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Anesthesia for young children

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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
#1
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
https://www.readbyqxmd.com/read/28667359/sensitivity-of-susceptibility-weighted-imaging-in-detecting-developmental-venous-anomalies-and-associated-cavernomas-and-microhemorrhages-in-children
#2
Allen Young, Andrea Poretti, Thangamadhan Bosemani, Reema Goel, Thierry A G M Huisman
PURPOSE: Developmental venous anomalies (DVA) are common neuroimaging abnormalities that are traditionally diagnosed by contrast-enhanced T1-weighted images as the gold standard. We aimed to evaluate the sensitivity of SWI in detecting DVA and associated cavernous malformations (CM) and microhemorrhages in children in order to determine if SWI may replace contrast-enhanced MRI sequences. METHODS: Contrast-enhanced T1-weighted images were used as diagnostic gold standard for DVA...
August 2017: Neuroradiology
https://www.readbyqxmd.com/read/28658119/is-neuromuscular-blocker-needed-in-children-undergoing-inguinal-herniorrhaphy-a-prospective-randomized-and-controlled-trial
#3
RANDOMIZED CONTROLLED TRIAL
Bon-Wook Koo, Kyu-Whan Jung, Ah-Young Oh, Eun-Young Kim, Hyo-Seok Na, Eun-Su Choi, Kwang-Suk Seo
BACKGROUND: Intraoperative neuromuscular blocker is widely used, but is known to be associated with postoperative residual paralysis, which is known to be associated with increased risk of pulmonary complications. Hence, its use should be individualized and restricted to procedures where it is mandatory. We examined whether not using a neuromuscular blocker affects the surgical conditions in children undergoing inguinal herniorrhaphy. METHODS: Anesthesia was induced and maintained with sevoflurane in 60% nitrous oxide, and the airway was maintained using an I-gel...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639687/risk-indicators-of-early-childhood-caries-ecc-in-children-with-high-treatment-needs
#4
Iris Kraljevic, Cornelia Filippi, Andreas Filippi
Early childhood caries (ECC) represents a major health and economic problem worldwide. Its consequences such as early pain experience may affect the immediate and long-term quality of life of the child. In very young and uncooperative children the therapy of ECC is often viable only under general anesthesia. After treatment these affected children have a higher risk for future caries either soon thereafter, or later in life. The aim of the present study was to determine risk indicators and their correlation among children with high caries prevalence and high treatment needs, in order to facilitate the development of targeted prophylaxis programs that would reduce future occurrences of ECC or at least positively influence the outcome...
2017: Swiss Dental Journal
https://www.readbyqxmd.com/read/28622158/general-anesthesia-and-young-brain-what-is-new
#5
Vesna Jevtovic-Todorovic, Ansgar Brambrick
Considering that growing population of very young children is exposed to general anesthesia every year, it is of utmost importance to understand how and whether such practice may affect the development and growth of their very immature and vulnerable brains. Compelling evidence from animal studies suggests that an early exposure to general anesthesia is detrimental to normal brain development leading to structural and functional impairments of neurons and glia, and long-lasting impairments in normal emotional and cognitive development...
June 15, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28609302/association-between-exposure-of-young-children-to-procedures-requiring-general-anesthesia-and-learning-and-behavioral-outcomes-in-a-population-based-birth-cohort
#6
Danqing Hu, Randall P Flick, Michael J Zaccariello, Robert C Colligan, Slavica K Katusic, Darrell R Schroeder, Andrew C Hanson, Shonie L Buenvenida, Stephen J Gleich, Robert T Wilder, Juraj Sprung, David O Warner
BACKGROUND: Exposure of young animals to general anesthesia causes neurodegeneration and lasting behavioral abnormalities; whether these findings translate to children remains unclear. This study used a population-based birth cohort to test the hypothesis that multiple, but not single, exposures to procedures requiring general anesthesia before age 3 yr are associated with adverse neurodevelopmental outcomes. METHODS: A retrospective study cohort was assembled from children born in Olmsted County, Minnesota, from 1996 to 2000 (inclusive)...
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28586779/effect-of-anesthesia-on-the-developing-brain-infant-and-fetus
#7
Dean B Andropoulos
The potential for commonly used anesthetics and sedatives to cause neuroapoptosis and other neurodegenerative changes in the developing mammalian brain has become evident in animal studies over the past 15 years. This concern has led to a number of retrospective studies in human infants and young children, and some of these studies observed an association between exposure to general anesthesia as an infant, and later neurobehavioral problems in childhood. This association is particularly evident for prolonged or repeated exposures...
