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After nectarine: how should we provide anesthesia for neonates?
Gianluca Bertolizio1, Nicola Disma2, Thomas Engelhardt1
1Department of Pediatric Anesthesiology, Montreal Children's Hospital, McGill University, Montreal, Canada.
Current Opinion in Anaesthesiology
|June 7, 2022
Summary
Neonatal anesthesia practice significantly impacts patient outcomes. Avoiding hypoxia, anemia, and hypotension is crucial for reducing perioperative morbidity and mortality in neonates and infants.
Area of Science:
- Pediatric Anesthesiology
- Neonatal Critical Care
- Surgical Outcomes
Background:
- Neonates face high risks of perioperative complications and mortality.
- The NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) study examined anesthesia practices in European hospitals.
- Recent publications are reviewed to reflect changes in clinical practice.
Purpose of the Study:
- To highlight recent publications on neonatal anesthesia.
- To contextualize findings within the NECTARINE study.
- To identify changes in clinical practice for neonates and infants.
Main Methods:
- Review of recent literature.
- Analysis of NECTARINE study data on anesthesia practice.
- Examination of perioperative complications and mortality.
Main Results:
- A triad of hypoxia, anemia, and hypotension increases 30-day mortality.
- Hypoxia is common during anesthesia induction and maintenance.
- Blood transfusion practices and blood pressure monitoring vary; newer technologies may improve perfusion assessment.
Conclusions:
- NECTARINE provided insights into European neonatal anesthesia.
- Maintaining physiological homeostasis and optimizing oxygen delivery are key to reducing mortality.
- Specialist care in pediatric centers is vital for high-risk neonates with underlying conditions.
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