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https://www.readbyqxmd.com/read/28108038/the-effect-of-endotracheal-tubes-versus-laryngeal-mask-airways-on-perioperative-respiratory-adverse-events-in-infants-a-randomised-controlled-trial
#1
Thomas F E Drake-Brockman, Anoop Ramgolam, Guicheng Zhang, Graham L Hall, Britta S von Ungern-Sternberg
BACKGROUND: Perioperative respiratory adverse events (PRAE) are the most common critical incidents in paediatric anaesthesia and occur more often in infants. Use of laryngeal mask airways (LMAs) is associated with reduced PRAE compared with endotracheal tubes in older children (>1 year). We aimed to evaluate the effect of these devices on the incidence of PRAE in infants. METHODS: We did a randomised controlled trial at the Princess Margaret Hospital for Children in Perth (WA, Australia) by recruiting infants (aged 0-12 months) undergoing general (with or without regional or local) anaesthesia with anticipated fentanyl dose 1 μg/kg or lower for minor elective surgery...
January 17, 2017: Lancet
https://www.readbyqxmd.com/read/28107788/the-indications-and-role-of-paediatric-bronchoscopy-in-a-developing-country-with-high-prevalence-of-pulmonary-tuberculosis-and-hiv
#2
Irwin Webster, Pierre Goussard, Robert Gie, Jacques Janson, Gawie Rossouw
BACKGROUND: Bronchoscopy, an important investigation for the diagnosis and management of respiratory diseases, is widely used in high income countries. There is limited information on value of paediatric bronchoscopy in low and middle income countries (LMIC). AIMS AND OBJECTIVES: Aim was to describe the indications, findings and complications of bronchoscopy in a middle income country with a high prevalence of tuberculosis and HIV. METHODOLOGY: A retrospective analysis of a database over a 3...
January 20, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28095939/safe-balloon-sizing-for-endoscopic-dilatation-of-subglottic-stenosis-in-children
#3
S D Sharma, S L Gupta, M Wyatt, D Albert, B Hartley
OBJECTIVES: To describe our experience and provide guidelines for maximum safe balloon sizes according to age in children undergoing balloon dilatation. METHOD: A retrospective review was conducted of children undergoing balloon dilatation for subglottic stenosis in a paediatric tertiary unit between May 2006 and February 2016. RESULTS: A total of 166 patients underwent balloon dilatation. Mean ( ± standard deviation) patient age was 4.5 ± 3...
January 18, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28095826/non-invasive-respiratory-support-for-infants-with-bronchiolitis-a-national-survey-of-practice
#4
H Turnham, R S Agbeko, J Furness, J Pappachan, A G Sutcliffe, P Ramnarayan
BACKGROUND: Bronchiolitis is a common respiratory illness of early childhood. For most children it is a mild self-limiting disease but a small number of children develop respiratory failure. Nasal continuous positive airway pressure (nCPAP) has traditionally been used to provide non-invasive respiratory support in these children, but there is little clinical trial evidence to support its use. More recently, high-flow nasal cannula therapy (HFNC) has emerged as a novel respiratory support modality...
January 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28093429/paediatric-ed-bipap-continuous-quality-improvement-programme-with-patient-analysis-2005-2013
#5
Thomas Abramo, Abby Williams, Samaiya Mushtaq, Mark Meredith, Rawle Sepaule, Kristen Crossman, Cheryl Burney Jones, Suzanne Godbold, Zhuopei Hu, Todd Nick
OBJECTIVE: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28058141/ultrasonographic-measurement-of-subglottic-diameter-for-paediatric-cuffed-endotracheal-tube-size-selection-feasibility-report
#6
Demet Altun, Mukadder Orhan Sungur, Achmet Ali, Emre Sertaç Bingül, Tülay Özkan Seyhan, Emre Çamcı
OBJECTIVE: The aim of this feasibility study was to investigate the first attempt success of ultrasonography (USG) in paediatric patients in predicting an appropriate cuffed endotracheal tube (ETT) size. METHODS: Fifty children who were 1-10 years of age and who received general anaesthesia with endotracheal intubation for adenoidectomy or adenotonsillectomy were enrolled in the study. In all participants, the transverse diameter of the subglottic airway was measured with USG at the cricoid level without ventilation...
December 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28032947/controversies-in-the-management-of-caustic-ingestion-injury-an-evidence-based-review
#7
J H Bird, S Kumar, C Paul, J D Ramsden
BACKGROUND: Caustic ingestion of acid or alkaline substances can cause damage to the upper respiratory and upper digestive tract. Initial presentation following caustic ingestion can include oropharyngeal pain, dysphagia and stridor. Due to this clinical presentation that the resident otolaryngologist is consulted to review and examine these patients to assess for airway compromise and commence initial management and care until airway concern has passed. OBJECTIVE OF REVIEW: This review aims to provide evidence based guidance in the management of those presenting with acute ingestion injury so that informed initial medical therapy can be commenced and appropriate investigations arranged to optimise patient outcome...