June 7, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28585495/tympanostomy-tube-placement-in-children-using-a-single-pass-tool-with-moderate-sedation
#8
Shelagh Cofer, Abby Meyer, Daniel Yoon, David Beebe, Chandra Castro, Frank Rimell, Kumar Belani
Insertion of tympanostomy tubes is a common elective pediatric surgical procedure and is typically performed under general anesthesia. The potential to reduce general anesthetic requirements for young children has led to increased interest in alternatives for tympanostomy tube placement. A tympanostomy tube system, developed to enable tympanostomy tube placement in a single pass on conscious patients under moderate sedation, was evaluated. A prospective study on 128 children and 253 tympanostomy tube placements conducted at 4 centers in the United States demonstrated an 88...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28570486/handheld-spectral-domain-optical-coherence-tomography-imaging-through-the-undilated-pupil-in-infants-born-preterm-or-with-hypoxic-injury-or-hydrocephalus
#9
Du Tran-Viet, Brittany M Wong, Shwetha Mangalesh, Ramiro Maldonado, C Michael Cotten, Cynthia A Toth
PURPOSE: The authors investigated feasibility of undilated handheld spectral domain optical coherence tomography (SDOCT) retinal imaging in preterm infants and children with neurologic abnormalities. METHODS: Under an institutional review board-approved protocol, the authors attempted handheld SDOCT imaging of the retina, choroid, and optic nerve in infants and young children without pupil dilation. Scans were analyzed for quality and successful capture of foveal, optic nerve, and retinal structural parameters and abnormalities...
May 29, 2017: Retina
https://www.readbyqxmd.com/read/28570404/surrogate-outcome-measures-for-corneal-neurotization-in-infants-and-children
#10
Sarvnaz Sepehripour, Mark Sheldon Lloyd, Hiroshi Nishikawa, Bruce Richard, Manoj Parulekar
BACKGROUND: Corneal anesthesia is a rare and challenging condition, particularly in young children. The insensate cornea leads to abnormal epithelial cell metabolism and loss of trophic influences supplied by the corneal nerve fibers. This results in recurrent spontaneous epithelia erosion and eventual loss of sight. Corneal reinnervation is a definitive treatment option for neuropathic keratitis. The outcome measures in young children following corneal sensitization are different to adults as esthesiometry is unachievable...
May 31, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28533303/cardiopulmonary-resuscitation-in-adults-and-children-with-mechanical-circulatory-support-a-scientific-statement-from-the-american-heart-association
#11
REVIEW
Mary Ann Peberdy, Jason A Gluck, Joseph P Ornato, Christian A Bermudez, Russell E Griffin, Vigneshwar Kasirajan, Richard E Kerber, Eldrin F Lewis, Mark S Link, Corinne Miller, Jeffrey J Teuteberg, Ravi Thiagarajan, Robert M Weiss, Brian O'Neil
Cardiac arrest in patients on mechanical support is a new phenomenon brought about by the increased use of this therapy in patients with end-stage heart failure. This American Heart Association scientific statement highlights the recognition and treatment of cardiovascular collapse or cardiopulmonary arrest in an adult or pediatric patient who has a ventricular assist device or total artificial heart. Specific, expert consensus recommendations are provided for the role of external chest compressions in such patients...
June 13, 2017: Circulation
https://www.readbyqxmd.com/read/28479221/do-baby-teeth-really-matter-changing-parental-perception-and-increasing-dental-care-utilization-for-young-children
#12
Suchitra Nelson, Mary Beth Slusar, Jeffrey M Albert, Christine A Riedy
INTRODUCTION: Parent/caregivers' inability to recognize the importance of baby teeth has been associated with inadequate self-management of children's oral health (i.e. lower likelihood of preventive dental visits) which may result in dental caries and the need for more expensive caries-related restorative treatment under general anesthesia. Health behavior theories aid researchers in understanding the impact and effectiveness of interventions on changing health behaviors and health outcomes...
August 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28457477/parental-perceptions-and-acceptance-of-silver-diamine-fluoride-staining
#13
Yasmi O Crystal, Malvin N Janal, Dylan S Hamilton, Richard Niederman
BACKGROUND: The caries arrest that can be achieved by using silver diamine fluoride (SDF) offers a minimally invasive and inexpensive alternative to traditional restorative caries treatment. The authors evaluated how the dentinal staining that is associated with SDF influences the acceptance of this treatment among parents of young children in the New York City metropolitan area. METHODS: The authors invited the parents of children who had experienced dental caries and who had appointments at the New York University Pediatric Dentistry Clinic and at several private clinics in New Jersey to participate in a Web-based survey designed to assess parents' demographics, perceptions of photographs of SDF-treated carious teeth, and acceptability of treatment in different behavior management scenarios...
