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Papers by Luciano Bortone
The Lancet. Respiratory medicine, May 28, 2017
Little is known about the incidence of severe critical events in children undergoing general anae... more Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered w...
Anesthesia, Intensive Care and Pain in Neonates and Children, 2016
Anesthesia, Intensive Care and Pain in Neonates and Children, 2016
Background: The preoperative assessment involves the process of evaluating the patient’s clinical... more Background: The preoperative assessment involves the process of evaluating the patient’s clinical condition, which is intended to define the physical status classification, eligibility for anesthesia, and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. We obtained evidence concerning pediatric preoperative evaluation on specific conditions and clinical problems: upper respiratory infections, asthma and bronchial hyperresponsiveness, bronchopulmonary dysplasia, allergies, heart murmurs, and vaccination. We produce a set of recommendations, with emphasis on the level of evidence, clinical relevance, and the risk/benefit ratio.
Paediatric anaesthesia, 2015
Minerva anestesiologica, 2014
The preoperative assessment involves the process of evaluating the patient's clinical conditi... more The preoperative assessment involves the process of evaluating the patient's clinical condition, which is intended to define the physical status classification, eligibility for anesthesia and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. The aim of this recommendation was provide a framework reference for the preoperative evaluation assessment of pediatric patients undergoing elective surgery or diagnostic/therapeutic procedures. We obtained evidence concerning pediatric preoperative evaluation from a systematic search of the electronic databases MEDLINE and Embase between January 1998 and February 2012. We used the format developed by the Italian Center for Evaluation of the Effectiveness of Health Care's scoring system for assessing the level of evidence and strength of recommendations. We produce a set of consensus guidelines on the preoperative assessment and on the request for preoperative tests....
Pediatric Anesthesia, 2006
The laryngeal tube (LT) is a supraglottic ventilatory device used in adults. However, there is li... more The laryngeal tube (LT) is a supraglottic ventilatory device used in adults. However, there is limited information about LT use in pediatric patients. This randomized controlled study compares LT with laryngeal mask (LMA) for airway management during spontaneous or assisted ventilation and during fiberoptic laryngoscopy in children. Thirty children under 10-years old, ASA I-II, scheduled for minor general surgery, Mallampati score I-II, fasted and premedicated were included. Patients with upper respiratory infection, craniofacial malformation, intracranial hypertension, emergency surgery were excluded. The primary outcome measure was the proportion of patients in whom effective spontaneous or assisted ventilation [Vt > or = 4 ml.kg(-1), SpO2 > or = 95% with FiO2 0.4, P(E)CO2 < or = 7.2 kPa (55 mmHg)] was achieved after 3 min of LT or LMA cuff inflation. The secondary endpoint was the proportion of patients in whom fiberoptic laryngoscopy resulted in identification of the vocal cords. Eleven children with LMA and two children in LT group had adequate spontaneous or assisted ventilation after initial positioning (P < 0.01). After head extension or device repositioning 15 of 15 patients in LMA group had adequate ventilation compared with 11 of 15 patients in LT group (P < 0.05). The vocal cords could be observed with fiberoptic laryngoscopy in 11 LMA group patients compared with no patients in the LT group (P < 0.001). The LT is less effective than the LMA to allow adequate spontaneous or assisted ventilation and for fiberoptic evaluation of the airway in children under 10 years old.
Pediatric Anesthesia, 2002
Pediatric Anesthesia, 2006
The Lancet. Respiratory medicine, May 28, 2017
Little is known about the incidence of severe critical events in children undergoing general anae... more Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. The APRICOT study was a prospective observational multicentre cohort study of children from birth to 15 years of age undergoing elective or urgent anaesthesia for diagnostic or surgical procedures. Children were eligible for inclusion during a 2-week period determined prospectively by each centre. There were 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring immediate intervention and that led (or could have led) to major disability or death. This study is registered w...
Anesthesia, Intensive Care and Pain in Neonates and Children, 2016
Anesthesia, Intensive Care and Pain in Neonates and Children, 2016
Background: The preoperative assessment involves the process of evaluating the patient’s clinical... more Background: The preoperative assessment involves the process of evaluating the patient’s clinical condition, which is intended to define the physical status classification, eligibility for anesthesia, and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. We obtained evidence concerning pediatric preoperative evaluation on specific conditions and clinical problems: upper respiratory infections, asthma and bronchial hyperresponsiveness, bronchopulmonary dysplasia, allergies, heart murmurs, and vaccination. We produce a set of recommendations, with emphasis on the level of evidence, clinical relevance, and the risk/benefit ratio.
Paediatric anaesthesia, 2015
Minerva anestesiologica, 2014
The preoperative assessment involves the process of evaluating the patient's clinical conditi... more The preoperative assessment involves the process of evaluating the patient's clinical condition, which is intended to define the physical status classification, eligibility for anesthesia and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. The aim of this recommendation was provide a framework reference for the preoperative evaluation assessment of pediatric patients undergoing elective surgery or diagnostic/therapeutic procedures. We obtained evidence concerning pediatric preoperative evaluation from a systematic search of the electronic databases MEDLINE and Embase between January 1998 and February 2012. We used the format developed by the Italian Center for Evaluation of the Effectiveness of Health Care's scoring system for assessing the level of evidence and strength of recommendations. We produce a set of consensus guidelines on the preoperative assessment and on the request for preoperative tests....
Pediatric Anesthesia, 2006
The laryngeal tube (LT) is a supraglottic ventilatory device used in adults. However, there is li... more The laryngeal tube (LT) is a supraglottic ventilatory device used in adults. However, there is limited information about LT use in pediatric patients. This randomized controlled study compares LT with laryngeal mask (LMA) for airway management during spontaneous or assisted ventilation and during fiberoptic laryngoscopy in children. Thirty children under 10-years old, ASA I-II, scheduled for minor general surgery, Mallampati score I-II, fasted and premedicated were included. Patients with upper respiratory infection, craniofacial malformation, intracranial hypertension, emergency surgery were excluded. The primary outcome measure was the proportion of patients in whom effective spontaneous or assisted ventilation [Vt > or = 4 ml.kg(-1), SpO2 > or = 95% with FiO2 0.4, P(E)CO2 < or = 7.2 kPa (55 mmHg)] was achieved after 3 min of LT or LMA cuff inflation. The secondary endpoint was the proportion of patients in whom fiberoptic laryngoscopy resulted in identification of the vocal cords. Eleven children with LMA and two children in LT group had adequate spontaneous or assisted ventilation after initial positioning (P < 0.01). After head extension or device repositioning 15 of 15 patients in LMA group had adequate ventilation compared with 11 of 15 patients in LT group (P < 0.05). The vocal cords could be observed with fiberoptic laryngoscopy in 11 LMA group patients compared with no patients in the LT group (P < 0.001). The LT is less effective than the LMA to allow adequate spontaneous or assisted ventilation and for fiberoptic evaluation of the airway in children under 10 years old.
Pediatric Anesthesia, 2002
Pediatric Anesthesia, 2006