer, Antonio, additional, Reinoso Barbero, Francisco, additional, Acevedo Bambaren, Ismael, additional, Domínguez, Fernando, additional, Franco, Teresa, additional, Jiménez, Anabel, additional, Melero, Alicia, additional, Feliu, Montserrat, additional, García, Irene, additional, Montferrer, Núria, additional, Munar, Francisca, additional, Muro, Cristina, additional, Nuño, Rosario, additional, Perera, Remel, additional, Schmucker, Erika, additional, Börjesson, Glenda, additional, Gillberg, Lars, additional, Castellheim, Albert, additional, Sandström, Kerstin, additional, Bauer, Annette, additional, Roos, Torbjörn, additional, Hedlund, Lars, additional, Boegli, Yann, additional, Dolci, Mirko, additional, Marcucci, Carine, additional, Spahr-Schopfer, Isabelle, additional, Habre, Walid, additional, Pellegrini, Michel, additional, Book, Malte, additional, Errass, Loreen, additional, Riggenbach, Christine, additional, Casutt, Mattias, additional, Hölzle, Martin, additional, Hurni, Thomas, additional, Mauch, Jacqueline, additional, Anselmi, Luciano, additional, Anselmi, Irene, additional, Jacomet, Alfred, additional, Oberhauser, Markus, additional, Wossner, Stephanie, additional, Zettl, Angelika, additional, Erb, Thomas, additional, Mackiewicz, Tomasz, additional, Simitzes, Helena, additional, Ozer, Yetkin, additional, Takil, Arzu, additional, Alanoglu, Zekeriyya, additional, Bermede, Onat, additional, Cakar Turhan, K.Sanem, additional, Alkis, Neslihan, additional, Yildirim Guclu, Cigdem, additional, Ceyda Meco, Basak, additional, Hatipoglu, Zehra, additional, Ozcengiz, Dilek, additional, Begec, Zekine, additional, Ilksen Toprak, Huseyin, additional, Kendigelen, Pinar, additional, Cigdem Tütüncü, Ayse, additional, Karadeniz, Meltem Savran, additional, Seyhan Ozkan, Tulay, additional, Sivrikoz, Nuket, additional, Kemal Arslantas, Mustafa, additional, Hizal, Ayse, additional, Tore Altun, Gülbin, additional, Umuroglu, Tumay, additional, Baris, Sibel, additional, Kazak Bengisun, Zuleyha, additional, Goncharenko, Galyna, additional, Khrapak, Maksym, additional, Klymenko, Tetyana, additional, Pavlenko, Vitaliy, additional, Prysiazhniuk, Dmytro, additional, Rudio, Olga, additional, Varyvoda, Mykhailo, additional, Vodianytskyi, Sergii, additional, Boryshkevych, Ivanna, additional, Kyselova, Iryna, additional, Trikash, Nikolay, additional, Albokrinov, Andrew, additional, Perova-Sharonova, Valentina, additional, Sklyar, Vitaliy, additional, Surkov, Denis, additional, Abdelaal, Amr, additional, Barber, Nicola, additional, Checuti, Sarah, additional, Godsiff, Leisha, additional, Johanne, Lynch, additional, Simpson, Joanna, additional, Underhill, Helen, additional, Diwan, Rishi, additional, Kelgeri, Nivedita, additional, Masip, Nuria, additional, Ravi, Radha, additional, Roberts, Steve, additional, Cillis, Annagrazia, additional, Marcus, Ritchie, additional, Merella, Federica, additional, Love, David, additional, Baraggia, Paolo, additional, Bird, Victoria, additional, Hussey, Joseph, additional, Alderson, Peter, additional, Bartholomew, Karen, additional, Moncreiff, Michael, additional, Davidson, Sarah, additional, Hare, Alison, additional, Kotecha, Ami, additional, Lee, Corina, additional, Liyanage, Ganga, additional, Patel, Shivali, additional, Samani, Amee, additional, Abou-Samra, Mark, additional, Boyd, Matthew, additional, Hullatt, Laurence, additional, Levy, David, additional, Pauling, Mark, additional, Sharman, Sarah-Jane, additional, Smith, Natalie, additional, Rutherford, John, additional, Cavalier, Alison, additional, Locke, Christie, additional, Sage, Frederic, additional, Bapat, Smita, additional, Hammerschlag, Jacinda, additional, Ioannou, Ioannis, additional, King, Stephanie, additional, Pegg, Rachel, additional, Salota, Vishal, additional, Sketcher, Jonathan, additional, Thadsad, Muthu, additional, Zeitlin, Deborah, additional, Jack, Ewan, additional, Lang, Colin, additional, Ahmed, Samira, additional, Ayyash, Reema, additional, Bari, Francoise, additional, Bell, Sarah J, additional, Elizabeth Biercamp, Claire, additional, Briggs, Sandra, additional, Gabriella Elena Clement, Maria, additional, Dalton, Mark, additional, Ali Eissa Eid, Mohamed, additional, Gandhi, Monica, additional, Harmen Herrema, Idse, additional, Khaffaf, Ranj, additional, Jeng Min Law, Savio, additional, McClintock, Joanna, additional, Ireland, Nicholas, additional, Majid Saleem, Mohammed, additional, Smith, Fiona, additional, Cohen, Marc, additional, Lee, Clover-Ann, additional, O'Donahue, Lizanne, additional, Powell, Alex, additional, Rawlinson, Ellen, additional, Snoek, Aarjan, additional, Weiss, Katja, additional, Wellesley, Hugo, additional, Crawford, Michael, additional, Abdel-Hafiz, Mostafa, additional, Day, Alexandra, additional, Rajamani, Balaji, additional, Saha, Rita, additional, Wright, Dave, additional, Chee, Lew-Chin, additional, Bew, Stephanie, additional, Homer, Rachel, additional, Malarkkan, Nalini, additional, Wolfe Barry, Juliet, additional, Angadi, Pradeep, additional, Cagney, Brid, additional, De Melo, Eric, additional, Dekker, Elsa, additional, Helm, Emma, additional, Jones, Gareth, additional, Peiris, Kawshala, additional, Russell, William, additional, Slater, Patricia, additional, Sodhi, Puja, additional, Browning, Mike, additional, Phillips, Trudie, additional, Van Hecke, Rachel, additional, Muir, Vimty, additional, Singh, Piyush, additional, Soskova, Tereza, additional, Cumming, Craig, additional, Farquharson, Pamela, additional, Pearson, Karen, additional, Shaw, Neil, additional, Whiteside, Jonathan, additional, Whyte, Emma, additional, Byers, Gordon, additional, Davies, Kay, additional, Engelhardt, Thomas, additional, Faliszewski, Isabella, additional, Johnston, Graham, additional, Kaufmann, Nils, additional, Kusnirikova, Zuzana, additional, Wilson, Graham, additional, Carachi, Peter, additional, Makin, Andrew, additional, Foster, Brian, additional, Lipczynski, Dariusz, additional, Mawer, Rebecca, additional, Rutherford, William, additional, Rogerson, David, additional, Rushman, Sarah, additional, Taylor, Christopher, additional, Tomlinson, William, additional, Dix, Philippa, additional, Woodward, Tom, additional, Bell, Graham, additional, Boyle, David, additional, Cloherty, Marianne, additional, Cullen, Julia, additional, Cullen, Pauline, additional, Fairgrieve, Ross, additional, Ghent, Robert, additional, Glasgow, Russell, additional, Gordeeva, Elena, additional, Harden, Alison, additional, Hivey, Sarah, additional, Jerome, Kevin, additional, McKee, Lesley, additional, Morton, Neil, additional, Pribul, Vicky, additional, Sinclair, John, additional, Steiner, Maria, additional, Steward, Heather, additional, Sweeney, Lorraine, additional, Thomson, Wendy, additional, Whiteside, Jeanette, additional, Dalton, Andrew, additional, Ross, Mark, additional, Smith, Carolyn, additional, Allen, Claire, additional, Anders, Nicola, additional, Barlow, Victoria, additional, Bassett, Mike, additional, Darwin, Leanne, additional, Davison, Rachel, additional, Diacono, Jacques, additional, Hobbs, Amy, additional, Hutchinson, Adel, additional, Lomas, Bernadette, additional, Lonsdale, Hannah, additional, Nasser, Leila, additional, Oshan, Vimmi, additional, Patel, Pradip, additional, Raistrick, Christopher, additional, Scott-Warren, Victoria, additional, Talbot, Laura, additional, Wai, Carolynn, additional, Childs, Sophie, additional, Dickinson, Matthew, additional, Bloomfield, Tom, additional, Garrioch, Sweyn, additional, Watson, Karen, additional, Gaynor, James, additional, Harrison, Richard, additional, Lee, Juliette, additional, Blythe, Elizabeth, additional, Dorman, Teresa, additional, Eissa, Ayman, additional, Ellwood, James, additional, Gooch, Ingrid, additional, Hearn, Robert, additional, Hodgetts, Vanessa, additional, John, Robert, additional, Kirton, Christine, additional, Ladak, Nadia, additional, Morgan, Judith, additional, Plant, Nina, additional, Shepherd, Elizabeth, additional, Short, Judith, additional, Stack, Charles, additional, Steel, Simon, additional, Taylor, Matthew, additional, Thomas, Deborah, additional, Wilson, Catharine, additional, Wilson-Smith, Elaine, additional, Bradbury, Carol L., additional, Hussain, Nageena, additional, Mayell, Antonia, additional, Mesbah, Ahmed, additional, Qureshi, Arif, additional, Vaidyanath, Chandra, additional, Geary, Tim, additional, Hawksworth, Chris, additional, Parasuraman, Tamaraichelvi, additional, Perry, Nicole, additional, Banerjee, Indrani, additional, Barr, Katharine, additional, Butler, Patrick, additional, Davies, Jack, additional, Flewin, Lisa, additional, Gande, Richard, additional, Montague, James, additional, Plumb, James, additional, Pratt, Thomas, additional, Sutherland, Paul, additional, Vail, Hannah, additional, Wilkins, Andrew, additional, Hunter, Catherine, additional, Russell, Susan, additional, Thomas, Alun, additional, Mifsud, Mark, additional, Strachan, Dominic, additional, Plichon, Benoit, additional, and Harlet, Pierre, additional

