Background and Goal of Study: 
This study analyses incidences of perioperative paediatric cardiac arrest (CA) before and after implementation of a specialised paediatric anaethesia team and training programme at tertiary care university hospital in Germany.

Materials and Methods: 
Reports on perioperative paediatric (0-18 yrs) CA were identified from all critical incident reports 2008-2016. CAs were classified as anaesthesia-attributable or anaesthesia-unrelated. Incidences of CA were calculated from the anaesthesia database. A logistic regression analysis with risk factors (age, ASA physical status grade [ASA-PS], emergency) was used to evaluate the impact of implementation of a specialised paediatric anaesthesia team and training programme in 2014 on perioperative paediatric CA.

Results: 
Between 2008 and 2016, 25 perioperative paediatric CAs were identified. Of these, 12 were classified as anaesthesia-attributable CA. The incidence of anaesthesia-attributable CA was 4.3 (95%-CI 2.3-7.9) in the period 2008-2013 and decreased to 1.6 (95%-CI 0.3-5.7) in 2014-2016 (Figure1). Likewise, the incidence of overall CA was lower after 2013 [4.6/10,000 (95%-CI 2.1-10.2) vs 8.1/10,000 (95%-CI 5.2-12.7)]. Children anaesthetised after 2013, had nearly a 70 percent lower probability of anaesthesia-attributable CA (OR 0.306; 95%-CI 0.067-1.397; p=0.1263) although proportions of children aged <1 year and classified ASA-PS 3-5 were greater in the period 2014-2016. For anaesthesia-attributable CA, young age
was the most contributing risk factor whereas in overall paediatric CA, ASA-PS 3-5 played a more important role. During the study period, 91.7% (11/12) of anaesthesia-attributable CAs occurred in children ≤3 years.

Conclusions: 
Young age, ASA-PS and cardiac procedures contribute as main risk factors to perioperative paediatric CA. In this study on the incidences of perioperative paediatric CA from a European tertiary care university hospital, implementation
of a specialised paediatric anaesthesia team and training programme was associated with lower incidences of perioperative paediatric CA and a reduced probability for anaesthesia-attributable CA.

05 / Effect of implementation of a specialised paediatric anaesthesia team and training programme on incidenes of perioperative paediatric cardiac arrest: a before and after analysis.