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Paediatric Anaesthesia

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https://www.readbyqxmd.com/read/29777565/unanticipated-hospital-admission-in-pediatric-patients-with-congenital-heart-disease-undergoing-ambulatory-noncardiac-surgical-procedures
#1
Koichi Yuki, Sophia Koutsogiannaki, Sandra Lee, James A DiNardo
BACKGROUND: An increasing number of surgical and nonsurgical procedures are being performed on an ambulatory basis in children. Analysis of a large group of pediatric patients with congenital heart disease undergoing ambulatory procedures has not been undertaken. AIMS: The objective of this study was to characterize the profile of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis at our institution, to determine the incidence of adverse cardiovascular and respiratory adverse events, and to determine the risk factors for unscheduled hospital admission...
May 18, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752878/a-healthy-measure-of-monitoring-fundamentals
#2
REVIEW
Mats Wallin, Per-Arne Lönnqvist
Monitoring represents a seminal part of modern anesthesia but it is imperative that clinicians and health care staff understand the fundamentals of measurements to correctly understand, apply, and at times discard various monitoring options. The world of measurements is a very precise science that needs to be fully acknowledged. This communication aims at highlighting certain issues relevant to everyday clinical monitoring.
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752858/enhanced-recovery-after-surgery-in-children-promising-evidence-based-multidisciplinary-care
#3
Kyle O Rove, John C Edney, Megan A Brockel
Enhanced recovery after surgery (ERAS) is a multimodal approach to the care of the surgical patient focused on reducing the stress response and associated physiologic changes that accompany surgery. Over the past 20 years, ERAS programs have been found to result in reduced LOS and complications in adult patients. Despite abundant adult literature describing implementation and outcomes of enhanced recovery programs, pediatric data in this area is sparse. This educational review describes the history and elements of ERAS protocols, reviews the available evidence in adult and pediatric populations, compares and contrasts ERAS with the PSH, and offers strategies for implementation and ideas for future directions of ERAS in children...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752854/perioperative-factors-associated-with-persistent-opioid-use-after-extensive-abdominal-surgery-in-children-and-adolescents-a-retrospective-cohort-study
#4
Pascal Owusu-Agyemang, Juan P Cata, Antoinette Van Meter, Ravish Kapoor, Acsa M Zavala, Uduak U Williams, January Tsai, Elizabeth Rebello, Lei Feng, Andrea Hayes-Jordan
BACKGROUND: In adults, preoperative opioid use and higher perioperative opioid consumption have been associated with higher odds of persistent opioid use after surgery. There are limited data on the prevalence and factors associated with persistent opioid use after major oncologic surgery in children. AIMS: In this study, we sought to determine the prevalence and factors associated with the development of persistent opioid use in a group of children and adolescents who had undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752853/dexmedetomidine-for-the-reduction-of-emergence-delirium-in-children-undergoing-tonsillectomy-with-propofol-anesthesia-a-double-blind-randomized-study
#5
Adelais G Tsiotou, Anna Malisiova, Elena Kouptsova, Maria Mavri, Maria Anagnostopoulou, Evagelia Kalliardou
BACKGROUND: Postanesthesia emergence delirium is a motor agitation state complicating pediatric anesthesia. We investigated the efficacy of dexmedetomidine in reducing emergence delirium in children undergoing tonsillectomy with and without adenoidectomy using total intravenous anesthesia with propofol. METHODS: This was a prospective, single-center, double-blind, randomized study. The primary outcome was the presence or absence of emergence delirium with and without dexmedetomidine...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752843/propofol-anesthesia-exposure-and-nonaversive-memory-retrieval-and-the-expression-of-molecules-involved-in-memory-process-in-the-dorsal-hippocampus-in-peripubertal-rats
#6
Željko Pavković, Desanka Milanović, Sabera Ruždijić, Selma Kanazir, Vesna Pešić
BACKGROUND: The effects of anesthetic drugs on postoperative cognitive function in children are not well defined and have not been experimentally addressed. AIMS: The present study aimed to examine the influence of propofol anesthesia exposure on nonaversive hippocampus-dependent learning and biochemical changes involved in memory process in the dorsal hippocampus, in peripubertal rats as the rodent model of periadolescence. METHODS: The intersession spatial habituation and the novel object recognition tasks were used to assess spatial and nonspatial, nonaversive hippocampus-dependent learning...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29752842/correlation-between-duration-of-preoperative-fasting-and-emergence-delirium-in-pediatric-patients-undergoing-ophthalmic-examination-under-anesthesia-a-prospective-observational-study
#7
Puneet Khanna, Kulbhushan Saini, Renu Sinha, Niseville Nisa, Shailendra Kumar, Souvik Maitra
BACKGROUND: Preoperative fasting in children can cause anxiety, which may ultimately lead to postoperative emergence delirium. However, no data are available whether duration of preoperative fasting correlates with postoperative emergence delirium. AIMS: The aim of this study was to identify if there is any correlation between the duration of preoperative fasting and emergence delirium in children undergoing ophthalmic examination under anesthesia. METHODS: In this prospective observational study, 100 children between the age group 2-6 years of American Society of Anesthesiologists physical status I or II, scheduled for examination of the eye under general anesthesia with sevoflurane were recruited...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29732652/tracheobronchial-angles-in-children-three-dimensional-computed-tomography-based-measurements
#8
Tariq M Wani, Basharat Buchh, Faris Saeed AlGhamdi, Ravees Jan, Dmitry Tumin, Joseph D Tobias
BACKGROUND: Studies have shown significant variation in the tracheobronchial angles in pediatric-aged patients. The current study revisits tracheobronchial angle measurements in children using accurate computed tomography-based 3-dimensional images to add clarity to the understanding of tracheobronchial angles. The primary objective of the current study was to measure the right and left bronchial angle take off from the trachea using 3-dimensional computed tomography-based images of the air column in the tracheobronchial tree...
