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Anesthesia for young children

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https://www.readbyqxmd.com/read/29339139/improved-coronary-magnetic-resonance-angiography-using-gadobenate-dimeglumine-in-pediatric-congenital-heart-disease
#1
Miguel Silva Vieira, Markus Henningsson, Nathalie Dedieu, Vassilios S Vassiliou, Aaron Bell, Sujeev Mathur, Kuberan Pushparajah, Carlos Alberto Figueroa, Tarique Hussain, René Botnar, Gerald F Greil
BACKGROUND: CMRA in pediatrics remains challenging due to the smaller vessel size, high heart rates (HR), potential image degradation caused by limited patient cooperation and long acquisition times. High-relaxivity contrast agents have been shown to improve coronary imaging in adults, but limited data is available in children. We sought to investigate whether gadobenate dimeglumine (Gd-BOPTA) together with self-navigated inversion-prepared coronary magnetic resonance angiography (CMRA) sequence design improves coronary image quality in pediatric patients...
January 12, 2018: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/29288070/neonatal-erythropoietin-mitigates-impaired-gait-social-interaction-and-diffusion-tensor-imaging-abnormalities-in-a-rat-model-of-prenatal-brain-injury
#2
Shenandoah Robinson, Christopher J Corbett, Jesse L Winer, Lindsay A S Chan, Jessie R Maxwell, Christopher V Anstine, Tracylyn R Yellowhair, Nicholas A Andrews, Yirong Yang, Laurel O Sillerud, Lauren L Jantzie
Children who are born preterm are at risk for encephalopathy of prematurity, a leading cause of cerebral palsy, cognitive delay and behavioral disorders. Current interventions are limited and none have been shown to reverse cognitive and behavioral impairments, a primary determinant of poor quality of life for these children. Moreover, the mechanisms of perinatal brain injury that result in functional deficits and imaging abnormalities in the mature brain are poorly defined, limiting the potential to target interventions to those who may benefit most...
December 26, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/29274102/effect-of-age-on-narcotrend-index-monitoring-during-sevoflurane-anesthesia-in-children-below-2%C3%A2-years-of-age
#3
Nils Dennhardt, Stefanie Arndt, Christiane Beck, Dietmar Boethig, Sebastian Heiderich, Barbara Schultz, Frank Weber, Robert Sümpelmann
BACKGROUND: In older children, different electroencephalogram-based algorithms for measuring depth of anesthesia displayed a similar performance as in adults, but in infants they have not displayed the same reliability so far. According to the individual developmental state, the Narcotrend distinguishes "differentiated" electroencephalograms, which can be classified using the full Narcotrend Index scale, from "undifferentiated" electroencephalograms, which are classified using a scale with fewer stages...
December 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29258430/long-duration-general-anesthesia-influences-the-intelligence-of-school-age-children
#4
Qingqing Zhang, Yuanzhi Peng, Yingwei Wang
BACKGROUND: General anesthesia has been linked to impaired brain development in immature animals and young children. In this study the influence of orthopedic surgery under general anesthesia on the intelligence of school age children has been evaluated. METHODS: A total of 209 subjects aged 6-12 years were recruited and allocated into 4 groups according to the duration of general anesthesia, including a control group (n = 30), short (< 1 h, n = 49), moderate- (1-3 h, n = 51) and long-duration groups (> 3 h, n = 79), respectively...
December 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29221922/pediatric-percutaneous-nephrostomy-a-multicenter-experience
#5
Sphoorti Shellikeri, Robert Daulton, Madeleine Sertic, Bairbre Connolly, Mark Hogan, Francis Marshalleck, Anne Marie Cahill
PURPOSE: To analyze technique, outcomes, and complications of a large series of pediatric percutaneous nephrostomy (PCN) procedures performed at 4 tertiary pediatric centers. MATERIALS AND METHODS: Retrospective multicenter study of PCNs performed during an 11-year period. Six hundred seventy-five PCNs were performed on 441 patients (median age: 4 y, range: 1 d-18 y, median weight: 17 kg, range: 0.7-112 kg); 31% were younger than 1 year. The most frequent indications for PCN procedures included hydronephrosis (57%), calculus (14%), and infection (12%)...