April 27, 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28424007/anesthetic-related-neurotoxicity-and-neuroimaging-in-children-a-call-for-conversation
#14
Kara A Bjur, Eric T Payne, Michael E Nemergut, Danqing Hu, Randall P Flick
Each year millions of young children undergo procedures requiring sedation or general anesthesia. An increasing proportion of the anesthetics used are provided to optimize diagnostic imaging studies such as magnetic resonance imaging. Concern regarding the neurotoxicity of sedatives and anesthetics has prompted the US Food and Drug Administration to change labeling of anesthetics and sedative agents warning against repeated or prolonged exposure in young children. This review aims to summarize the risk of anesthesia in children with an emphasis on anesthetic-related neurotoxicity, acknowledge the value of pediatric neuroimaging, and address this call for conversation...
May 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/28393462/current-use-of-factor-concentrates-in-pediatric-cardiac-anesthesia
#15
REVIEW
Nina A Guzzetta, Glyn D Williams
Excessive bleeding following pediatric cardiopulmonary bypass is associated with increased morbidity and mortality, both from the effects of hemorrhage and the therapies employed to achieve hemostasis. Neonates and infants are especially at risk because their coagulation systems are immature, surgeries are often complex, and cardiopulmonary bypass technologies are inappropriately matched to patient size and physiology. Consequently, these young children receive substantial amounts of adult-derived blood products to restore adequate hemostasis...
July 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28384676/microscope-integrated-optical-coherence-tomography-angiography-in-the-operating-room-in-young-children-with-retinal-vascular-disease
#16
Xi Chen, Christian Viehland, Oscar M Carrasco-Zevallos, Brenton Keller, Lejla Vajzovic, Joseph A Izatt, Cynthia A Toth
Importance: Intraoperative optical coherence tomography (OCT) has gained traction as an important adjunct for clinical decision making during vitreoretinal surgery, and OCT angiography (OCTA) has provided novel insights in clinical evaluation of retinal diseases. To date, these two technologies have not been applied in combination to evaluate retinal vascular disease in the operating suite. Objective: To conduct microscope-integrated, swept-source OCTA (MIOCTA) in children with retinal vascular disease...
May 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28356445/diagnosis-treatment-and-long-term-management-of-kawasaki-disease-a-scientific-statement-for-health-professionals-from-the-american-heart-association
#17
REVIEW
Brian W McCrindle, Anne H Rowley, Jane W Newburger, Jane C Burns, Anne F Bolger, Michael Gewitz, Annette L Baker, Mary Anne Jackson, Masato Takahashi, Pinak B Shah, Tohru Kobayashi, Mei-Hwan Wu, Tsutomu T Saji, Elfriede Pahl
BACKGROUND: Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries. METHODS AND RESULTS: To revise the previous American Heart Association guidelines, a multidisciplinary writing group of experts was convened to review and appraise available evidence and practice-based opinion, as well as to provide updated recommendations for diagnosis, treatment of the acute illness, and long-term management...
April 25, 2017: Circulation
https://www.readbyqxmd.com/read/28347727/a-novel-method-for-examining-corneal-endothelial-cell-morphology-in-infants
#18
Sohaib R Rufai, Nicole Y Tan, Ramez Barbara, Rachael Hartrey, Jay E Self
Previous studies have suggested that central corneal endothelial cell density (ECD) decreases from 6,100 cells/mm(2) in neonates to 3,100 cells/mm(2) in 10-year-olds. Currently data on ECD in young children as well as the trend for ECD decrease during childhood is sparse because of the difficulty of examination using existing clinic-based specular microscopes. We developed a novel method of imaging young children intraoperatively with the goal of beginning to establish age-specific normative data for ECD and hexagonality of cells (%HEX)...
March 24, 2017: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28333779/impact-of-chronic-suppurative-otitis-media-in-pediatric-cochlear-implant-recipients-insight-into-the-challenges-from-a-tertiary-referral-center-in-uk
#19
Paramita Baruah, Kate Hanvey, Richard Irving, Konstance Tzifa
OBJECTIVE: Analyze the presentation and evolution of chronic suppurative otitis media (CSOM) in children with cochlear implants (CI) and explore the merit of early intervention. STUDY DESIGN: Retrospective patient review. SETTING: Tertiary referral hospital and cochlear implant programme. PATIENTS: Children with a CI who developed CSOM. INTERVENTION: Tympanoplasty. MAIN OUTCOME MEASURES: Disease control, recurrence of cholesteatoma, cochlear implant preservation...
June 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28306679/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-implications-for-anesthesiologists
#20
Constance S Houck, Jayant K Deshpande, Randall P Flick
PURPOSE OF REVIEW: The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV)...
June 2017: Current Opinion in Anaesthesiology
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