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Pediatric obesity and anesthesia

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https://www.readbyqxmd.com/read/29106880/utility-of-screening-questionnaire-and-polysomnography-to-predict-postoperative-outcomes-in-children
#1
Hiromi Kako, Jennifer Tripi, Hina Walia, Dmitry Tumin, Mark Splaingard, Kris R Jatana, Joseph D Tobias, Vidya T Raman
INTRODUCTION: The prevalence of pediatric obstructive sleep apnea (OSA) has increased concurrently with the increasing prevalence of obesity. We have previously validated a short questionnaire predicting the occurrence of OSA on polysomnography (PSG). This follow-up study assessed the utility of the questionnaire in predicting postoperative outcomes. METHODS: Children undergoing surgery and completing a sleep study were prospectively screened for OSA using a short questionnaire...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29090036/the-autoimmunity-s-footprint-in-pediatrics-type-1-diabetes-coeliac-disease-thyroiditis
#2
Anca Orzan, Carmen Novac, Mihaela Mihu, Constantin Ionescu Tirgoviste, Mihaela Balgradean
The present case report aims to describe and discuss the approach for the management of difficult endotracheal intubation in an adult with Down syndrome undergoing cataract surgery. A 26-year-old female with Down syndrome and a validated diagnosis of cataract requiring surgery was examined in order to assess the degree of difficulty of endotracheal intubation. Patients with Down syndrome have characteristic craniofacial abnormalities which require a thorough pre-operative assessment to anticipate and prepare for a difficult endotracheal intubation...
June 2017: Mædica
https://www.readbyqxmd.com/read/28965443/effect-of-body-mass-index-on-surgical-outcomes-after-posterior-spinal-fusion-for-adolescent-idiopathic-scoliosis
#3
Rafael De la Garza Ramos, Jonathan Nakhla, Rani Nasser, Jacob F Schulz, Taylor E Purvis, Daniel M Sciubba, Merritt D Kinon, Reza Yassari
OBJECTIVE Obesity is an increasing public health concern in the pediatric population. The purpose of this investigation was to examine the impact of body mass index (BMI) on 30-day outcomes after posterior spinal fusion for adolescent idiopathic scoliosis (AIS). METHODS The American College of Surgeons National Surgical Quality Improvement Program Pediatric database (2013 and 2014) was reviewed. Patients 10-18 years of age who had undergone fusion of 7 or more spinal levels for AIS were included. Thirty-day outcomes (complications, readmissions, and reoperations) were compared based on patient BMI per age- and sex-adjusted growth charts as follows: normal weight (NW; BMI < 85th percentile), overweight (OW; BMI 85th-95th percentile), and obese (OB; BMI > 95th percentile)...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28875259/the-impact-of-obesity-on-30-day-complications-in-pediatric-surgery
#4
A T Train, S B Cairo, H A Meyers, C M Harmon, D H Rothstein
PURPOSE: To examine the effects of obesity on specialty-specific surgical outcomes in children. MATERIALS AND METHODS: Retrospective cohort study using the National Surgical Quality Improvement Program, Pediatric, 2012-2014. Patients included those aged 2-17 years who underwent a surgical procedure in one of six specialties. Obesity was the primary patient variable of interest. Outcomes of interest were postoperative complications and operative times. Odds ratios for development of postoperative complications were calculated using stepwise multivariate regression analysis...
November 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28733098/obesity-and-failure-of-nonsurgical-management-of-pediatric-both-bone-forearm-fractures
#5
Ugochi C Okoroafor, Lisa K Cannada, Jasmin L McGinty
PURPOSE: In pediatric extremity fractures treated nonsurgically, maintaining reduction can be difficult in obese children owing to the larger soft tissue envelope. The purpose of this study was to investigate the relationship between obesity and failure of nonsurgical management of pediatric both-bone forearm fractures. METHODS: We conducted a retrospective review of 129 skeletally immature patients older than 2 years who received nonsurgical treatment for closed radius and ulna shaft fractures at a level I pediatric trauma center between 2011 and 2014...
September 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28717532/retrograde-intrarenal-surgery-for-renal-stones-part-1
#6
REVIEW
Ben Van Cleynenbreugel, Özcan Kılıç, Murat Akand
The main aim in the treatment of renal stones is to clearance of the stones completely with the least morbidity. Parallel to the improvements in technology during recent years, new flexible ureterorenoscopes and effective lithotripters such as holmium laser have been developed, thus retrograde intrarenal surgery (RIRS) has become an efficient and safe option in the management of urinary system stone disease with a gradually increasing popularity. Therewithal, innovations in auxiliary equipment such as guide-wires, ureteral access sheath and stone baskets have made this procedure more effective...
June 2017: Turkish Journal of Urology
https://www.readbyqxmd.com/read/28688993/fat-demented-and-stupid-an-unrecognized-legacy-of-pediatric-urology
#7
REVIEW
Christopher S Cooper
The human body is an unfathomably intricate structure consisting of many connected and intertwined systems. This makes it impossible for therapeutic interventions to selectively target only one physiologic system without some impact or side effects on all the other systems. The resiliency of the human body modifies and disguises side effects, some of which may be undetectable for years and not apparent without scientific investigation. Pediatric urologists employ relatively few medications for the common conditions they treat and in general these consist of antibiotics, anticholinergics, and anesthetics...