December 5, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29140967/near-infrared-spectroscopy-and-vascular-occlusion-test-for-predicting-clinical-outcome-in-pediatric-cardiac-patients-a-prospective-observational-study
#6
Ji-Hyun Lee, Young-Eun Jang, In-Kyung Song, Eun-Hee Kim, Hee-Soo Kim, Jin-Tae Kim
OBJECTIVES: This study is designed to determine the feasibility and utility of vascular occlusion test variables as measured by INVOS Medtronic, Dublin, Ireland) in pediatric cardiac patients. DESIGN: A prospective observational study. SETTING: A tertiary children's hospital. PATIENTS: Children less than or equal to 8 years old who were scheduled for elective cardiac surgery under cardiopulmonary bypass. INTERVENTIONS: A vascular occlusion test (3 min of ischemia and reperfusion) was performed on the calf at three time points: after induction of anesthesia (T0), during cardiopulmonary bypass (T1), and after sternal closure (T2)...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29077256/screening-with-whole-body-magnetic-resonance-imaging-in-pediatric-subjects-with-li-fraumeni-syndrome-a-single-institution-pilot-study
#7
Allison F O'Neill, Stephan D Voss, Jyothi P Jagannathan, Junne Kamihara, Callie Nibecker, Elena Itriago-Araujo, Serena Masciari, Erin Parker, Mauricio Barreto, Wendy B London, Judy E Garber, Lisa Diller
BACKGROUND: Li-Fraumeni syndrome (LFS) is an autosomal dominant hereditary cancer syndrome associated with germline mutations in the TP53 gene and a high risk of childhood-onset malignancies. Cancer surveillance is challenging in pediatric mutation carriers given the anatomic spectrum of malignancies and young age of onset. Whole-body magnetic resonance imaging (WB-MRI) may provide an acceptable method for early cancer detection. PROCEDURE: We conducted a prospective feasibility pilot study of pediatric subjects (age < 18 years) with LFS to determine return rates for annual WB-MRI scan...
October 27, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29077183/safety-of-the-use-of-xylometazoline-nasal-spray-in-young-children-undergoing-lacrimal-surgery-an-observational-study
#8
Varajini Joganathan, Bijan Beigi
PURPOSE: It is common practice to prepare the nasal mucosa with decongestant in children undergoing lacrimal surgery. Xylometazoline 0.05% (Otrivine) nasal spray is commonly used. It has been reported to cause cardiovascular side effects. In the absence of formal guidelines on the safety of the use of nasal decongestants in children, we reviewed our practice to answer the question: How safe is preoperative use of xylometazoline in children undergoing lacrimal surgery? To our knowledge, this is the first study to address the potential side effects of the use of xylometazoline preoperatively in children undergoing lacrimal surgery...
October 24, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/29071560/sevoflurane-affects-oxidative-stress-and-alters-apoptosis-status-in-children-and-cultured-neural-stem-cells
#9
Xue Zhou, Dihan Lu, Wen-da Li, Xiao-Hui Chen, Xiao-Yu Yang, Xi Chen, Zhi-Bin Zhou, Jiang-Hong Ye, Xia Feng
Anesthesia-induced neurotoxicity in immature animals has raised concerns about similar effects occurring in young children. Our study investigated two commonly used anesthetics-sevoflurane and propofol-for neurotoxicity in young children. Forty-seven children (aged 12-36 months) undergoing hypospadias repair surgery were randomized to receive sevoflurane (SG, n = 24) or propofol (PG, n = 23) general anesthesia. Venous blood was collected at three different times-immediately after induction, 2 h, and 3 days after surgery...