December 29, 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28029591/cardiorespiratory-interactions-in-paediatrics-it-s-almost-always-the-circulation-stupid
#8
REVIEW
M L Rigby, M Rosenthal
The interaction of the heart and lungs is probably the most important aspect of life and survival. Fortunately, it is not difficult to understand the fundamentals. The purpose of the lungs and their ventilation is to present oxygen to the circulation via the alveoli and to receive carbon dioxide from the circulation and then expel it. The relations of the heart and lungs and the matching of blood flow to the various organs with ventilation and lung perfusion may be disrupted by a variety of congenital or acquired heart malformations...
August 12, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28007521/children-with-challenging-airways-what-about-glidescope-%C3%A2-video-laryngoscopy
#9
Chrystelle Sola, Anne-Charlotte Saour, Christine Macq, Sophie Bringuier, Olivier Raux, Christophe Dadure
BACKGROUND: GlideScope® video-laryngoscopy is becoming increasingly used, including in paediatrics. However, to date, very few data are available on efficiency during situations involving difficult intubation. Our objective was to describe the usefulness of the GlideScope® in children with presumed challenging airway criteria. METHODS: In this observational study, all children with predicted criteria of potential difficult intubation and requiring general anaesthesia with tracheal intubation were prospectively enrolled over a 12-month period...
December 19, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28003692/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-paediatrics
#10
Dilip K Pawar, Jeson Rajan Doctor, Ubaradka S Raveendra, Singaravelu Ramesh, Sumalatha Radhakrishna Shetty, Jigeeshu Vasishtha Divatia, Sheila Nainan Myatra, Amit Shah, Rakesh Garg, Pankaj Kundra, Apeksh Patwa, Syed Moied Ahmed, Sabyasachi Das, Venkateswaran Ramkumar
The All India Difficult Airway Association guidelines for the management of the unanticipated difficult tracheal intubation in paediatrics are developed to provide a structured, stepwise approach to manage unanticipated difficulty during tracheal intubation in children between 1 and 12 years of age. The incidence of unanticipated difficult airway in normal children is relatively rare. The recommendations for the management of difficult airway in children are mostly derived from extrapolation of adult data because of non-availability of proven evidence on the management of difficult airway in children...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27998886/the-choking-hazard-of-grapes-a-plea-for-awareness
#11
REVIEW
Amy J Lumsden, Jamie G Cooper
Deaths from choking are a major cause of childhood mortality, especially in the very young. Whole grapes are ideally suited to cause paediatric airway obstruction and, though regularly implicated, knowledge that this popular fruit, and other similarly shaped foods, is a choking hazard is not widespread. We present the cases of three children who presented to our institution after grape aspiration. Increased dissemination of the learning points among health professionals working with children may aid in the prevention of further episodes...
December 20, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27957481/respiratory-infection-rates-differ-between-geographically-distant-paediatric-cystic-fibrosis-cohorts
#12
Kathryn A Ramsey, Emily Hart, Lidija Turkovic, Marc Padros-Goossens, Stephen M Stick, Sarath C Ranganathan
Respiratory infections are a major cause of pulmonary decline in children with cystic fibrosis (CF). We compared the prevalence of infection in early life at geographically distant CF treatment centres participating in the same surveillance programme in Australia. Lower airway microbiology, inflammation and structural lung disease at annual review were evaluated for 260 children 0-8 years old with CF at 1032 visits to CF treatment centres in Melbourne or Perth. Melbourne patients were more likely to be culture-positive for common respiratory pathogens at all age groups (odds ratio (OR) 1...
July 2016: ERJ Open Research
https://www.readbyqxmd.com/read/27942052/critical-incidents-in-paediatric-anaesthesia-a-prospective-analysis-over-a-1-year-period
#13
Raylene Dias, Nandini Dave, Swapna Chiluveru, Madhu Garasia
BACKGROUND AND AIMS: Critical incident reporting helps to identify errors and formulate preventive strategies. Many countries have existing national reporting systems. Such a system is yet to be established in India. We aimed to study the incidence of critical events in the paediatric operation theatre (OT) of our institute. METHODS: We conducted a prospective observational study of all children receiving anaesthesia in paediatric OT over a period of 1 year. They were monitored intraoperatively as well as postoperatively, and critical incidents were noted in terms of date and time of incident, location (OT/post-anaesthesia care unit, clinical category, age of patient, degree of patient harm resulting from the incident, description of what happened and duration of surgery...