August 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28238111/use-of-fentanyl-in-adolescents-with-clinically-severe-obesity-undergoing-bariatric-surgery-a-pilot-study
#8
Janelle D Vaughns, Victoria C Ziesenitz, Elaine F Williams, Alvina Mushtaq, Ricarda Bachmann, Gisela Skopp, Johanna Weiss, Gerd Mikus, Johannes N van den Anker
BACKGROUND: The number of obese pediatric patients requiring anesthesia is rapidly increasing. Although fentanyl is a commonly used narcotic during surgery, there are no pharmacokinetic (PK) data available for optimal dosing of fentanyl in adolescents with clinically severe obesity. MATERIALS AND METHODS: An institutional review board-approved exploratory pilot study was conducted in six adolescents aged 14-19 years undergoing bariatric surgery. Mean total body weight (TBW) and mean BMI were 137...
June 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/27875102/obesity-increases-operative-time-in-children-undergoing-laparoscopic-cholecystectomy
#9
T K Pandian, Daniel S Ubl, Elizabeth B Habermann, Christopher R Moir, Michael B Ishitani
INTRODUCTION: Few studies have assessed the impact of obesity on laparoscopic cholecystectomy (LC) in pediatric patients. MATERIALS AND METHODS: Children who underwent LC were identified from the 2012 to 2013 American College of Surgeons' National Surgical Quality Improvement Program Pediatrics data. Patient characteristics, operative details, and outcomes were compared. Multivariable logistic regression was utilized to identify predictors of increased operative time (OT) and duration of anesthesia (DOAn)...
March 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27861607/transient-elastography-based-liver-stiffness-age-dependently-increases-in-children
#10
Daisuke Tokuhara, Yuki Cho, Haruo Shintaku
BACKGROUND AND AIMS: Pediatric use of liver transient elastography (TE) is attractive for its non-invasiveness, but reference values have not been established. We aimed to determine reference values for TE in children. METHODS: In pediatric patients (1 to 18 years), TE (FibroScan®) with an M probe was used for both liver stiffness measurement (LSM) and measurement of hepatic fat deposition by using a controlled attenuation parameter (CAP). The patients were divided into three relevant age groups: preschoolers (1 to 5 years), elementary school children (6 to 11 years), and adolescents (12 to 18 years)...
2016: PloS One
https://www.readbyqxmd.com/read/27726001/-perioperative-adverse-respiratory-events-in-overweight-and-obese-children
#11
J Ulrici, G Hempel, M Sasse, J Vollrath, C Höhne
BACKGROUND: Overweight and obesity are increasing problems in pediatric anesthesia. This observational study was designed to examine how airway-related complications occur in overweight children and adolescents during general anesthesia and if this is a relevant problem in Germany. METHODS: From October 2008 until August 2009, at the university clinic in Leipzig, 504 in- and outpatients, aged 2-18 years, ASA I-III, undergoing elective procedures (ENT and pediatric surgery), were observed...
December 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27101501/perioperative-respiratory-adverse-events-in-pediatric-ambulatory-anesthesia-development-and-validation-of-a-risk-prediction-tool
#12
Rajeev Subramanyam, Samrat Yeramaneni, Mohamed Monir Hossain, Amy M Anneken, Anna M Varughese
BACKGROUND: Perioperative respiratory adverse events (PRAEs) are the most common cause of serious adverse events in children receiving anesthesia. Our primary aim of this study was to develop and validate a risk prediction tool for the occurrence of PRAE from the onset of anesthesia induction until discharge from the postanesthesia care unit in children younger than 18 years undergoing elective ambulatory anesthesia for surgery and radiology. The incidence of PRAE was studied. METHODS: We analyzed data from 19,059 patients from our department's quality improvement database...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27008066/anesthetic-considerations-for-pediatric-obesity-and-adolescent-bariatric-surgery
#13
Paul J Samuels, Matthew D Sjoblom
PURPOSE OF REVIEW: Pediatric obesity has become commonplace in our clinical practice, and presents anesthesia providers with numerous challenges. This study provides an up-to-date review of their perioperative care, including the measurement of pediatric obesity, rational drug dosing in obese children, and recent data on bariatric outcomes in adolescents. RECENT FINDINGS: Pediatric obesity is associated with a number of relevant comorbidities that impact anesthesia care, and specific children are at particularly high risk...
June 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26847776/perioperative-adverse-respiratory-events-in-overweight-obese-children-systematic-review
#14
REVIEW
Panagiotis Kiekkas, Nikolaos Stefanopoulos, Nick Bakalis, Antonios Kefaliakos, Evangelos Konstantinou
Childhood obesity is associated with numerous respiratory disorders, which may be aggravated when general anesthesia is administered. This systematic review aimed to investigate and synthesize the published literature on the associations between childhood obesity and perioperative adverse respiratory events (PAREs). By using key terms, observational studies published between 1990 and 2014 in English-language journals indexed by Cumulative Index for Nursing and Allied Health Literature, PubMed, Web of Science, Cochrane Database, and EMBASE were searched for reports of relevant associations...
