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[Perioperative morbidity and mortality in the first year of life: a systematic review (1997-2012)]
Dora Catré1, Maria Francelina Lopes2, Joaquim Silva Viana3
1Centro Hospitalar Tondela-Viseu, Viseu, Portugal; Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal.
Insights
Infants, especially neonates, face higher risks of anesthesia-related complications and death. This review highlights increased anesthetic morbidity and mortality in infants under one year old.
Area of Science:
- Pediatric Anesthesiology
- Neonatal Critical Care
- Surgical Outcomes Research
Context:
- The first year of life, particularly the neonatal period (0-30 days), presents heightened anesthetic risks.
- Limited research specifically addresses anesthetic morbidity and mortality in these vulnerable pediatric subpopulations.
- Existing literature shows significant variability in outcomes for infants undergoing anesthesia and surgery.
Purpose:
- To systematically review and analyze the epidemiology of morbidity and mortality linked to general anesthesia and surgery in infants.
- To specifically examine outcomes in neonates (0-30 days) and older infants (1-12 months).
- To evaluate the prevalence of cardiac arrest and critical perioperative events in these age groups.
Summary:
- A systematic literature review of the past 15 years analyzed anesthetic-related morbidity and mortality in infants.
- Outcomes assessed included early mortality, cardiac arrest, and critical perioperative events in neonates and infants.
- Findings indicate higher anesthetic morbidity and mortality rates in children under one year, with the highest incidence in neonates.
Impact:
- Highlights the increased risks associated with anesthesia in neonates and infants.
- Underscores the need for further research and specialized anesthetic protocols for pediatric populations.
- Informs clinical practice regarding the management of anesthesia in high-risk infant surgical patients.
Background And Objectives:
Although many recognize that the first year of life and specifically the neonatal period are associated with increased risk of anesthetic morbidity and mortality, there are no studies directed to these pediatric subpopulations. This systematic review of the scientific literature including the last 15 years aimed to analyze the epidemiology of morbidity and mortality associated with general anesthesia and surgery in the first year of life and particularly in the neonatal (first month) period.
Content:
The review was conducted by searching publications in Medline/PubMed databases, and the following outcomes were evaluated: early mortality in the first year of life (<1 Yr) and in subgroups of different vulnerability in this age group (0-30 days and 1-12 months) and the prevalence of cardiac arrest and perioperative critical/adverse events of various types in the same subgroups.
Conclusions:
The current literature indicates great variability in mortality and morbidity in the age group under consideration and in its subgroups. However, despite the obvious methodological heterogeneity and absence of specific studies, epidemiological profiles of morbidity and mortality related to anesthesia in children in the first year of life show higher frequency of morbidity and mortality in this age group, with the highest peaks of incidence in the neonates' anesthesia.
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