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Paediatric Anaesthesia

Albert-Neels van Schoor, Marius C Bosman, Gerda Venter, Adrian T Bösenberg
BACKGROUND: Information regarding the position and relationship of vital structures within the caudal canal is important for anesthesiologists who perform a caudal block. This information can be acquired by anatomical dissection, with ultrasound technology, or radiological studies. AIMS: The aim of this study was to determine the position of the dural sac in neonates by measuring the distance of the termination of the dural sac from the apex of the sacral hiatus in neonatal cadavers...
September 12, 2018: Paediatric Anaesthesia
Tian Wang, Xiangyu Wang, Jinping Liu, Lihua Zou, Jingtao Wang, Mingxia Zhao, Yongli Cui
BACKGROUND: In many centers, fresh frozen plasma is generally used as the main component of pump prime in pediatric cardiopulmonary bypass. However, many factors have resulted in stringent control of plasma transfusion and prompted the study of safe and efficient substitutes. AIMS: The aim of this study was to investigate the feasibility of a priming strategy with gelatin during cardiopulmonary bypass in pediatric patients undergoing cardiac surgery and identify the factors associated with postoperative chest-tube drainage...
September 12, 2018: Paediatric Anaesthesia
Gianluca Bertolizio, Christine Saint-Martin, Pablo Ingelmo
Patients with Trisomy 21 are particularly at risk of cervical instability due to ligamentous laxity and osseous abnormalities. Up to 30% of Trisomy 21 patients are affected by atlanto-axial or atlanto-occipital instability, but only 1%-2% of cases are symptomatic. The radiologic assessment of cervical instability is not unanimously considered mandatory. The dynamic cervical spine radiograph is the most common screening tool for ruling out cervical spine instability in patients with Trisomy 21, and it is often requested before surgery...
September 12, 2018: Paediatric Anaesthesia
Lionel Bouvet, Nicolas Bellier, Anne-Charlotte Gagey-Riegel, François-Pierrick Desgranges, Dominique Chassard, Mathilde De Queiroz Siqueira
BACKGROUND: Though pulmonary aspiration of gastric contents occurs mainly in the setting of emergency surgery, it may also occur in children scheduled for elective surgery without any obvious clinical risk factor. Increased gastric content volume is one the predisposing factors for pulmonary aspiration that could affect such children and may be identified using ultrasound examination of the gastric antrum. AIMS: We aimed to assess the prevalence of "at-risk stomach" defined by ultrasound visualization of any solid content in the antrum and/or by calculated gastric fluid volume > 1...
September 12, 2018: Paediatric Anaesthesia
Colleen Cloyd, Brady S Moffett, Melanie Brooke Bernhardt, Evelyn M Monico, Nihar Patel, Darrell Hanson
BACKGROUND: Liposomal bupivacaine may be an option for reducing opioid utilization in pediatric scoliosis surgery. The use of liposomal bupivacaine in this patient population has not been previously described. METHODS: Patients who underwent posterior spinal fusion surgery at our institution from 2011-2016 were identified. We performed a retrospective matched cohort study, matching patients who received intraoperative liposomal bupivacaine by age, gender, and extent of surgery to patients who did not...
September 11, 2018: Paediatric Anaesthesia
Jacqueline A Hannam, Brian J Anderson, Amanda Potts
BACKGROUND: The impact of tramadol in children given acetaminophen-ibuprofen combination therapy is uncertain in acute pediatric pain management. A model describing the interaction between these three drugs would be useful to understand the role of supplemental analgesic therapy. METHODS: Children undergoing tonsillectomy were given oral paracetamol and ibuprofen perioperatively. Blood was taken for paracetamol and ibuprofen drug assay on up to six occasions over 6 h after the initial dose...
August 16, 2018: Paediatric Anaesthesia
Lukas Schroeder, Heiko Reutter, Ullrich Gembruch, Christoph Berg, Andreas Mueller, Florian Kipfmueller
INTRODUCTION: Infants after surgical correction of congenital diaphragmatic hernia are at high risk for extubation failure, but little is known about contributing factors. Therefore, our study aimed to analyze clinical and echocardiographic parameters. MATERIALS AND METHODS: Data of 34 infants with congenital diaphragmatic hernia treated at our department (July 2013-December 2015) were analyzed. Inclusion criteria were: presence of congenital diaphragmatic hernia and echocardiography performed within 48 hours before the first, and, in case of reintubation, the final extubation attempt...
August 16, 2018: Paediatric Anaesthesia
Emily D Geyer, Dmitry Tumin, Rebecca Miller, Richard S Cartabuke, Joseph D Tobias
BACKGROUND: Understanding how survey methodology and quality measures are associated with progress from abstract presentation to manuscript publication can help optimize the design of survey research in anesthesiology, and enhance respondents' confidence in the value of survey participation. AIMS: The aim of this study was to determine if adherence to survey method recommendations and attainment of high response rates are associated with faster progress to publication among abstracts initially presented at anesthesiology society meetings...
August 16, 2018: Paediatric Anaesthesia
Luis Ignacio Cortínez, Brian J Anderson
BACKGROUND: Sevoflurane pharmacokinetics have been traditionally described using physiological models, while pharmacodynamics employed the use of minimal alveolar concentration. AIMS: The integrated pharmacokinetic-pharmacodynamic relationship of sevoflurane in both adults and children was reviewed using compartment models. We wished to delineate age-related changes in both pharmacokinetics and pharmacodynamics. METHODS: The bispectral index and sevoflurane endtidal concentration were continuously measured in 50 patients, aged 3-71 years, scheduled for minor surgery...
