Airway Management Practice Patterns in Paediatric Anaesthesia: A Survey

Study Overview
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Brief Summary
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Respiratory adverse events continue to be the leading reason for perioperative critical events in children. It is crucial for the anaesthesiologist to anticipate, recognize and treat these respiratory adverse events. Respiratory adverse events are one of the major causes of morbidity and mortality during paediatric anaesthesia. To avoid trouble, one must be prepared for trouble: if a difficult airway is very likely, anaesthesia should be administered by experienced anaesthesiologists and should only be performed in a protected well-equipped area where the personnel adequately trained. This survey focuses on assessment and management of paediatric airway and highlights the unique challenges encountered in children.

Detailed Description
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Airway management is one of the key areas of paediatric anaesthesia practice. The paediatric patients have significant anatomical and physiological differences compared with adults, which impact on the techniques and tools that the anaesthesiologist might choose to provide safe and effective control of the airway. Furthermore, there are a number of pathological processes, typically seen in the paediatric population, which present unique anatomical or functional difficulties in airway management. The presence of one of these syndromes or conditions can predict a difficult airway. Respiratory adverse events continue to be the leading reason for perioperative critical events in children. New developments in airway management in paediatric patients can only improve perioperative outcome if anaesthesiologists who are fully acquainted with these fundamental aspects of paediatric anaesthesia care for these children. This survey was taken out within members of the Community of European Anaesthesiologists, to describe and explore current patterns of their airway management in paediatric anaesthesia. The purpose of the study was to see whether there are more uniform practice patterns among anaesthesiologist with paediatric experience than those without paediatric experience. Secondarily, the survey also explored anaesthetists'' knowledge about the risks of respiratory adverse events and, and about national organizations' recommendations. Therefore, this survey highlighted some of the important anatomical and physiological differences and their implication in daily anaesthesiological practice.

Official Title
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A Survey of Airway Management Practice Patterns in Paediatric Anaesthesia by Anaesthesiologists in Different European Hospitals

Conditions
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Paediatric Airway Management

Intervention / Treatment
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* Behavioral: Voluntarily response all items in the questionnaire.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Anaesthesiologists currently working in the operating rooms. Exclusion Criteria: unwilling to join the study
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Expert<br>Anaesthesiologist with large paediatric daily practice. All participant voluntarily response all items in the questionnaire database. | Behavioral: Voluntarily response all items in the questionnaire.<br>* The study type is a cross-sectional study, by means of electronic self-administered survey as online questionnaire sent by e-mail. The questionnaire for the survey was developed with reference to previously published guidelines on the design of questionnaire surveys. The content validity of the questionnaire was verified by review of clinicians not participating into the project and by a statistician.<br>|
| Non-experts<br>Anaesthesiologist with little paediatric daily practice. All participant voluntarily response all items in the questionnaire database. | Behavioral: Voluntarily response all items in the questionnaire.<br>* The study type is a cross-sectional study, by means of electronic self-administered survey as online questionnaire sent by e-mail. The questionnaire for the survey was developed with reference to previously published guidelines on the design of questionnaire surveys. The content validity of the questionnaire was verified by review of clinicians not participating into the project and by a statistician.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of anaesthesiologist with paediatric experience using intravenous induction compared to those without paediatric experience. | The primary objective will be to compare anaesthesiologists with and without paediatric experience in terms of proportion of anaesthesiologists adopting standard practice. | A time of survey; generally less than 20 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of anaesthesiologist with paediatric experience measuring cuff pressure with pressure manometer compared to those without paediatric experience. | The objective will be to compare anaesthesiologists with and without paediatric experience in terms of proportion of anaesthesiologists adopting standard practice. | A time of survey; generally less than 20 minutes | 
| Proportion of participants correctly identifying predictability of difficult airway in children. | To assess variables associated to adoption of standard practice, in particular: knowledge of the anatomical, physiological, and pathological features related to the airway. | A time of survey; generally less than 20 minutes | 
| Proportion of participants correctly answering questions about the use of (modified) rapid sequence induction in the paediatric population. | To compare anaesthesiologists with and without paediatric experience in terms of different practice patterns, and items explored by the questionnaire. | A time of survey; generally less than 20 minutes | 
| Proportion of anaesthesiologist correctly identifying national organisations difficult airway recommendations. | To informally compare practiced elicited within this study to existing guidelines and algorithms in paediatric anaesthesia. | A time of survey; generally less than 20 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Airway anatomy, difficult intubation, congenital syndromes