October 25, 2017: Neurotoxicity Research
https://www.readbyqxmd.com/read/28968276/sevoflurane-acts-on-ubiquitination-proteasome-pathway-to-reduce-postsynaptic-density-95-protein-levels-in-young-mice
#10
Han Lu, Ning Liufu, Yuanlin Dong, Guanghong Xu, Yiying Zhang, Liqi Shu, Sulpicio G Soriano, Hui Zheng, Buwei Yu, Zhongcong Xie
BACKGROUND: Children with multiple exposures to anesthesia and surgery may have an increased risk of developing cognitive impairment. Sevoflurane, a commonly used anesthetic in children, has been reported to decrease levels of postsynaptic density 95 protein. However, the upstream mechanisms and downstream consequences of the sevoflurane-induced reduction in postsynaptic density 95 protein levels remains largely unknown. We therefore set out to assess whether sevoflurane acts on ubiquitination-proteasome pathway to facilitate postsynaptic density 95 protein degradation...
December 2017: Anesthesiology
https://www.readbyqxmd.com/read/28953732/behind-the-black-box-the-evidence-for-the-u-s-food-and-drug-administration-warning-about-the-risk-of-general-anesthesia-in-children-younger-than-3-years
#11
REVIEW
Christopher A Derderian, Peter Szmuk, Courtney K Derderian
On December 14, 2016, the U.S. Food and Drug Administration issued a Drug Safety Communication warning "that repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 years or in pregnant women during their third trimester may affect the development of children's brains." Health care professionals were urged to "balance the benefits of appropriate anesthesia in young children and pregnant women against the potential risks, especially for procedures that may last more than 3 hours or if multiple procedures are required in children under 3 years...
October 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28953535/comparison-of-transperianal-ultrasound-with-colonoscopy-and-magnetic-resonance-imaging-in-perianal-crohn-s-disease
#12
Eun Hye Lee, Hye Ran Yang, Ji Young Kim
OBJECTIVES: Perianal fistulae and/or abscesses are common complications of Crohn's disease (CD), especially in children. Magnetic resonance imaging (MRI) and gross examination under anesthesia are accurate diagnostic modalities for evaluating perianal lesions. However, both methods are expensive and have some limitations for use in children. This study aims to assess the accuracy of transperianal ultrasound (TPUS) and colonoscopic examination, compared with MRI, in pediatric patients with perianal CD (PACD)...
September 26, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28932056/erupted-odontome-associated-with-a-primary-molar-a-unique-clinical-presentation-4-year-follow-up
#13
Shaik Hasanuddin, E Rajendra Reddy
Erupted odontomas occur very rarely in both the primary and permanent dentitions. The present case report discusses an unusual erupted odontome associated with a primary first mandibular molar. A 7-year-old female patient with an erupted odontome in the oral cavity was reported. The surgical extraction of odontome was performed under local anesthesia to allow eruption of underlying premolar tooth. After 4 years of follow-up, the first premolar had erupted with an unusual occlusal morphology, similar to that of a primary first molar...
May 2017: Journal of Oral and Maxillofacial Pathology: JOMFP
https://www.readbyqxmd.com/read/28922233/endoscopic-versus-open-repair-for-craniosynostosis-in-infants-using-propensity-score-matching-to-compare-outcomes-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#14
Douglas R Thompson, David Zurakowski, Charles M Haberkern, Paul A Stricker, Petra M Meier
BACKGROUND: The North American Pediatric Craniofacial Collaborative Group (PCCG) established the Pediatric Craniofacial Surgery Perioperative Registry to evaluate outcomes in infants and children undergoing craniosynostosis repair. The goal of this multicenter study was to utilize this registry to assess differences in blood utilization, intensive care unit (ICU) utilization, duration of hospitalization, and perioperative complications between endoscopic-assisted (ESC) and open repair in infants with craniosynostosis...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28915907/effect-of-a-mother-s-recorded-voice-on-emergence-from-general-anesthesia-in-pediatric-patients-study-protocol-for-a-randomized-controlled-trial
#15
Seok Young Song, Sang Gyu Kwak, Eugene Kim
BACKGROUND: Emergence delirium is a behavioral disturbance after general anesthesia in children and may distress both the patients and the primary caregivers, such as parents and medical staff, looking after the patients. Various medical and emotional interventions have been investigated to reduce emergence delirium; however, none are completely effective. This trial intends to assess whether the mother's recorded voice can reduce this adverse post-anesthesia event and facilitate arousal from general anesthesia...