August 16, 2018: Paediatric Anaesthesia
Dario Galante
No abstract text is available yet for this article.
September 2018: Paediatric Anaesthesia
Ferenc Petak, Walid Habre
No abstract text is available yet for this article.
September 2018: Paediatric Anaesthesia
Andrew Davidson
No abstract text is available yet for this article.
September 2018: Paediatric Anaesthesia
Preeti Thakur, Anju R Bhalotra, Kapil Chaudhary
No abstract text is available yet for this article.
September 2018: Paediatric Anaesthesia
Malcolm J Lucy, Jonathan J Gamble, Andrew Peeling, Jimmy T H Lam, Lloyd Balbuena
BACKGROUND: Positive-pressure ventilation in critically ill patients is commonly administered via a manual resuscitation device or a mechanical ventilator during transport. Our group previously compared delivered ventilation parameters between a self-inflating resuscitator and a flow-inflating resuscitator during simulated in-hospital pediatric transport. However, unequal group access to inline pressure manometry may have biased our results. In this study, we examined the performance of the self-inflating resuscitator and the flow-inflating resuscitator, both equipped with inline manometry, and several mechanical ventilators to deliver prescribed ventilation parameters during simulated pediatric transport...
September 2018: Paediatric Anaesthesia
Nicola Disma, James D O'Leary, Andreas W Loepke, Ansgar M Brambrink, Karin Becke, Nicola G Clausen, Jurgen C De Graaff, Fang Liu, Tom G Hansen, Mary E McCann, Cynthia F Salorio, Sulpicio Soriano, Lena S Sun, Peter Szmuk, David O Warner, Laszlo Vutskits, Andrew J Davidson
All commonly used general anesthetics have been shown to cause neurotoxicity in animal models, including nonhuman primates. Opinion, however, remains divided over how cumulative evidence from preclinical and human studies in this field should be interpreted and its translation to current practices in pediatric anesthesia and surgery. A group of international experts in laboratory and clinical sciences recently convened in Genoa, Italy, to evaluate the current state of both laboratory and clinical research and discuss future directions for basic, translational, and clinical studies in this field...
September 2018: Paediatric Anaesthesia
Joel W E Chin, Grant M Stuart
Osteogenesis imperfecta is a heterogeneous genetic disorder characterized by bone fragility, with disease ranging from mild fractures to death in utero. We describe a child with autosomal recessive osteogenesis imperfecta type VIII (severe or lethal phenotype), who successfully underwent posterior spinal fusion, was extubated on postoperative day 1 and discharged home 25 days later. Recently identified recessive forms of osteogenesis imperfecta are associated with severe/lethal phenotype. Special consideration is needed in scoliosis surgery, with challenges arising from prone positioning, neurophysiology monitoring, and blood loss...
September 2018: Paediatric Anaesthesia
Ania Kaiser, Kati Miller, Ganzhong Tian, Reneé H Moore, Nina A Guzzetta
INTRODUCTION: Allogeneic blood product transfusion is common in pediatric patients undergoing cardiopulmonary bypass although it is associated with an increased risk for adverse events. Furthermore, numerous donor exposures may affect future blood transfusion needs and human leukocyte antigen matching for patients who may ultimately require cardiac transplantation. Autologous intraoperative blood collection and retransfusion is a known method of blood preservation, but has not been extensively practiced in pediatric patients...
September 2018: Paediatric Anaesthesia
Johan M Berghmans, Marten J Poley, Jan van der Ende, Francis Veyckemans, Stephanie Poels, Frank Weber, Bert Schmelzer, Dirk Himpe, Frank C Verhulst, Elisabeth Utens
BACKGROUND: Children undergoing adenotonsillectomy are at risk of severe postoperative pain and sleep problems. Little is known about the specific child risk factors for these problems. AIMS: The aim of this study was to assess the occurrence of postoperative pain, sleep problems, and medication adherence, and assess the influence of internalizing and externalizing problems on postoperative pain. METHODS: This prospective cohort study included 160 children, aged 1...
September 2018: Paediatric Anaesthesia
Michael R J Sury
This is an account of an interview with David John Hatch who was one of the first Professors of Pediatric Anesthesia in the world. He began his anesthesia career as a medical student administering chloroform and ended it 40 years later as a Consultant at Great Ormond Street Hospital where he developed and led a world renowned research team measuring and assessing lung function in infants and children. These productive years earned him his chair at the Institute of Child Health in London (part of University College London) funded by Portex (currently, a branch of Smiths Medical)...
September 2018: Paediatric Anaesthesia
Tomoharu Shakuo, Katsunori Oe, Yuko Shimura, Hanae Awakura, Arata Yamada
A newborn infant was diagnosed with an imperforate anus, and colostomy was performed one day after birth. He exhibited repeated episodes of poor oxygenation during intubation, and a CT scan revealed a bridging bronchus. He was scheduled to undergo sacroperineal repair in the prone position 8 months later. A tracheal tube, with its tip modified to widen the opening, was inserted through the nose. This led to normal oxygenation, even while in the prone position. The surgery was completed without any complications...
September 2018: Paediatric Anaesthesia
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