Published
2017
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7. Incidence of severe critical events in paediatric anaesthesia in Scandinavia: Secondary analysis of Anaesthesia PRactice In Children Observational Trial (APRICOT).

Author

Hansen, Tom G., Børke, Wenche Bakken, Isohanni, Mika H., Castellheim, Albert, and APRICOT Study Group of the European Society of Anaesthesiology Clinical Trial Network

Subjects
APRICOT, SECONDARY analysis, ANESTHESIA, MEDICATION errors, CHILDREN, PERIOPERATIVE care, RESEARCH, PEDIATRIC anesthesia, RESEARCH methodology, DISEASE incidence, EVALUATION research, COMPARATIVE studies, RESEARCH funding
Abstract

Background: The Anaesthesia PRactice In Children Observational Trial (APRICOT) in 261 European hospitals revealed a 5.2% incidence of severe critical events in the perioperative period and wide variability in practice.Methods: A sub-analysis of the Scandinavian data was undertaken to investigate differences from the rest of Europe in the incidence and nature of perioperative severe critical events and to attempt to identify areas for quality improvement.Findings: In the Scandinavian cohorts of 1520 paediatric patients out of 31 127 patients, the overall incidence of perioperative severe critical events was lower than the rest of Europe (4.4% (95% CI [3.5-5.6]) vs 5.2% (95% CI [5.0-5.5]); RR 0.57), albeit the incidence varied across countries. There was a lower rate of bronchospasm (0.9%), stridor (1.1%) and cardiovascular instability (0.9%) than the rest of Europe. The proportion of bronchospasm events occurring at induction was 0.13% in Scandinavian cohort which was less than the rest of Europe (1.2%). The proportion of sicker patients where less experienced teams were managing the care was notably lower in Scandinavia than in the rest of Europe (14.4% vs 20.4% of the American Society of Anesthesiologists Physical Status Classification System Score (ASA-PS III and 8.3% vs 12.8% of the ASA-PS IV. Cardiovascular instability was lower in Scandinavia (0.92%) compared to Europe (1.9%). The incidence of drug errors was low in both the overall APRICOT (0.2%) and in Scandinavia (0.3%). There were no deaths.Interpretation: This sub-analysis shows that current Scandinavia paediatric perioperative clinical practice compares favourably with the rest of Europe. The lower incidence of cardiovascular and respiratory complications could be partly attributed to more experienced dedicated paediatric anaesthesia providers managing the higher risk groups of patients in Scandinavia. Whether this cohort of anaesthetized children is truly representative of the entire Scandinavia countries is unknown. Areas for quality improvement include: standardisation of the definition of severe critical events, increased reporting, development of evidence-based protocols for the management of severe critical events, development and rational implementation of paediatric perioperative risk assessment scores, implementation of current best practice in the provision of competent paediatric anaesthesia service in Europe, development of specific training and ensuring maintenance skills in paediatric anaesthesia. Furthermore, based on data from the original Apricot paper children under the age of 3 years and ASA-PS III and IV patients should not be anaesthetised without direct supervision of a specialist in paediatric anaesthesia. Given the sample size of the Scandinavian cohort this conclusion cannot be investigated further. [ABSTRACT FROM AUTHOR]

