Anesthesia and the developing brain: a way forward for clinical research

Andrew J Davidson, Karin Becke, Jurgen de Graaff, Gaia Giribaldi, Walid Habre, Tom Hansen, Rodney W Hunt, Caleb Ing, Andreas Loepke, Mary Ellen McCann, Gillian D Ormond, Alessio Pini Prato, Ida Salvo, Lena Sun, Laszlo Vutskits, Suellen Walker, Nicola Disma

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

It is now well established that many general anesthetics have a variety of effects on the developing brain in animal models. In contrast, human cohort studies show mixed evidence for any association between neurobehavioural outcome and anesthesia exposure in early childhood. In spite of large volumes of research, it remains very unclear if the animal studies have any clinical relevance; or indeed how, or if, clinical practice needs to be altered. Answering these questions is of great importance given the huge numbers of young children exposed to general anesthetics. A recent meeting in Genoa brought together researchers and clinicians to map a path forward for future clinical studies. This paper describes these discussions and conclusions. It was agreed that there is a need for large, detailed, prospective, observational studies, and for carefully designed trials. It may be impossible to design or conduct a single study to completely exclude the possibility that anesthetics can, under certain circumstances, produce long-term neurobehavioural changes in humans; however , observational studies will improve our understanding of which children are at greatest risk, and may also suggest potential underlying etiologies, and clinical trials will provide the strongest evidence to test the effectiveness of different strategies or anesthetic regimens with respect to better neurobehavioral outcome.

OriginalsprogEngelsk
TidsskriftPaediatric Anaesthesia
Vol/bind25
Udgave nummer5
Sider (fra-til)447-452
ISSN1155-5645
DOI
StatusUdgivet - maj 2015

Fingeraftryk

Research
Cohort Studies
Research Personnel
Clinical Trials
Prospective Studies
Clinical Studies

Citer dette

Davidson, A. J., Becke, K., de Graaff, J., Giribaldi, G., Habre, W., Hansen, T., ... Disma, N. (2015). Anesthesia and the developing brain: a way forward for clinical research. Paediatric Anaesthesia, 25(5), 447-452. https://doi.org/10.1111/pan.12652
Davidson, Andrew J ; Becke, Karin ; de Graaff, Jurgen ; Giribaldi, Gaia ; Habre, Walid ; Hansen, Tom ; Hunt, Rodney W ; Ing, Caleb ; Loepke, Andreas ; McCann, Mary Ellen ; Ormond, Gillian D ; Pini Prato, Alessio ; Salvo, Ida ; Sun, Lena ; Vutskits, Laszlo ; Walker, Suellen ; Disma, Nicola. / Anesthesia and the developing brain : a way forward for clinical research. I: Paediatric Anaesthesia. 2015 ; Bind 25, Nr. 5. s. 447-452.
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title = "Anesthesia and the developing brain: a way forward for clinical research",
abstract = "It is now well established that many general anesthetics have a variety of effects on the developing brain in animal models. In contrast, human cohort studies show mixed evidence for any association between neurobehavioural outcome and anesthesia exposure in early childhood. In spite of large volumes of research, it remains very unclear if the animal studies have any clinical relevance; or indeed how, or if, clinical practice needs to be altered. Answering these questions is of great importance given the huge numbers of young children exposed to general anesthetics. A recent meeting in Genoa brought together researchers and clinicians to map a path forward for future clinical studies. This paper describes these discussions and conclusions. It was agreed that there is a need for large, detailed, prospective, observational studies, and for carefully designed trials. It may be impossible to design or conduct a single study to completely exclude the possibility that anesthetics can, under certain circumstances, produce long-term neurobehavioural changes in humans; however , observational studies will improve our understanding of which children are at greatest risk, and may also suggest potential underlying etiologies, and clinical trials will provide the strongest evidence to test the effectiveness of different strategies or anesthetic regimens with respect to better neurobehavioral outcome.",
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Davidson, AJ, Becke, K, de Graaff, J, Giribaldi, G, Habre, W, Hansen, T, Hunt, RW, Ing, C, Loepke, A, McCann, ME, Ormond, GD, Pini Prato, A, Salvo, I, Sun, L, Vutskits, L, Walker, S & Disma, N 2015, 'Anesthesia and the developing brain: a way forward for clinical research', Paediatric Anaesthesia, bind 25, nr. 5, s. 447-452. https://doi.org/10.1111/pan.12652