September 15, 2017: Trials
https://www.readbyqxmd.com/read/28915132/clinical-update-regarding-general-anesthesia-associated-neurotoxicity-in-infants-and-children
#16
M Ruth Graham
PURPOSE OF REVIEW: The U.S. Federal Drug Administration (FDA) recently released a warning stating that 'repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 years or in pregnant women during their third trimester may affect the development of children's brains' (www.fda.gov/ucm582356.htm). The goal of this article is to review the most recent clinical studies which provide evidence that these concerns may be overstated for the majority of healthy young children who require surgery and anesthesia...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28888583/food-and-drug-administration-warning-on-anesthesia-and-brain-development-implications-for-obstetric-and-fetal-surgery
#17
Olutoyin A Olutoye, Byron Wycke Baker, Michael A Belfort, Oluyinka O Olutoye
There has been growing concern about the detrimental effects of certain anesthetic agents on the developing brain. Preclinical studies in small animal models as well as nonhuman primates suggested loss or death of brain cells and consequent impaired neurocognitive function following anesthetic exposure in neonates and late gestation fetuses. Human studies in this area are limited and currently inconclusive. On Dec. 14, 2016, the US Food and Drug Administration issued a warning regarding impaired brain development in children following exposure to certain anesthetic agents used for general anesthesia, namely the inhalational anesthetics isoflurane, sevoflurane, and desflurane, and the intravenous agents propofol and midazolam, in the third trimester of pregnancy...
September 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28885668/the-role-of-intraoperative-optical-coherence-tomography-in-pediatric-hyphema-a-case-report
#18
Michele Coppola, Maria Vittoria Cicinelli, Alessandro Rabiolo, Giuseppe Querques, Francesco Bandello
PURPOSE: Intraoperative optical coherence tomography (iOCT) is a valuable tool during vitreoretinal surgery, helping the decision-making process. It is particularly useful in pediatric cases to evaluate the macular anatomy intraoperatively, avoiding further potentially dangerous surgery in children. The aim of this report is to describe the role of integrated iOCT in the management of traumatic hyphema in a pediatric patient. CASE REPORT: A 5-year-old girl was referred to our department with a history of recent domestic trauma in her right eye...
September 8, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28817401/challenges-in-the-anesthetic-management-of-ambulatory-patients-in-the-mri-suites
#19
Jasper Deen, Yzabel Vandevivere, Peter Van de Putte
PURPOSE OF REVIEW: MRI is becoming an indispensable diagnostic tool. The need for prolonged motion-free periods has substantially increased the need for deep sedation or anesthesia in a challenging environment. This review summarises recent literature with respect to pharmacological sedative strategies, nonpharmacological alternative approaches, airway management and safety issues in the ambulatory setting. RECENT FINDINGS: Most literature researches the pediatric patient population...
December 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28713211/early-extubation-in-pediatric-heart-surgery-across-a-spectrum-of-case-complexity-impact-on-hospital-length-of-stay-and-chest-tube-days
#20
Staci Beamer, Sunita Ferns, Lloyd Edwards, Greer Gunther, Jennifer Nelson
Early extubation is increasingly common in congenital heart surgery, but there are limited outcomes data across the spectrum of case complexity. We performed a retrospective review of 201 pediatric operations using cardiopulmonary bypass between 2012 and 2014. Patients extubated in the operating room or immediately on arrival to the ICU were compared to those extubated by traditional protocols. In-hospital mortality, major complications, need for re-intubation, hospital length of stay, and chest-tube days were compared between groups and by Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Congenital Heart Surgery (STAT) mortality category...
June 2017: Progress in Pediatric Cardiology
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