Published
2019
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8. Cytochrome P450-mediated drug interactions affecting lidocaine

Author

Isohanni, Mika, University of Helsinki, Faculty of Medicine, Institute of Clinical Medicine, Department of Clinical Pharmacology, Department of Anaesthesiology and Intensive Care Medicine, Helsingin yliopisto, lääketieteellinen tiedekunta, kliininen laitos, Helsingfors universitet, medicinska fakulteten, institutionen för klinisk medicin, and Kokki, Hannu

Subjects
lääketiede
Abstract

Lidocaine is a widely used local anaesthetic agent that also has anti-arrhythmic effects. It is classified as a type Ib anti-arrhythmic agent and is used to treat ventricular tachycardia or ventricular fibrillation. Lidocaine is eliminated mainly by metabolism, and less than 5% is excreted unchanged in urine. Lidocaine is a drug with a medium to high extraction ratio, and its bioavailability is about 30%. Based on in vitro studies, the earlier understanding was that CYP3A4 is the major cytochrome P450 (CYP) enzyme involved in the metabolism of lidocaine. When this work was initiated, there was little human data on the effect of inhibitors of CYP enzymes on the pharmacokinetics of lidocaine. Because lidocaine has a low therapeutic index, medications that significantly inhibit lidocaine clearance (CL) could increase the risk of toxicity. These studies investigated the effects of some clinically important CYP1A2 and CYP3A4 inhibitors on the pharmacokinetics of lidocaine administered by different routes. All of the studies were randomized, double-blind, placebo-controlled cross-over studies in two or three phases in healthy volunteers. Pretreatment with clinically relevant doses of CYP3A4 inhibitors erythromycin and itraconazole or CYP1A2 inhibitors fluvoxamine and ciprofloxacin was followed by a single dose of lidocaine. Blood samples were collected to determine the pharmacokinetic parameters of lidocaine and its main metabolites monoethylglycinexylidide (MEGX) and 3-hydroxylidocaine (3-OH-lidocaine). Itraconazole and erythromycin had virtually no effect on the pharmacokinetics of intravenous lidocaine, but erythromycin slightly prolonged the elimination half-life (t½) of lidocaine (Study I). When lidocaine was taken orally, both erythromycin and itraconazole increased the peak concentration (Cmax) and the area under the concentration-time curve (AUC) of lidocaine by 40-70% (Study II). Compared with placebo and itraconazole, erythromycin increased the Cmax and the AUC of MEGX by 40-70% when lidocaine was given intravenously or orally (Studies I and II). The pharmacokinetics of inhaled lidocaine was unaffected by concomitant administration of itraconazole (Study III). Fluvoxamine reduced the CL of intravenous lidocaine by 41% and prolonged the t½ of lidocaine by 35%. The mean AUC of lidocaine increased 1.7-fold (Study IV). After oral administration of lidocaine, the mean AUC of lidocaine in-creased 3-fold and the Cmax 2.2-fold by fluvoxamine (Study V). During the pretreatment with fluvoxamine combined with erythromycin, the CL of intravenous lidocaine was 53% smaller than during placebo and 21% smaller than during fluvoxamine alone. The t½ of lidocaine was significantly longer during the combination phase than during the placebo or fluvoxamine phase. The mean AUC of intravenous lidocaine increased 2.3-fold and the Cmax 1.4-fold (Study IV). After oral administration of lidocaine, the mean AUC of lidocaine increased 3.6-fold and the Cmax 2.5-fold by concomitant fluvoxamine and erythromycin. The t½ of oral lidocaine was significantly longer during the combination phase than during the placebo (Study V). When lidocaine was given intravenously, the combination of fluvoxamine and erythromycin prolonged the t½ of MEGX by 59% (Study IV). Compared with placebo, ciprofloxacin increased the mean Cmax and AUC of intravenous lidocaine by 12% and 26%, respectively. The mean plasma CL of lidocaine was reduced by 22% and its t½ prolonged by 7% (Study VI). These studies clarify the principal role of CYP1A2 and suggest only a modest role of CYP3A4 in the elimination of lidocaine in vivo. The inhibition of CYP1A2 by fluvoxamine considerably reduces the elimination of lidocaine. Concomitant use of fluvoxamine and the CYP3A4 inhibitor erythromycin further increases lidocaine concentrations. The clinical implication of this work is that clinicians should be aware of the potentially increased toxicity of lidocaine when used together with inhibitors of CYP1A2 and particularly with the combination of drugs inhibiting both CYP1A2 and CYP3A4 enzymes. Lidokaiini on laajasti käytetty puudutusaine, jota käytetään myös suonensisäisesti kammioperäisten rytmihäiriöiden hoidossa. Lidokaiini poistuu elimistöstä pääasiassa hajoamalla (metaboloitumalla) sytokromi P450 (CYP) entsyymien välityksellä. Useat lääkkeet voivat estää (inhiboida) näiden entsyymien kautta tapahtuvaa lääkeainemetaboliaa nostaen siten muiden lääkeaineiden pitoisuuksia ja mahdollisesti lisäten niiden tehoa ja myös haittavaikutuksia. Ennen tätä väitöstutkimusta lidokaiinin yhteisvaikutuksista oli vain vähän julkaistua tutkimustietoa. Tässä työssä tutkimme lidokaiinin yhteisvaikutuksia terveillä vapaaehtoisilla koehenkilöillä käyttäen vaihtovuoroista koeasetelmaa. Koehenkilöille annettiin CYP1A2- ja/tai CYP3A4-entsyymiä estävää lääkitystä muutaman päivän ajan ja tämän jälkeen kerta-annos lidokaiinia joko suonensisäisesti, suun kautta tai hengittäen. Koehenkilöiltä otettiin useita verinäytteitä, joista määritettiin lääkeainepitoisuudet. CYP3A4-estäjillä itrakonatsolilla ja erytromysiinillä ei ollut juurikaan vaikutusta suonensisäisesti annetun lidokaiinin pitoisuuksiin. Kun lidokaiinia annettiin suun kautta, nostivat nämä CYP3A4-estäjät lidokaiinin pitoisuuksia 40-70%. Itrakonatsolilla ei ollut vaikutusta hengitetyn lidokaiinin pitoisuuksiin. Voimakas CYP1A2- ja heikompi CYP3A4- estäjä fluvoksamiini pienensi suonensisäisesti annetun lidokaiinin puhdistumaa n. 40% ja nosti sen pitoisuuksia n. 70%. Fluvoksamiinin ja erytromysiinin yhdistelmän vaikutus oli vielä suurempi, lidokaiinin puhdistuma pieneni puoleen ja pitoisuudet yli kaksinkertaistuivat. Kun lidokaiinia annettiin suun kautta, nosti fluvoksamiini lidokaiinin pitoisuuksia 120-200%. Fluvoksamiinin ja erytromysiinin yhdistelmä nosti lidokaiinin pitoisuuksia 150-260%. Vain CYP1A2:ta estävä siprofloksasiini pienensi suonensisäisesti annetun lidokaiinin puhdistumaa n. 20% ja vaikutus lidokaiinin pitoisuuksiin oli vain kohtalainen. Tulokset viittaavat siihen, että aiemmasta käsityksestä poiketen lidokaiinin metaboliassa CYP3A4:n merkitys on vähäisempi kuin CYP1A2:n. Mahdollisuus käytännön lääkehoidon kannalta merkittäviin yhteisvaikutuksiin tulee ottaa huomioon annettaessa lidokaiinia potilaille, jotka käyttävät samanaikaisesti CYP1A2:n inhibiittoreita, ja erityisesti, kun lidokaiinia käytetään suun ja nielun limakalvoilla. Kliinisesti merkittävien yhteisvaikutusten todennäköisyys lisääntyy entisestään, mikäli potilaat käyttävät lidokaiinin kanssa samanaikaisesti sekä CYP1A2:ta että CYP3A4:ää estäviä lääkeaineita.