Anesthesia and the developing brain : a way forward for clinical research. / Davidson, Andrew J; Becke, Karin; de Graaff, Jurgen; Giribaldi, Gaia; Habre, Walid; Hansen, Tom; Hunt, Rodney W; Ing, Caleb; Loepke, Andreas; McCann, Mary Ellen; Ormond, Gillian D; Pini Prato, Alessio; Salvo, Ida; Sun, Lena; Vutskits, Laszlo; Walker, Suellen; Disma, Nicola.

I: Paediatric Anaesthesia, Bind 25, Nr. 5, 05.2015, s. 447-452.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Anesthesia and the developing brain

T2 - a way forward for clinical research

AU - Davidson, Andrew J

AU - Becke, Karin

AU - de Graaff, Jurgen

AU - Giribaldi, Gaia

AU - Habre, Walid

AU - Hansen, Tom

AU - Hunt, Rodney W

AU - Ing, Caleb

AU - Loepke, Andreas

AU - McCann, Mary Ellen

AU - Ormond, Gillian D

AU - Pini Prato, Alessio

AU - Salvo, Ida

AU - Sun, Lena

AU - Vutskits, Laszlo

AU - Walker, Suellen

AU - Disma, Nicola

N1 - © 2015 John Wiley & Sons Ltd.

PY - 2015/5

Y1 - 2015/5

N2 - It is now well established that many general anesthetics have a variety of effects on the developing brain in animal models. In contrast, human cohort studies show mixed evidence for any association between neurobehavioural outcome and anesthesia exposure in early childhood. In spite of large volumes of research, it remains very unclear if the animal studies have any clinical relevance; or indeed how, or if, clinical practice needs to be altered. Answering these questions is of great importance given the huge numbers of young children exposed to general anesthetics. A recent meeting in Genoa brought together researchers and clinicians to map a path forward for future clinical studies. This paper describes these discussions and conclusions. It was agreed that there is a need for large, detailed, prospective, observational studies, and for carefully designed trials. It may be impossible to design or conduct a single study to completely exclude the possibility that anesthetics can, under certain circumstances, produce long-term neurobehavioural changes in humans; however , observational studies will improve our understanding of which children are at greatest risk, and may also suggest potential underlying etiologies, and clinical trials will provide the strongest evidence to test the effectiveness of different strategies or anesthetic regimens with respect to better neurobehavioral outcome.

AB - It is now well established that many general anesthetics have a variety of effects on the developing brain in animal models. In contrast, human cohort studies show mixed evidence for any association between neurobehavioural outcome and anesthesia exposure in early childhood. In spite of large volumes of research, it remains very unclear if the animal studies have any clinical relevance; or indeed how, or if, clinical practice needs to be altered. Answering these questions is of great importance given the huge numbers of young children exposed to general anesthetics. A recent meeting in Genoa brought together researchers and clinicians to map a path forward for future clinical studies. This paper describes these discussions and conclusions. It was agreed that there is a need for large, detailed, prospective, observational studies, and for carefully designed trials. It may be impossible to design or conduct a single study to completely exclude the possibility that anesthetics can, under certain circumstances, produce long-term neurobehavioural changes in humans; however , observational studies will improve our understanding of which children are at greatest risk, and may also suggest potential underlying etiologies, and clinical trials will provide the strongest evidence to test the effectiveness of different strategies or anesthetic regimens with respect to better neurobehavioral outcome.

U2 - 10.1111/pan.12652

DO - 10.1111/pan.12652

M3 - Journal article

C2 - 25818094

VL - 25

SP - 447

EP - 452

JO - Paediatric Anaesthesia

JF - Paediatric Anaesthesia

SN - 1155-5645

IS - 5

ER -