May 6, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29732645/procedural-sedation-in-children-with-autism-spectrum-disorders-a-survey-of-current-practice-patterns-of-the-society-for-pediatric-sedation-members
#9
Pradip P Kamat, Leah N Bryan, Courtney E McCracken, Harold K Simon, John W Berkenbosch, Jocelyn R Grunwell
BACKGROUND: Children with autism spectrum disorder are challenging to sedate because of communication, sensory, and behavioral challenges. AIMS: The aim of this survey was to determine how procedural sedation is provided to children with autism spectrum disorders and whether sedation programs have specialized protocols for procedural sedation of these children. METHODS: We surveyed physician Medical Directors of sedation programs who are members of the Society for Pediatric Sedation, asking about practice characteristics and resource utilization during procedural sedation of children with autism spectrum disorders...
May 6, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29722100/estimating-pediatric-general-anesthesia-exposure-quantifying-duration-and-risk
#10
Devan Darby Bartels, Mary Ellen McCann, Andrew J Davidson, David M Polaner, Elizabeth L Whitlock, Brian T Bateman
INTRODUCTION: Understanding the duration of pediatric general anesthesia exposure in contemporary practice is important for identifying groups at risk for long general anesthesia exposures and designing trials examining associations between general anesthesia exposure and neurodevelopmental outcomes. METHODS: We performed a retrospective cohort analysis to estimate pediatric general anesthesia exposure duration during 2010-2015 using the National Anesthesia Clinical Outcomes Registry...
May 2, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29701278/the-impact-of-general-anesthesia-on-child-development-and-school-performance-a-population-based-study
#11
Francisco J Schneuer, Jason P Bentley, Andrew J Davidson, Andrew Ja Holland, Nadia Badawi, Andrew J Martin, Justin Skowno, Samantha J Lain, Natasha Nassar
BACKGROUND: There has been considerable interest in the possible adverse neurocognitive effects of exposure to general anesthesia and surgery in early childhood. AIMS: The aim of this data linkage study was to investigate developmental and school performance outcomes of children undergoing procedures requiring general anesthesia in early childhood. METHODS: We included children born in New South Wales, Australia of 37+ weeks' gestation without major congenital anomalies or neurodevelopmental disability with either a school entry developmental assessment in 2009, 2012, or Grade-3 school test results in 2008-2014...
April 27, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29700894/consensus-statement-on-clear-fluids-fasting-for-elective-pediatirc-general-anesthesia
#12
Mark Thomas, Christa Morrison, Richard Newton, Ehrenfried Schindler
Pediatric anesthetic guidelines for the management of preoperative fasting of clear fluids are currently 2 hours. The traditional 2 hours clear fluid fasting time was recommended to decrease the risk of pulmonary aspiration and is not in keeping with current literature. It appears that a liberalized clear fluid fasting regime does not affect the incidence of pulmonary aspiration and in those who do aspirate, the sequelae are not usually severe or long-lasting. With a 2-hour clear fasting policy, the literature suggests that this translates into 6-7 hours actual duration of fasting with several studies up to 15 hours...
April 27, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29700892/prevention-of-perioperative-venous-thromboembolism-in-pediatric-patients-guidelines-from-the-association-of-paediatric-anaesthetists-of-great-britain-and-ireland-apagbi
#13
Judith Morgan, Matthew Checketts, Amaia Arana, Elizabeth Chalmers, Jamie Maclean, Mark Powis, Neil Morton
The Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) Guidelines Working Group on Thromboprophylaxis in Children has reviewed the literature and where possible provided advice on the care of children in the perioperative period. Areas reviewed include the incidence of perioperative venous thromboembolism (VTE), risk factors, evidence for mechanical and chemical prophylaxis, and complications. Safe practice of regional anesthesia with anticoagulant prophylaxis is detailed. In summary, there are few areas of strong evidence...
