The State of Paediatric Anaesthesia in Europe – Report of one year of activity from SSC 5 Paediatric Anaesthesia

The State of Paediatric Anaesthesia in Europe – Report of one year of activity from SSC 5 Paediatric Anaesthesia

  • Issue 69

Becke K (Chair), Disma N, Engelhardt T, Galvez I; Vutskits L, Hansen TG (EuroSTAR); Lönnqvist PA (ESPA representative).

The last 12 months has seen intense activity for the ESA Scientific Sub-Committee Paediatric Anaesthesia (SSC5). A major achievement was to welcome the European Society for Paediatric Anaesthesiology as a specialist society of ESA enabling a close and regulated collaboration between the two societies. PA Lönnqvist is the ESPA representative at ESA SSC5.

FDA Warning: response from European societies

A ‘black box’ warning on anaesthetics and sedatives in young children and pregnant women was issued by the US-FDA in December 2016. This required a measured European response. SSC5/EuroSTAR prepared a European Consensus Statement that has been endorsed by ESA, ESPA, and EACTA. The statement will be published soon in the European Journal of Anaesthesiology (EJA) and Paediatric Anaesthesia, and on the ESA website.

APRICOT and NECTARINE study: a success story of ESA-Clinical Trial Network

A major achievement was the ESA-sponsored completion of the APRICOT study (Anaesthesia PRactice In Children Observational Trial): a prospective multicentre observational study in 261 hospitals in Europe on the incidence of severe critical events in paediatric anaesthesiology. This has now been published in Lancet Respiratory Medicine. This study included a cohort of over 31,000 children undergoing anaesthesia in 261 centres across Europe, with an incidence of severe critical events of 5.2%. The authors analysed predictive factors of critical events in children, concluding that national, regional, and specialist societies should target education of anaesthesiologists and their teams and implement strategies for quality improvement in paediatric anaesthesia. The APRICOT study represents the first large prospective study on critical events in children on such a large scale and will shape the setup of future paediatric registries and interventional studies.

Following the success of the above study a further ESA-sponsored project (NECTARINE, NEonate-Children sTudy of Anaesthesia pRactice IN Europe) focussed on a very fragile population: neonates and infants. This second clinical trial network has just concluded recruitment, exceeding the target number of 5,000 patients. The Steering Committee is currently working at database cleaning and looking forward to planning the subgroup statistical analysis for the future publication.

EuroSTAR initiative: expanded activities

The EuroSTAR initiative represented by the two chairpersons Tom Hansen and Laszlo Vutskits has been moved under the umbrella of SSC5. EuroSTAR was initially created to promote research initiatives of ‘paediatric anaesthesia and neurotoxicity‘. More recently, EuroSTAR has expanded its role to the wider area of ‘paediatric anaesthesia and perioperative outcomes‘. EuroSTAR will provide the ideal platform where ideas and initiatives can be easily exchanged, and the APRICOT and NECTARINE trial networks are two well-identified examples of collaboration endorsed by EuroSTAR.

Workshop at the European Parliament

Finally, Karin Becke, the chairperson of SSC5, has recently been invited to the European Parliament in Brussels to talk about the present and future of paediatric anaesthesia in Europe. Her lecture ‘Competence centres for children in Europe‘ highlighted the state of the art and the future needs for paediatric anaesthesia across Europe. In particular, the establishment of European standards for paediatric anaesthesia training and setup of dedicated paediatric registries are required to address the most urgent needs.

Outlook 2018

Despite the current achievements future challenges are expected, and the key to success remains maintenance of the effective established network and the collaboration between paediatric specialist societies. Members of the SSC5 believe that the way forward for improving clinical standards is continuous training and education, establishment of validated standards of quality, and planning large collaborative studies.

Children are the future of our society and require the best care.

Save the date: SSC5/EuroSTAR will meet at Euroanaesthesia 2017 in Geneva, Saturday 3 June 2017, 12:15–13:45 (Room: Office 1) – those interested in paediatric anaesthesia are welcome!