APAGBI Project Grant

The successful applicant for the APAGBI Project Grant was:

Primary Applicant
Dr Suellen Walker
Great Ormond Street Hospital

NECTARINE: NEonate-Children audiT of Anaesthesia pRactice IN Europe. Epidemiology of morbidity and mortality in neonatal anaesthesia: UK participation in a European prospective multicentre observational audit of practice.


Scientific Abstract

Neonates and infants are at increased risk of peri-operative adverse events that may influence peri-operative morbidity and mortality. There is limited prospective data regarding the incidence or management of perioperative anaesthetic complications in this vulnerable group.

This study will evaluate associations between adverse peri-operative events and altered morbidity and mortality following neonatal and infant anaesthesia in the UK.

United Kingdom paediatric centres will join the European Society of Anaesthesiology (ESA) "NECTARINE" (NEonate-Children audiT of Anaesthesia pRactice IN Europe) study (ClinicalTrials.gov#NCT02350348). Following parental consent, this prospective, observational, multi-centre cohort study will recruit neonates (term or preterm) and infants (≤60 weeks post-menstrual age) undergoing general anaesthesia for elective or emergency surgery or procedures. Usual care will not be altered. Over 12 weeks, an anticipated 400 UK participants will be recruited (total European sample 4000). Anaesthetists will collect standardised peri-operative data regarding management, critical events, and interventions for altered physiological parameters. Morbidity and mortality at discharge (or 30 days if still hospitalized) will be sought from medical records. This application will fund collection of UK 90 day morbidity and mortality data by an independent research nurse (Clinical Research Facility, London). The ESA Clinical Trial Network will oversee statistical analysis.

Expected outcomes
The incidence of acute peri-operative events, triggers for intervention, and associations with adverse outcomes will provide up-to-date data related to UK and European practice and perioperative risk.

Information regarding the impact of critical events on postoperative morbidity and mortality will inform management guidelines, to improve outcome.