April 27, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29687529/lymphatic-imaging-and-intervention-in-a-pediatric-population-anesthetic-considerations
#14
David R Jobes, Lauren A Brown, Yoav Dori, Maxim Itkin, Susan C Nicolson
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29687523/safety-of-anesthesia-for-children-with-mucopolysaccharidoses-a-retrospective-analysis-of-54-patients
#15
Vittorio Scaravilli, Alberto Zanella, Valentina Ciceri, Mariagrazia Bosatra, Claudia Flandoli, Alessia La Bruna, Simone Sosio, Rossella Parini, Serena Gasperini, Antonio Pesenti, Alessandra Moretto
BACKGROUND: Complications are common during anesthesia for patients with mucopolysaccharidoses. San Gerardo Hospital (Italy) is a reference center for mucopolysaccharidoses with a dedicated pediatric anesthesia service. AIMS: This study aims to evaluate the safety of anesthesia for mucopolysaccharidoses patients, describe their anesthetic management at our institution, and assess risk factors for complications. METHODS: The anesthetic charts of mucopolysaccharidoses patients admitted from January 1999 to December 2014 were retrospectively analyzed...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29635764/postoperative-pain-management-in-children-guidance-from-the-pain-committee-of-the-european-society-for-paediatric-anaesthesiology-espa-pain-management-ladder-initiative
#16
Maria Vittinghoff, Per-Arne Lönnqvist, Valeria Mossetti, Stefan Heschl, Dusica Simic, Vesna Colovic, Dmytro Dmytriiev, Martin Hölzle, Marzena Zielinska, Anna Kubica-Cielinska, Elizabeth Lorraine-Lichtenstein, Ivana Budić, Marijana Karisik, Belen De Josè Maria, Francesco Smedile, Neil S Morton
The main remit of the European Society for Paediatric Anaesthesiology (ESPA) Pain Committee is to improve the quality of pain management in children. The ESPA Pain Management Ladder is a clinical practice advisory based upon expert consensus to help to ensure a basic standard of perioperative pain management for all children. Further steps are suggested to improve pain management once a basic standard has been achieved. The guidance is grouped by the type of surgical procedure and layered to suggest basic, intermediate, and advanced pain management methods...
April 10, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29633434/an-in-vitro-evaluation-of-the-influence-of-neonatal-endotracheal-tube-diameter-and-length-on-the-work-of-breathing
#17
Fuyu Miyake, Rika Suga, Takahiro Akiyama, Fumihiko Namba
BACKGROUND: Neonates, particularly premature babies, are often managed with endotracheal intubation and subsequent mechanical ventilation to maintain adequate pulmonary gas exchange. There is no consensus on the standard length of endotracheal tube. Although a short tube reduces resistance and respiratory dead space, it is believed to increase the risk of accidental extubation. There are not entirely coherent data regarding the effect of endotracheal tube length on work of breathing in infants...
April 6, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29603862/intraoperative-hypoxia-secondary-to-pneumothorax-the-role-of-lung-ultrasound
#18
Cristian Mirabile, Sophie Malekzadeh-Milani, Tran Quang Vinh, Ayman Haydar
Intraoperative pneumothorax during general anesthesia is a dangerous event. It is a possible cause of sudden intraoperative hypoxia, which can be critical especially in high-risk patients such as those with end-stage heart failure. Early diagnosis and effective treatment are essential. We describe the case of a pneumothorax during cardiac transplantation, diagnosed by ultrasound and immediately treated. A good skill in lung ultrasound is advantageous in the management of intraoperative hypoxia, particularly for prompt diagnosis of pneumothorax...
March 30, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29603847/inclusion-of-non-english-speaking-patients-in-research-a-single-institution-experience
#19
Rachel Bernier, Erin Halpin, Steven J Staffa, Lindsey Benson, James A DiNardo, Viviane G Nasr
BACKGROUND: Considering the recent increase in medical care provided to patients from foreign countries and the diversity of languages spoken by families living within the United States, it is important to determine whether non-English-speaking patients have access to participate in clinical research from which they may benefit. AIMS: We aimed to determine the number of non-English-speaking patients presenting to Boston Children's Hospital for medical care between 2011 and 2016, the number of clinical research protocols active within the Department of Anesthesiology, Critical Care and Pain Medicine approved to enroll non-English-speaking patients, as well as the number of both non-English- and English-speaking patients approached and enrolled in these studies...
March 30, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29575610/a-red-cell-preservation-strategy-reduces-postoperative-transfusions-in-pediatric-heart-surgery-patients
#20
Meena Nathan, Brielle Tishler, Kimberlee Gauvreau, Gregory S Matte, Robert J Howe, Linda Durham, Sharon Boyle, Derek Mathieu, Francis Fynn-Thompson, James A DiNardo, Juan C Ibla
BACKGROUND: Blood transfusion has well-documented adverse effects. As part of a blood conservation initiative at our center, we began routine use of cell saver for all congenital heart surgery performed on cardiopulmonary bypass since 2014. AIMS: This study aimed to compare transfusion rates prior to, and in the first and second year after this initiative. We hypothesized that cell saver use would decrease transfusion requirements in second year after use of the cell saver compared to the pre cell saver group...
March 25, 2018: Paediatric Anaesthesia
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