Paediatric patients present a special challenge to anaesthetists. The anaesthesia-related mortality of children is currently estimated at 1:30,000, vs. 1:250,000 in adults – so it becomes clear that there is still room for improvement when it comes to standards around ventilating a child under general anaesthesia. At the moment, there is very little evidence regarding paediatric ventilation practices during surgery, which could lead to paediatric anaesthetists determining ventilator settings mainly based on personal experience1. Here, we discuss the main considerations when ventilating children and newborns and offer further insight into this topic to help you best protect your patient.
The particular challenges of anaesthetising newborns, infants and young children is reflected in the higher perioperative mortality of paediatric patients as compared to adults. The incidence of intraoperative cardiac arrests is 1:10,000 and respiratory causes are responsible for about a third of these paediatric mortalities. The pitfalls and risks for small children and especially newborns were recently confirmed in the APRICOT study, which analysed a total of 31,000 anaesthetic procedures in around 30,000 children treated in 261 centres across 33 European countries.