• Christophe Dadure, Nada Sabourdin, Francis Veyckemans, Florence Babre, Nathalie Bourdaud, Souhayl Dahmani, Queiroz Mathilde De M Département d'Anesthésiologie Réanimation Pédiatrique, Hôpital Femme Mère Enfant, 69677 Bron, France., Jean-Michel Devys, Marie-Claude Dubois, Delphine Kern, Anne Laffargue, Marc Laffon, Corinne Lejus-Bourdeau, Karine Nouette-Gaulain, Gilles Orliaguet, Etienne Gayat, Lionel Velly, Nadège Salvi, and Chrystelle Sola.
• Département d'anesthesiologie réanimation femme-mère-enfant, CHU de Lapeyronie, institut de génomique fonctionnelle, UMR 5203 CNRS - U 1191 Inserm, université de Montpellier, 34285 Montpellier, France. Electronic address: c-dadure@chu-montpellier.fr.
• Anaesth Crit Care Pain Med. 2019 Dec 1; 38 (6): 681-693.

ObjectiveTo provide French guidelines about "Airway management during paediatric anaesthesia".DesignA consensus committee of 17 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société Française d'Anesthésie-Réanimation, SFAR) and the Association of French speaking paediatric anaesthesiologists and intensivists (Association Des Anesthésistes Réanimateurs Pédiatriques d'Expression Francophone, ADARPEF) was convened. The entire process was conducted independently of any industry funding. The authors followed the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to assess the quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. Few recommendations were not graded.MethodsThe panel focused on 7 questions: 1) Supraglottic Airway devices 2) Cuffed endotracheal tubes 3) Videolaryngoscopes 4) Neuromuscular blocking agents 5) Rapid sequence induction 6) Airway device removal 7) Airway management in the child with recent or ongoing upper respiratory tract infection. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. The analysis of the literature and the redaction of the recommendations were then conducted according to the GRADE® methodology.ResultsThe SFAR Guideline panel provides 17 statements on "airway management during paediatric anaesthesia". After two rounds of discussion and various amendments, a strong agreement was reached for 100% of the recommendations. Of these recommendations, 6 have a high level of evidence (Grade 1 ± ), 6 have a low level of evidence (Grade 2 ± ) and 5 are experts' opinions. No recommendation could be provided for 3 questions.ConclusionsSubstantial agreement exists among experts regarding many strong recommendations for paediatric airway management.Copyright © 2019 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

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