Published
2009

9. Cytochrome P450-mediated drug interactions affecting lidocaine

Author

Helsingin yliopisto, lääketieteellinen tiedekunta, kliininen laitos, Helsingfors universitet, medicinska fakulteten, institutionen för klinisk medicin, University of Helsinki, Faculty of Medicine, Institute of Clinical Medicine, Department of Clinical Pharmacology, Department of Anaesthesiology and Intensive Care Medicine, Isohanni, Mika, Helsingin yliopisto, lääketieteellinen tiedekunta, kliininen laitos, Helsingfors universitet, medicinska fakulteten, institutionen för klinisk medicin, University of Helsinki, Faculty of Medicine, Institute of Clinical Medicine, Department of Clinical Pharmacology, Department of Anaesthesiology and Intensive Care Medicine, and Isohanni, Mika

Abstract

Lidocaine is a widely used local anaesthetic agent that also has anti-arrhythmic effects. It is classified as a type Ib anti-arrhythmic agent and is used to treat ventricular tachycardia or ventricular fibrillation. Lidocaine is eliminated mainly by metabolism, and less than 5% is excreted unchanged in urine. Lidocaine is a drug with a medium to high extraction ratio, and its bioavailability is about 30%. Based on in vitro studies, the earlier understanding was that CYP3A4 is the major cytochrome P450 (CYP) enzyme involved in the metabolism of lidocaine. When this work was initiated, there was little human data on the effect of inhibitors of CYP enzymes on the pharmacokinetics of lidocaine. Because lidocaine has a low therapeutic index, medications that significantly inhibit lidocaine clearance (CL) could increase the risk of toxicity. These studies investigated the effects of some clinically important CYP1A2 and CYP3A4 inhibitors on the pharmacokinetics of lidocaine administered by different routes. All of the studies were randomized, double-blind, placebo-controlled cross-over studies in two or three phases in healthy volunteers. Pretreatment with clinically relevant doses of CYP3A4 inhibitors erythromycin and itraconazole or CYP1A2 inhibitors fluvoxamine and ciprofloxacin was followed by a single dose of lidocaine. Blood samples were collected to determine the pharmacokinetic parameters of lidocaine and its main metabolites monoethylglycinexylidide (MEGX) and 3-hydroxylidocaine (3-OH-lidocaine). Itraconazole and erythromycin had virtually no effect on the pharmacokinetics of intravenous lidocaine, but erythromycin slightly prolonged the elimination half-life (t½) of lidocaine (Study I). When lidocaine was taken orally, both erythromycin and itraconazole increased the peak concentration (Cmax) and the area under the concentration-time curve (AUC) of lidocaine by 40-70% (Study II). Compared with placebo and itraconazole, erythromycin increased the Cmax and the AUC, Lidokaiini on laajasti käytetty puudutusaine, jota käytetään myös suonensisäisesti kammioperäisten rytmihäiriöiden hoidossa. Lidokaiini poistuu elimistöstä pääasiassa hajoamalla (metaboloitumalla) sytokromi P450 (CYP) entsyymien välityksellä. Useat lääkkeet voivat estää (inhiboida) näiden entsyymien kautta tapahtuvaa lääkeainemetaboliaa nostaen siten muiden lääkeaineiden pitoisuuksia ja mahdollisesti lisäten niiden tehoa ja myös haittavaikutuksia. Ennen tätä väitöstutkimusta lidokaiinin yhteisvaikutuksista oli vain vähän julkaistua tutkimustietoa. Tässä työssä tutkimme lidokaiinin yhteisvaikutuksia terveillä vapaaehtoisilla koehenkilöillä käyttäen vaihtovuoroista koeasetelmaa. Koehenkilöille annettiin CYP1A2- ja/tai CYP3A4-entsyymiä estävää lääkitystä muutaman päivän ajan ja tämän jälkeen kerta-annos lidokaiinia joko suonensisäisesti, suun kautta tai hengittäen. Koehenkilöiltä otettiin useita verinäytteitä, joista määritettiin lääkeainepitoisuudet. CYP3A4-estäjillä itrakonatsolilla ja erytromysiinillä ei ollut juurikaan vaikutusta suonensisäisesti annetun lidokaiinin pitoisuuksiin. Kun lidokaiinia annettiin suun kautta, nostivat nämä CYP3A4-estäjät lidokaiinin pitoisuuksia 40-70%. Itrakonatsolilla ei ollut vaikutusta hengitetyn lidokaiinin pitoisuuksiin. Voimakas CYP1A2- ja heikompi CYP3A4- estäjä fluvoksamiini pienensi suonensisäisesti annetun lidokaiinin puhdistumaa n. 40% ja nosti sen pitoisuuksia n. 70%. Fluvoksamiinin ja erytromysiinin yhdistelmän vaikutus oli vielä suurempi, lidokaiinin puhdistuma pieneni puoleen ja pitoisuudet yli kaksinkertaistuivat. Kun lidokaiinia annettiin suun kautta, nosti fluvoksamiini lidokaiinin pitoisuuksia 120-200%. Fluvoksamiinin ja erytromysiinin yhdistelmä nosti lidokaiinin pitoisuuksia 150-260%. Vain CYP1A2:ta estävä siprofloksasiini pienensi suonensisäisesti annetun lidokaiinin puhdistumaa n. 20% ja vaikutus lidokaiinin pitoisuuksiin oli vain kohtalainen. Tulokset viittaavat siihen, että aiemmasta käsityksestä poiketen lidokai