February 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/26683111/preoperative-risk-assessment-in-children-undergoing-major-urologic-surgery
#15
Daryl J McLeod, Lindsey Asti, Justin B Mahida, Katherine J Deans, Peter C Minneci
BACKGROUND: Preoperative risk assessment is standard in adult surgery, but often these risk assessments cannot be applied to children. Previous studies emphasize the differences between pediatric and adult populations and variability by surgical procedure types. OBJECTIVE: We investigated preoperative risk factors for several outcomes in children undergoing major urologic surgery using the National Surgical Quality Improvement Program (NSQIP) Pediatric. STUDY DESIGN: A cohort of 2-18-year-old children who underwent major urologic surgery was identified by Current Procedure Terminology (CPT) codes in the 2012-2013 NSQIP-Pediatric...
February 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/26323414/clinical-pharmacology-of-frequently-used-intravenous-drugs-during-bariatric-surgery-in-adolescents
#16
REVIEW
Janelle D Vaughns, Victoria C Ziesenitz, John N van den Anker
Obesity represents one of the most important public health issues according to the World Health Organization. Additionally, in a recent National Health and Nutrition Survey of 2011-2012, approximately 17 % of children and adolescents in the United States were considered obese. The obesity rate is higher within the adolescent age group as compared to preschool children. Childhood obesity is particularly problematic, because the co-morbid disease states which accompany obesity may require frequent pharmacotherapy and/ or surgical intervention...
2015: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/26218257/prevalence-and-predictors-of-adverse-events-during-procedural-sedation-anesthesia-outside-the-operating-room-for-esophagogastroduodenoscopy-and-colonoscopy-in-children-age-is-an-independent-predictor-of-outcomes
#17
Jennifer L Biber, Veerajalandhar Allareddy, Veerasathpurush Allareddy, Susan M Gallagher, Kevin G Couloures, David G Speicher, Joseph P Cravero, Anne G Stormorken
OBJECTIVES: Procedural sedation/anesthesia outside the operating room for a variety of procedures is well described with an overall low adverse event rate in certain settings. Adverse event associated with procedural sedation/anesthesia outside the operating room for gastrointestinal procedures have been described, albeit in small, single-center studies with wide variance in outcomes. Predictors of such outcomes are unclear. We aimed to estimate the prevalence of adverse event in children undergoing procedural sedation/anesthesia outside the operating room for esophagogastroduodenoscopy, colonoscopy, or both to identify predictors of adverse event...
October 2015: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/25827276/anesthesiological-considerations-for-children-with-obstructive-sleep-apnea
#18
REVIEW
Charles J Coté
PURPOSE OF REVIEW: To summarize recent evidence-based data regarding outcomes associated with children who have obstructive sleep apnea (OSA). RECENT FINDINGS: Internet surveys conducted by pediatric otolaryngologists and pediatric anesthesiologists have reported a disturbing number of deaths within 24 h of tonsillectomy attributed to postsurgical/anesthesia apnea. Several occurred in the post anesthesia care unit after routine monitors had been removed. In addition, a number of deaths also have been attributed to children who have duplicated cytochromes allowing the rapid conversion of codeine to morphine, thus producing a relative drug overdose...
June 2015: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/25817924/the-impact-of-obesity-on-pediatric-procedural-sedation-related-outcomes-results-from-the-pediatric-sedation-research-consortium
#19
Patricia D Scherrer, Michael D Mallory, Joseph P Cravero, Lia Lowrie, James H Hertzog, John W Berkenbosch
OBJECTIVES: To evaluate the impact of obesity on adverse events and required interventions during pediatric procedural sedation. METHODS: The Pediatric Sedation Research Consortium database of prospectively collected procedural sedation encounters was queried to identify patients for whom body mass index (BMI) could be calculated. Obesity was defined as BMI ≥95th percentile for age and gender. Sedation-related outcomes, adverse events, and therapeutic interventions were compared between obese and nonobese patients...
July 2015: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/25716128/use-of-enoxaparin-in-obese-adolescents-during-bariatric-surgery-a-pilot-study
#20
Alvina Mushtaq, Janelle D Vaughns, Victoria C Ziesenitz, Evan P Nadler, John N van den Anker
BACKGROUND: Obese patients have a higher risk of venous thromboembolism when immobilized due to surgery. The objective of this study was to assess anti-factor Xa activity in adolescent bariatric surgical patients receiving prophylactic enoxaparin. METHODS: Four morbidly obese adolescents undergoing laparoscopic sleeve gastrectomy were enrolled. Enoxaparin was administered (40 mg subcutaneous (SC) if BMI ≤50 kg/m(2) or 60 mg SC if BMI >50 kg/m(2)) for prevention of venous thromboembolism every 12 h starting after induction of anesthesia until discharge...
October 2015: Obesity Surgery
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