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Promoting safe anaesthesia for every child: the SAFETOTS initiative and beyond

Jean-Philippe Salaün1,2, Gianluca Bertolizio3, Jacob Karlsson4,5

  • 1Institut Blood and Brain at Caen-Normandy, UMR-S U1237/Physiopathology and Imaging of Neurological Disorders, Normandy University, UNICAEN, INSERM, GIP Cyceron.

Current Opinion in Anaesthesiology
|April 29, 2026
PubMed

Insights

Pediatric anesthesia safety is improving but still varies globally, especially for neonates and infants in resource-limited areas. Critical events during anesthesia can lead to poor outcomes, highlighting the need for enhanced safety initiatives.

Area of Science:

  • Anesthesiology
  • Pediatric Critical Care

Background:

  • Paediatric anaesthesia has advanced significantly, but safety outcomes remain inconsistent across different demographics and healthcare settings.
  • Contemporary data indicate persistent perioperative morbidity and mortality, particularly impacting neonates, infants, and children in resource-limited environments.

Purpose of the Study:

  • To review the current landscape and challenges in paediatric anaesthesia safety.
  • To examine paediatric anaesthesia safety through the lens of the Safe Anaesthesia for Every Tots (SAFETOTS) initiative.

Main Methods:

  • Review of large observational studies and multicentric investigations.
  • Analysis of critical events related to anaesthetic conduct and their potential impact.
  • Exploration of the SAFETOTS initiative's framework for improving paediatric anaesthesia safety.

Main Results:

  • Significant disparities in paediatric anaesthesia safety exist globally.
  • High incidence of critical anaesthesia-related events observed, posing risks for catastrophic outcomes if unaddressed.
  • While direct causality is not established, critical events underscore safety concerns in paediatric perioperative care.

Conclusions:

  • The Safe Anaesthesia for Every Tots (SAFETOTS) initiative promotes safe anaesthesia practices, physiological stability, and child-centred care.
  • Addressing safety disparities and critical events is crucial for improving paediatric anaesthesia outcomes worldwide.
  • A focus on organizational and patient-centered values is essential for advancing paediatric anaesthesia safety.
Abstract

Keywords:
SAFETOTSpaediatric anaesthesiapatient safetyperioperative complicationsquality of care

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