Published
2009

12. Incidence of severe critical events in paediatric anaesthesia (APRICOT): a prospective multicentre observational study in 261 hospitals in Europe

Author

Walid Habre, Nicola Disma, Katalin Virag, Karin Becke, Tom G Hansen, Martin Jöhr, Brigitte Leva, Neil S Morton, Petronella M Vermeulen, Marzena Zielinska, Krisztina Boda, Francis Veyckemans, Walter Klimscha, Regina Konecny, Robert Luntzer, Ulrike Morawk-Wintersperger, Franz Neiger, Lydia Rustemeyer, Christian Breschan, Denise Frey, Manuela Platzer, Reinhard Germann, Joachim Oeding, Birgit Stoegermüller, Bernhard Ziegler, Philipp Brotatsch, Anton Gutmann, Gerlinde Mausser, Brigitte Messerer, Wolfgang Toller, Maria Vittinghoff, Gregor Zangl, Natascha Seidel-Ahyai, Christoph Hochhold, Ruth Kroess, Peter Paal, Steven Cnudde, Patricia Coucke, Birgit Loveniers, John Mitchell, David Kahn, Thierry Pirotte, Caroline Pregardien, Marc Coppens, Stefan De Hert, Björn Heyse, Martine Neckebroek, Aliaksandra Parashchanka, Jurgen Van Limmen, Nancy Van Den Eynde, Caroline Vanpeteghem, Piet Wyffels, Michaël Lalot, Jean-Paul Lechat, France Stevens, Sari Casaer, Françoise De Groote, Françoise De Pooter, Andrée De Villé, Marc Gerin, Natalia Magasich, Cristel Sanchez Torres, Denise Van Deenen, Johan Berghmans, Dirk Himpe, Eva Roofthooft, Ellen Joukes, Carine Smitz, Veronique Van Reeth, Christel Huygens, Julie Lauweryns, Karen De Smet, Nadia Najafi, Jan Poelaert, Anne Van de Velde, Veerle Van Mossevelde, Ivan Bekavac, Diana Butkovic, Dubravka Heli Litvic, Ivana Kerovec Soric, Hrvoje Maretic, Djurdjica Moscatello, Ljiljana Popovic, Slobodan Micici, Ivana Stuck Tus, Lada Kalagac Fabris, Tatjana Simurina, Nina Sulen, Gordana Kesic-Valpotic, Dajana Djapic, Jirí Žurek, Lucie Jureckova, Iveta Mackova, Monika Skacel, Stanislava Weinlichova, Jan Divák, Michal Frelich, René Urbanec, Vera Biskupova, Vladimir Mixa, Jana Pavlickova, Arash Afshari, Morten Bøttger, Marguerite B. Ellekvist, Mathias Johansen, Birgitte Ingeborg Madsen, Jens Christian Nilsson, Birgitte MB Schousboe, Nicola G. Clausen, Tom G. Hansen, Nick Phaff Steen, Mari-Liis Ilmoja, Virge Tonise, Juri Karjagin, Reet Kikas, Mika Isohanni, Anniina Lyly, Annika Takala, Johanna Happo, Kai Kiviluoma, Kati Martikainen, Riku Aantaa, Tuula Manner, Sanna Vilo, Catherine Amory, Hugues Ludot, Patricia Lambotte, René Busche, Olivier Jacqmarcq, Corinne Lejus, Julien Corouge, Christian Erb, Delphine Garrigue, Patricia Gillet, Anne Laffargue, Veronique Lambelin, Hélène Le Freche, Daliana Peresbota, Pierre Richart, Jerome Berton, Catherine Chapotte, Laurent Colbus, Thierry Lehousse, Jean Monrigal, Catherine Baujard, Philippe Roulleau, Giuseppe Staiti, Hélène Batoz, Maryline Bordes, Anne Didier, Yann Hamonic, Sylvaine Lagarde, Karine Nouette-Gaulain, François Semjen, Brigitte Zaghet, Jacky Dekens, Axelle Delcuze, Hervé Dupont, Aurélien Legrand, Celine Raffoflandreur, Noémie Audren, Blandine Camus, Marielle Cartal, Chantal Chazelet, Isabelle Davin, Marion Guillier, Luc Desjeux, Claire Larcher, Elodie Grein, Mickeal Leclercq, Roxana Levitchi, Lilica Rosu, Dominique Simon, Aurélien Zang, Anne Migeon, Anne-Charlotte Gagey, Nathalie Bourdaud, Anne-Charlotte Carre, Frédéric Duflo, Jean-Claude Riche, Philippe Robert, Emilie Druot, Olivier Maupain, Gilles Orliaguet, Lucie Sabau, Hanna Taright, Lynn Uhrig, Juliette Verchere-Montmayeur, Lise Debrabant, Clotaire Pilla, Alexandre Podvin, Benjamin Roth, Souhayl Dahmani, Florence Julien-Marsollier, Nada Sabourdin, Bogdan Alexandri, Gilles Brezac, Francois de la Brière, Catherine Hayem, Elizabeth Lhubat, Jean Paul Mission, Charlotte Rémond, Christophe Dadure, Maud Maniora, Anais Marie, Philippe Pirat, Anne-Charlotte Saour, Chrystelle Sola, Claude Ecoffey, Eric Wodey, Christian Adam, Thomas Standl, Ehrenfried Schindler, Tomohiro Yamamoto, Michael Brackhahn, Christoph Bernhard Eich, Holger Guericke, Petra Kindermann, Michael Laschat, Cornel Schink, Frank Wappler, Claudia Hoehne, Natalia Skordou, Johanna Ulrici, Martin Jetzek-Zader, Peter Kienbaum, Tanja Meyer-Treschan, Olaf Picker, Maximilian S. Schaefer, Golo Mielke, Sabine Baethge, Axel Ramminger, Martin Bauer, Matthias Bollinger, José Hinz, Michael Quintel, Sebastian G. Russo, Michael Bauer, Dfominik Geil, Andreas Kortgen, Niels-Peter Preussler, Ulrich Hofmann, Manfred Raber, Doris Reindl, Karin Oppenrieder, Bettina Schierlinger, Jens Roth, Wolfgang Funk, Thomas Fischer, Christian Gernoth, Christina Wiefelspütz, Hauke Volger, Nicole Zederer, Anja Diers, Matthias Huber, Clemens Schorer, Andreas Weyland, Konrad Schwarzkopf, Catharina Grau, Winfried Roth, Rolf Holy, Thomas Mader, Laura Peter, Hauke Supthut, Thomas Kuehhirt, Alexander Milde, Fritz Fiedler, Carsten Isselhorst, Ulrich Grundmann, Alexander