{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:04:12Z","timestamp":1790377452006,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T00:00:00Z","timestamp":1621468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Children with neuromuscular diseases (NMDs) often display respiratory muscle weakness which increases the risk of postoperative pulmonary complications (PPCs) after general anaesthesia. Non\u2010invasive ventilation (NIV) associated with mechanical insufflation\u2013exsufflation (MI\u2010E) can reduce the incidence and severity of PPCs. The aim of this study was to report our experience with a shared perioperative protocol that consists in using NIV combined with MI\u2010E to improve the postoperative outcome of NMD children (IT\u2010NEUMA\u2010Ped).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We conducted a multicentre, observational study on 167 consecutive paediatric patients with NMDs undergoing anaesthesia from December 2015 to December 2018 in a network of 13 Italian hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that 89% of the 167 children (mean age 8\u00a0years old) were at high risk of PPCs, due to the presence of at least one respiratory risk factor. In particular, 51% of them had preoperative ventilatory support dependence. Only 14 (8%) patients developed PPCs, and only two patients needed tracheostomy. Average hospital length of stay (LOS) was 6 (2\u201014) days. The study population was stratified according to preoperative respiratory devices dependency and invasiveness of the procedure. Patients with preoperative ventilatory support dependence showed significantly higher intensive care unit (ICU) admission rate and longer hospital LOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Disease severity seems to be more related to the outcome of this population than invasiveness of procedures. NIV combined with MI\u2010E can help in preventing and resolve PPCs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13844","type":"journal-article","created":{"date-parts":[[2021,5,9]],"date-time":"2021-05-09T06:24:52Z","timestamp":1620541492000},"page":"1195-1204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Perioperative management of children with neuromuscular disorders based on a common protocol: A prospective, national study in Italy"],"prefix":"10.1111","volume":"65","author":[{"given":"Fabrizio","family":"Racca","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo Alessandria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaroslava","family":"Longhitano","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Azienda Ospedaliera SS. 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Antonio e Biagio e Cesare Arrigo Alessandria Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinella","family":"Astuto","sequence":"additional","affiliation":[{"name":"Dipartimento Chirurgia Generale e Specialit\u00e0 Medico Chirurgiche A.O.Universitaria \u201cPoliclinico\u2010Vittorio Emanuele\u201d Universit\u00e0 degli Studi di Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Gallo","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine University of Eastern Piedmont Amedeo Avogadro School of Medicine Novara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5764-6118","authenticated-orcid":false,"given":"Christian","family":"Zanza","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Azienda Ospedaliera SS. 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