Anesthesia-Related Adverse Events in Infants With Gastroschisis at a South African Tertiary Pediatric Hospital: A Retrospective Cohort Study
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View abstract on PubMed
Summary
This summary is machine-generated.Anesthesia-related adverse events (ARAEs) are common in infants with gastroschisis, especially during surgery. Improving perioperative care in low-resource settings is crucial for better outcomes.
Area Of Science
- Pediatric Surgery
- Anesthesiology
- Global Health
Background
- Infants with gastroschisis face high surgical risks, particularly in low- and middle-income countries (LMICs).
- Survival rates for gastroschisis vary significantly, with higher mortality reported in Sub-Saharan Africa compared to high-income settings.
- Anesthesia-related adverse events (ARAEs) may contribute to poor perioperative outcomes, but data are limited.
Purpose Of The Study
- To determine the incidence and types of ARAEs in infants with gastroschisis.
- To identify risk factors associated with ARAEs in this vulnerable population.
- To evaluate the frequency and safety of general anesthesia for central venous catheter (CVC) procedures.
Main Methods
- Retrospective cohort study of infants with gastroschisis (2012-2021).
- ARAEs defined using established criteria (APRICOT, NECTARINE).
- Generalized estimating equations (GEE) used to analyze repeated anesthetic exposures.
Main Results
- 196 general anesthetics administered to 65 infants; 78.5% of patients experienced ARAEs.
- Cardiovascular instability and respiratory complications were the most frequent ARAEs.
- ARAEs were significantly more common during pathology-related surgery (45.7%) than CVC procedures (12.5%).
Conclusions
- ARAEs are a significant concern in infants with gastroschisis, particularly during non-CVC related surgeries.
- Strategies like optimized fluid management and reduced anesthetic exposure are suggested.
- Enhanced perioperative data systems and prospective studies are needed to improve care pathways in LMICs.
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