Pattar, Jennifer Reinert, Birgit Ehm, Katrin Fritzsche, Ralf Gaebler, Patrick Meybohm, Maximilian Hein, Ines Guzman, Johanna Jokinen, Peter Kranke, Ulrich Goebel, Sarah Harris, Christoph Eisner, Miriam Ochsenreiter, Michael Schoeler, Elke Thil, Richard Ellerkmann, Andreas Hoeft, Claudia Neumann, Stefan Weber, Julia Keilhauer, Jan Kloessing, Michael Schramm, Uwe Trieschmann, Kristina Knauss, Barbara Sinner, Johannes Steinmann, Herbert Koessler, Evagelia Kalliardou, Anna Malisiova, Adelais Tsiotou, Pelagia Chloropoulou, Mpratzou Chrysi, Despoina Iordanidou, Merkourios Ntavlis, Krisztina B Boda, Christilynn Guerin, Janice Irwin, Claire Magner, Solmaz Nakhjavani, Brendan O'Hare, Deborah Galvin, Yosry Jamil, Carlos Lesmes, Yuri Barak, Haran Fisher, Ludmyla Kachko, Jacob Katz, Dmitry Kirilov, Michael Levinzon, Yair Manevich, Konstantin Nekrasov, Elia Peled, Elena Sanko, Dmitri Schmain, Olga Sheinkin, Eliahu Simhi, Alex Tarabikin, Evelina Trabkin, Irena Yagudaev, Yelena Zeitlin, Igor Zunser, Elisabetta Cerutti, Maria Maddalena Schellino, Silvia Valzan, Rosa Lucia Pinciroli, Luciano Bortone, Giorgia Cerati, Fabiana Salici, Leonardo Bussolin, Giuliana Rizzo, Francesca Rossetti, Laura Marchesini, Simonetta Tesoro, Brita De Lorenzo, Fabio Guarracino, Beate Kuppers, Marinella Astuto, Sofia Pitino, Rita Scalisi, Lucia Scordo, Sandra D'Alessandro, Luigi Dei Giudici, Ivano Farinelli, Giuseppe Lofino, Giuliano Marchetti, Sergio Giuseppe Picardo, Simone Reali, Alessandro Vittori, Francesco Antonio Idone, Maria Sammartino, Fabio Sbaraglia, Cinzia Barbera, Michela Bevilacqua, Valeria Cento, Svetlana Kotzeva, Leila Mameli, Giovanni Montobbio, Leandro Passariello, Cinzia Punzo, Rosanna Sileo, Rosanna Viacava, Claudia Volpe, Clelia Zanaboni, Edoardo Calderini, Daniele Genco, Simona Neri, Davide Ottolina, Anna Camporesi, Francesca Izzo, Ida Salvo, Andrea Wolfler, Andrea Sanna, Angela Sciascia, Paolo Stoia, Annamaria Guddo, Maria Lapi, Giorgio Ivani, Annalisa Longobardo, Valeria Mossetti, Dino Pedrotti, Maurizia Grazzini, Luisa Meneghini, Salvatore Metrangolo, Stefania Michelon, Carmelo Minardi, Costanza Tognon, Nicola Zadra, Ilaria Busi, Magda Khotcholava, Bruno Guido Locatelli, Valter Sonzogni, Giusi Starita, Nicole Almenrader, Caterina Aurilio, Pasquale Sansone, Raffaella Albarello, Paolo Bracci, Mariateresa Cecini, Maria Cristina Mondardini, Lorena Pasini, Milo Vason, Gianluca Zani, Roberto Zoppellari, Laura Pistidda, Andrea Cortegiani, Santi Maurizio Raineri, Antigona Hasani, Medita Hashimi, Agris Ancupans, Arta Barzdina, Zane Straume, Anda Zundane, Mikhail Chlopin, Dalia Gestautaite, Laura Lukosiene, Evelina Paliokaite, Ilona Razlevice, Inesa Armoniene, Aurelija Bernotiene, Vidunas Daugelavicius, Ilona Dockiene, Lina Gaidelyte, Nijole Saviciene, Jolita Krikstaponiene, Dominika Sidlovskaite-Baltake, Vladyslav Stasevski, Agne Vaitoskaite, David Gatt, Stephanie Mifsud, Simone Zammit, Celia Allison, Hamid Aslami, Susanne Eberl, Mireille F M van Stijn, Markus F Stevens, Kees Punt, Rob van Osch, Arthur Bauwman, Harm Scholten, Vesna Svircevic, Veronique Adriaens, Maaike Dirckx, Jaap Dogger, Ilse Dons-Sinke, Andreas Machotta, Xavier Moors, Mandana Rad, Lonneke Staals, Anouk van der Knijff - van Dortmont, Caroline van der Marel, Anne Sieben, Tim van der Zwan, Marianne Veldhuizen, David Alders, Wolfgang Buhre, Nicole Engel, Carine Vossen, Ravin Mahadewsing, Patrick Meijer, Volker Gerling, Roelof van der Schatte Olivier, Thea van Doorn, Kristy Vons Mark Hendriks, Sandra Lako, Gert jan Scheffer, Luc Tielens, Marieke Voet, Anthony Absalom, Margot Bergsma, Vera Spanjer, Rob Spanjersberg, Yvette van de Riet, Martin Volkers, Jurgen C. de Graaff, Geranne A.J. Hopman, Teus H. Kappen, J. Hannie, A.M. Megens, Sandra C. Numan, Anton N.J. Schouten, Nigel M. Turner, Désirée B.M. Van Der Werff, Renee T.M. Wensing, Erik Ephraim, Claire Nolte, Tore Reikvam, Ole Fredrik Lund, Lene Skaaden, Kari Marthe Ballovarre, Wenche Bakken Boerke, Guro Grindheim, Pal H H Lindenskov, Anne Beate Solas, Sjur Sponheim, Kyrre Ullensvang, Oddbjorn Viken, Inger Marie Drage, Kasper Gymoese Berthelsen, Bjørn Anders Kroken, Unni Bergland, Miroslaw Pryzmont, Mariola Talalaj, Malgorzata Wasiluk, Dorota Zalewska, Maria Damps, Jadzia Siemek-Mitela, Pawel Wieczorek, Magdalena Juzwa, Jowita Rosada-Kurasinska, Alicja Bartkowska-Sniatkowska, Maciej Cettler, Renata Kopycinska, Iwona Rudewicz, Jaek Sobczyk, Dariusz Wojciechowski, Artur Baranowski, Ewa Basiewicz, Magdalena Mierzewska-Schmidt, Wlodzimierz Retka, Piotr Sawicki, Magdalena Checinska, Magdalena Zurawska, Teresa Leal, Catia Mascarenhas, António Pedro Pina, Maria Joao Susano, Antonio Moniz, Maria Teresa Rocha, Carolina Calvao Santos, M Domingas Patuleia, Ricardo