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27894292/reliability-of-breath-by-breath-spirometry-and-relative-flow-time-indices-for-pulmonary-function-testing-in-horses
#14
K Burnheim, K J Hughes, D L Evans, S L Raidal
BACKGROUND: Respiratory problems are common in horses, and are often diagnosed as a cause of poor athletic performance. Reliable, accurate and sensitive spirometric tests of airway function in resting horses would assist with the diagnosis of limitations to breathing and facilitate investigations of the effects of various treatments on breathing capacity. The evaluation of respiratory function in horses is challenging and suitable procedures are not widely available to equine practitioners...
November 28, 2016: BMC Veterinary Research
https://www.readbyqxmd.com/read/27868188/patency-of-paediatric-endotracheal-tubes-for-airway-instrumentation
#15
J Elfgen, P K Buehler, J Thomas, M Kemper, S Imach, M Weiss
BACKGROUND: Airway exchange catheters (AEC) and fiberoptic bronchoscopes (FOB) for tracheal intubation are selected so that there is only a minimal gap between their outer and inner diameter of endotracheal tube (ETT) to minimize the risk of impingement during airway instrumentation. This study aimed to test the ease of passage of FOBs and AECs through paediatric ETT of different sizes and from different manufacturers when using current recommendations for dimensional equipment compatibility taken from text books and manufacturers information...
January 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27863620/paediatric-airway-foreign-body-the-human-factors-influencing-patient-safety-in-our-hospitals
#16
O C Okonkwo, A Simons, J Nichani
Foreign bodies in the pediatric airway are an uncommon emergency with a high morbidity and mortality rate. Morbidity ranges from 10 to 20% worldwide and this pathology accounts for up to 7% of accidental deaths in children under 4. Dealing with this emergency safely and effectively is complex, requiring a tight coupling of procedures and processes and optimal anesthetic and operating conditions to prevent errors. These factors are recognized by the World Health Organization as 'Human Factors'. We perform a multi-center assessment of human factors pertinent to this emergency...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27836871/patient-safety-events-in-out-of-hospital-paediatric-airway-management-a-medical-record-review-by-the-csi-ems
#17
Matthew Hansen, Garth Meckler, William Lambert, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: To describe the frequency and characterise the nature of patient safety events in paediatric out-of-hospital airway management. METHODS: We conducted a retrospective cross-sectional medical record review of all 'lights and sirens' emergency medicine services transports from 2008 to 2011 in patients <18 years of age in the Portland Oregon metropolitan area. A chart review tool (see online supplementary appendix) was adapted from landmark patient safety studies and revised after pilot testing...
November 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27832551/anaesthetic-implications-of-the-changing-management-of-patients-with-mucopolysaccharidosis
#18
H A Hack, Rwm Walker, P Gardiner
The mucopolysaccharidoses are a group of inherited metabolic disorders that are renowned for presenting clinical problems, particularly related to cardiac, airway, and skeletal abnormalities, in children during anaesthesia. The changing clinical management of the mucopolysaccharidoses can be described in three phases. An initial phase of accumulation and dissemination of knowledge about the management of this rare disease with a growing recognition that untreated Hurler syndrome and more severe forms of other phenotypes such as Hunter syndrome and Maroteaux-Lamy syndrome were associated with severe complications under anaesthesia...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27821212/neurofibromatosis-clinic-a-report-on-patient-demographics-and-evaluation-of-the-clinic
#19
Alireza Mansouri, Saber Ghadakzadeh, Talha Maqbool, Carolina Barnett, Karolyn Au, Paul Kongkham, Vera Bril, Zadeh Gelareh
BACKGROUND: Neurofibromatosis type 1 (NF1) is a common single-gene disorder. A multidisciplinary approach to the management of NF1 patients is necessitated by the heterogeneity of clinical manifestations. Although multidisciplinary paediatric clinics have been well established, there is a dearth of such resources for adults with NF1. Herein we report our one-year institutional experience with a multidisciplinary adult NF1 clinic. METHODS: A multidisciplinary team was assembled, and an NF Patient Registry Initiative questionnaire was adapted to collect patient-reported data during clinics...
November 8, 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27804241/towards-reconstruction-of-epithelialized-cartilages-from-autologous-adipose-tissue-derived-stem-cells
#20
Sophie E P New, Amel Ibrahim, Leonardo Guasti, Eleonora Zucchelli, Martin Birchall, Neil W Bulstrode, Alexander M Seifalian, Patrizia Ferretti
Deformities of the upper airways, including those of the nose and throat, are typically corrected by reconstructive surgery. The use of autologous somatic stem cells for repair of defects could improve quality and outcomes of such operations. The present study explored the ability of paediatric adipose-derived stem cells (pADSCs), a readily available source of autologous stem cells, to generate a cartilage construct with a functional epithelium. Paediatric ADSCs seeded on the biodegradable nanocomposite polymer, polyhedral oligomeric silsesquioxane poly(ϵ-caprolactone-urea) urethane (POSS-PCL), proliferated and differentiated towards mesenchymal lineages...
November 1, 2016: Journal of Tissue Engineering and Regenerative Medicine
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