{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T07:01:10Z","timestamp":1771138870644,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infants with gastroschisis represent a high\u2010risk surgical population, particularly in low\u2010 and middle\u2010income countries (LMICs) where perioperative resources are constrained. While survival in high\u2010income settings exceeds 90%, reported mortality in Sub\u2010Saharan Africa ranges from 58.1% to 100%. Anesthesia\u2010related adverse events (ARAEs) may contribute to poor perioperative risk, yet data on their incidence and associated factors in this population are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe the incidence and nature of ARAEs in infants with gastroschisis and identify associated risk factors. A secondary aim was to assess the frequency and safety of general anesthesia administered solely for central venous catheter (CVC) procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of all infants with gastroschisis admitted to Red Cross War Memorial Children's Hospital between 2012 and 2021. ARAEs were defined using criteria from APRICOT and NECTARINE studies. Generalized estimating equations (GEE) were used to account for repeated anesthetic exposures per patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010five infants underwent 196 general anesthetics (median 2 [IQR 1\u20134] per patient). Sixteen infants underwent 4 or more GAEs for CVC procedures alone. ARAEs occurred in 79 procedures (40.3%), affecting 51 patients (78.5%). Cardiovascular instability was most common, followed by respiratory complications. ARAEs were significantly more frequent during pathology\u2010related surgery than during CVC procedures (45.7% vs. 12.5%; adjusted OR 0.17, 95% CI 0.08 to 0.35,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ARAEs are common in infants with gastroschisis, particularly during pathology\u2010related procedures. Potential lessons include careful fluid management, anticipatory extubation planning, and reducing repeated anesthetic exposure. Strengthening perioperative data systems in LMICs and conducting prospective studies are needed to identify modifiable risks and develop safe, context\u2010specific care pathways to improve outcomes for infants with gastroschisis in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pan.70099","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T01:11:52Z","timestamp":1765588312000},"page":"292-299","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anesthesia\u2010Related Adverse Events in Infants With Gastroschisis at a South African Tertiary Pediatric Hospital: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"36","author":[{"given":"Andrew","family":"Heald","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Perioperative Medicine Groote Schuur Hospital and University of Cape Town  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4704-3705","authenticated-orcid":false,"given":"Rebecca M.","family":"Gray","sequence":"additional","affiliation":[{"name":"Division of Paediatric Anaesthesia, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences University of Cape Town  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Arnold","sequence":"additional","affiliation":[{"name":"Division of Paediatric Surgery Red Cross War Memorial Children's Hospital, University of Cape Town  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2227-2686","authenticated-orcid":false,"given":"Heidi M.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Division of Paediatric Anaesthesia, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences University of Cape Town  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2018.08.004"},{"issue":"10","key":"e_1_2_13_3_1","article-title":"Improved Mortality of Patients With Gastroschisis: A Historical Literature Review of Advances in Surgery and Critical Care From 1960 to 2020","volume":"9","author":"Georgeades C.","year":"2022","journal-title":"Children (Basel)"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2020.00008"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/0189-6725.150924"},{"issue":"4","key":"e_1_2_13_6_1","first-page":"164","article-title":"Characteristics and Outcomes of Neonates With Gastroschisis Managed in a Public Tertiary Hospital in a Developing Country","volume":"13","author":"Gom S.","year":"2019","journal-title":"South African Journal of Child Health"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.20221116"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.07.065"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1241729"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(17)30116-9"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000005796"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2021.02.016"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1295639"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004116"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/wjps-2023-000657"},{"issue":"1","key":"e_1_2_13_17_1","first-page":"20","article-title":"Risk Factors and Outcomes of Extubation Failure in a South African Tertiary Paediatric Intensive Care Unit","volume":"38","author":"Kuba M. 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