Pereira, Helena Roxo, Rosa Amaral, Isabel Guedes, Cristina Gomes, Marta Gonçalves, Helena Salgado, Maria Santos, Sara Rodrigues, Angela Sa, Elvira Machado, Sandra Pé d'Arca, Manuel Seabra, Ligia Mihaela Gheorghe, Constantin Ivascu, Lucia Moraru-Draghici, Mirela Suvejan, Remus Babici, Kovacs Eniko, Cristiana Hogea, Dubau Mihaela, Daraban Nicoleta, Danut Barbunc, Alina Maria Nistor, Violeta Stefan, Gabriela Catalina Ionescu, Irina Davidescu, Alina Teodora Nastase, Florin Dumitru Rusu, Victoria Badarau, Iulia Cindea, Melania Moscaliuc, Dana Olteanu, Luxita Petrescu, Daniela Ceuca, Irena Galinescu, Rodica Badeti, Alin Capusan, Cosmina Cucui-Cozma, Barbura Popescu, Luminita Cimpeanu, Mihaela-Petronela Birliba, Magdalena Miulescu, Stefania Balamat, Adriana Gurita, Luminita Ilie, Gabriel Mocioiu, Darina Pick, Rodica Sirghie, Radu Tabacaru, Irinel Trante, Lucian Horhota, Daniela Bandrabur, Tudor Ciobanu, Veaceslav Cuciuc, Valentin Munteanu, Valentin Olaru, Corneliu Paiu, Anca Savu, Oana Trifan, Anca Elena Malos, Anton Glazunov, Alexander Ivanov, Evgeny Poduskov, Alexander Popov, Igor Guskov, Alexander Lugovoy, Vladislav Nechaev, Alexey Ovezov, Mikhail Basov, Vladimir Kochkin, Vladimir Lazarev, Dmitri Chizhov, Ivan Ostreikov, Konstantin Tolasov, Ivana Budic, Vesna Marjanovic, Biljana Draskovic, Marina Pandurov, Jovana Simin, Vladimir Dolinaj, Dusanka Janjevic, Ana Mandras, Maja Mircetic, Sladjana Petrovic, Vlatka Rebac, Bojana Slavkovic, Vesna Stevanovic, Ana Velcev, Mirjana Knezevic, Irina Milojevic, Selena Puric, Irena Simic, Marija Stevic, Vladimir Stranjanac, Dusica Simic, Barbora Cabanova, Miloslav Hanula, Andry Grynyuk, Jelena Berger, Uros Cerne, Andraz Nastran, Dejan Pirc, Rok Popic, Spela Stupnik, Paloma Rubio, Cristina del Río, Pilar Benito, Gema Pino, Ignacio Gutierrez, Andrea Gutierrez Valcarcel, Irene León Carsi, Anibal Perez Garcia, Sílvia López Galera, Joan Marco Valls, Laura Ricol Lainez, Andrea Vallejo Tarrat, David Artes, Ester Banus, Luca Chirichiello, Leidy De Abreu, Belen De Josemaria, M Helena Gaitan, Antonio Garces, Juan J Lazaro, Ferran Manen Berga, Dolors Molies, Enric Monclus, Montserrat Navaro, Carmen Pamies, Marina Perelló, Mar Prat, Laura Ribo, M Angeles Sanz, Silvia Serrano, Eva Sola Ruiz, Blanca Anuncia Escontrela Rodríguez, Andrea Maria Gago Martinez, Alberto Martínez Ruiz, Fausto De La Cruz Benito, Gustavo Gabilondo Garcia, Ever Martinez Maldonado, Bryant Noriega, Lara Oller Duque, Alberto Olmos Mendez, Antonio Perez- Ferrer, Francisco Reinoso Barbero, Ismael Acevedo Bambaren, Fernando Domínguez, Teresa Franco, Anabel Jiménez, Alicia Melero, Montserrat Feliu, Irene García, Núria Montferrer, Francisca Munar, Cristina Muro, Rosario Nuño, Remel Perera, Erika Schmucker, Glenda Börjesson, Lars Gillberg, Albert Castellheim, Kerstin Sandström, Annette Bauer, Torbjörn Roos, Lars Hedlund, Yann Boegli, Mirko Dolci, Carine Marcucci, Isabelle Spahr-Schopfer, Michel Pellegrini, Malte Book, Loreen Errass, Christine Riggenbach, Mattias Casutt, Martin Hölzle, Thomas Hurni, Jacqueline Mauch, Luciano Anselmi, Irene Anselmi, Alfred Jacomet, Markus Oberhauser, Stephanie Wossner, Angelika Zettl, Thomas Erb, Tomasz Mackiewicz, Helena Simitzes, Yetkin Ozer, Arzu Takil, Zekeriyya Alanoglu, Onat Bermede, K.Sanem Cakar Turhan, Neslihan Alkis, Cigdem Yildirim Guclu, Basak Ceyda Meco, Zehra Hatipoglu, Dilek Ozcengiz, Zekine Begec, Huseyin Ilksen Toprak, Pinar Kendigelen, Ayse Cigdem Tütüncü, Meltem Savran Karadeniz, Tulay Seyhan Ozkan, Nuket Sivrikoz, Mustafa Kemal Arslantas, Ayse Hizal, Gülbin Tore Altun, Tumay Umuroglu, Sibel Baris, Zuleyha Kazak Bengisun, Galyna Goncharenko, Maksym Khrapak, Tetyana Klymenko, Vitaliy Pavlenko, Dmytro Prysiazhniuk, Olga Rudio, Mykhailo Varyvoda, Sergii Vodianytskyi, Ivanna Boryshkevych, Iryna Kyselova, Nikolay Trikash, Andrew Albokrinov, Valentina Perova-Sharonova, Vitaliy Sklyar, Denis Surkov, Amr Abdelaal, Nicola Barber, Sarah Checuti, Leisha Godsiff, Lynch Johanne, Joanna Simpson, Helen Underhill, Rishi Diwan, Nivedita Kelgeri, Nuria Masip, Radha Ravi, Steve Roberts, Annagrazia 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van Dortmont, Anouk, Hopman, Geranne A.J., Megens, A.M., Schouten, Anton N.J., Van Der Werff, Désirée B.M., Wensing, Renee T.M., Lindenskov, Pal H H, Siemek-Mitela, Jadzia, Rosada-Kurasinska, Jowita, Bartkowska-Sniatkowska, Alicja, Mierzewska-Schmidt, Magdalena, Moraru-Draghici, Lucia, Cucui-Cozma, Cosmina, Birliba, Mihaela-Petronela, Perez- Ferrer, Antonio, Spahr-Schopfer, Isabelle, Cakar Turhan, K.Sanem, Perova-Sharonova, Valentina, Abou-Samra, Mark, Sharman, Sarah-Jane, McClintock, Joanna, Lee, Clover-Ann, Abdel-Hafiz, Mostafa, Chee, Lew-Chin, McKee, Lesley, Scott-Warren, Victoria, and Wilson-Smith, Elaine

Subjects
Male, Pediatrics, Health Status, OPERATING-ROOM, Respiratory Tract Diseases, CHILDREN, 0302 clinical medicine, REGIONAL ANESTHESIA, Postoperative Complications, 030202 anesthesiology, CARDIAC-ARREST, Medicine, General anaesthesia, Prospective Studies, Prospective cohort study, Child, Intraoperative Complications, COMPLICATIONS, ddc:617, Incidence (epidemiology), Mortality rate, musculoskeletal, neural, and ocular physiology, Incidence, Age Factors, Hospitals, Europe, Cardiovascular Diseases, Child, Preschool, RESPIRATORY ADVERSE EVENTS, Female, Clinical Competence, Cohort study, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, macromolecular substances, Anesthesia, General, Drug Hypersensitivity, 03 medical and health sciences, MORBIDITY, Journal Article, Humans, business.industry, Infant, Newborn, Infant, 030208 emergency & critical care medicine, Perioperative, nervous system, PROSPECTIVE COHORT, Relative risk, RISK-FACTORS, Observational study, Human medicine, Nervous System Diseases, business, SYSTEM
Abstract

Background Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. Methods The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered with ClinicalTrials.gov, number NCT01878760. Findings Between April 1, 2014, and Jan 31, 2015, 31 127 anaesthetic procedures in 30 874 children with a mean age of 6·35 years (SD 4·50) were included. The incidence of perioperative severe critical events was 5·2% (95% CI 5·0–5·5) with an incidence of respiratory critical events of 3·1% (2·9–3·3). Cardiovascular instability occurred in 1·9% (1·7–2·1), with an immediate poor outcome in 5·4% (3·7–7·5) of these cases. The all-cause 30-day in-hospital mortality rate was 10 in 10 000. This was independent of type of anaesthesia. Age (relative risk 0·88, 95% CI 0·86–0·90; p

Published
2017
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