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https://www.readbyqxmd.com/read/28926473/hydrogen-gas-attenuates-sevoflurane-neurotoxicity-through-inhibiting-nuclear-factor-%C3%AE%C2%BA-light-chain-enhancer-of-activated-b-cells-signaling-and-proinflammatory-cytokine-release-in-neonatal-rats
#1
Yiwei Shi, Gang Wang, Jinyuan Li, Wenli Yu
Anesthesia neurotoxicity in developing brain has gained increasing attention. However, knowledge regarding its mitigating strategies remains scant. Sevoflurane, a commonly used anesthetic, is responsible for learning and memory deficits in neonates. Molecular hydrogen is reported to be a potential neuroprotective agent because of its antioxidative and anti-inflammatory activities. This study aimed to investigate the effect of hydrogen gas on sevoflurane neurotoxicity. The newborn rats were treated with sevoflurane and/or hydrogen gas for 2 h...
September 18, 2017: Neuroreport
https://www.readbyqxmd.com/read/28922234/consensus-statement-by-the-congenital-cardiac-anesthesia-society-milestones-for-the-pediatric-cardiac-anesthesia-fellowship
#2
Viviane G Nasr, Nina A Guzzetta, Wanda C Miller-Hance, Mark Twite, Gregory J Latham, Luis Zabala, Susan C Nicolson, Emad B Mossad, James A DiNardo
Pediatric cardiac anesthesiology has evolved as a subspecialty of both pediatric and cardiac anesthesiology and is devoted to caring for individuals with congenital heart disease ranging in age from neonates to adults. Training in pediatric cardiac anesthesia is a second-year fellowship with variability in both training duration and content and is not accredited by the Accreditation Council on Graduate Medical Education. Consequently, in this article and based on the Accreditation Council on Graduate Medical Education Milestones Model, an expert panel of the Congenital Cardiac Anesthesia Society, a section of the Society of Pediatric Anesthesiology, defines 18 milestones as competency-based developmental outcomes for training in the pediatric cardiac anesthesia fellowship...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28914327/repeated-2-sevoflurane-administration-in-7%C3%A2-and-60-day-old-rats-neurotoxicity-and-neurocognitive-dysfunction
#3
He Huang, Cun-Ming Liu, Jie Sun, Wen-Jie Jin, Yu-Qing Wu, Jing Chen
BACKGROUND: Sevoflurane is one of the most widely used inhalation anesthetics in pediatric anesthesia. A large number of studies have demonstrated that repeated treatment with high concentrations or long durations of sevoflurane anesthesia during the neonatal period can induce neuroapoptosis and long-term learning disability. In clinical practice, we observed that a subset of patients underwent minor surgery under sevoflurane anesthesia more than once from birth to adolescence. Therefore, this research was conducted to investigate whether a 2% concentration of sevoflurane (clinically relevant usage of sevoflurane) for 1 h (a short duration) can induce neuroapoptosis and neurocognitive dysfunction in adolescent rats that received sevoflurane (2% for 1 h) during the neonatal period...
September 15, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28891072/stable-control-of-physiological-parameters-but-not-infection-in-preterm-lambs-maintained-on-ex-vivo-uterine-environment-therapy
#4
Yuichiro Miura, Haruo Usuda, Shimpei Watanabe, Eleanor Woodward, Masatoshi Saito, Gabrielle C Musk, Suhas G Kallapur, Shinichi Sato, Ryuta Kitanishi, Tadashi Matsuda, John P Newnham, Sarah J Stock, Matthew W Kemp
Ex vivo uterine environment (EVE) therapy is an experimental neonatal intensive care strategy wherein gas exchange is performed by membranous oxygenators attached to the umbilical vessels. Our aim was to assess the ability of a newly refined EVE system to maintain key physiological parameters in preterm lambs within optimal ranges for 48 h. EVE group; n = 6: Preterm lambs were delivered under general anesthesia at 115 ± 2 days of gestational age. Animals were submerged in a bath of artificial amniotic fluid on EVE therapy for 48 h...
September 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28890046/effect-of-multiple-neonatal-sevoflurane-exposures-on-hippocampal-apolipoprotein-e%C3%A2-levels-and-learning-and-memory-abilities
#5
Junli Jiang, Chunchun Tang, Juanjuan Ren, Chao Zhang, Liang Dong, Zhaoqiong Zhu
BACKGROUND: Sevoflurane anesthesia is widely used in pediatric patients. In this study, we investigated whether early multiple exposures to sevoflurane induced cognitive dysfunction by altering the hippocampal expression of ApoE later in development. METHODS: Sprague-Dawley rats were exposed to 2.6% sevoflurane at postnatal day 7 (P7), P14, and P21 for 2 h. The ability of learning and memory was assessed using the Morris water maze at P37 and P97. The hippocampal volume was measured by magnetic resonance imaging (MRI) at P37 and P97...
August 31, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28888583/food-and-drug-administration-warning-on-anesthesia-and-brain-development-implications-for-obstetric-and-fetal-surgery
#6
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/28874628/ureterocele-fenestration-with-holmium-laser-in-neonates
#7
Predrag Ilic, Mirjana Jankovic, Maja Milickovic, Slobodan Dzambasanovic, Vladimir Kojovic
AIM: To evaluate the effectiveness of holmium-laser fenestration of intravesical ureteroceles in neonatal period. MATERIAL AND METHOD: We retrospectively analyzed the results of the holmium-laser puncture in ten neonates with intravesical ureterocele, between September 2013 and September 2016. Laser probe was placed through the cystoscope to the lowest and medial portion of the ureterocele, near the bladder floor. Few punctures (4 to 8) were made, until ureterocele has been collapsed...
June 23, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28872734/xenon-as-an-adjuvant-to-sevoflurane-anesthesia-in-children-younger-than-4%C3%A2-years-of-age-undergoing-interventional-or-diagnostic-cardiac-catheterization-a-randomized-controlled-clinical-trial
#8
Sarah Devroe, Roselien Meeusen, Marc Gewillig, Bjorn Cools, Koen Poesen, Robert Sanders, Steffen Rex
BACKGROUND: Xenon has repeatedly been demonstrated to have only minimal hemodynamic side effects when compared to other anesthetics. Moreover, in experimental models, xenon was found to be neuroprotective and devoid of developmental neurotoxicity. These properties could render xenon attractive for the anesthesia in neonates and infants with congenital heart disease. However, experience with xenon anesthesia in children is scarce. AIMS: We hypothesized that in children undergoing cardiac catheterization, general anesthesia with a combination of sevoflurane with xenon results in superior hemodynamic stability, compared to sevoflurane alone...
September 5, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28868940/vigilance-on-use-of-drugs-herbal-products-and-food-supplements-during-pregnancy-focus-on-fosfomycin
#9
C Mannucci, G Dante, M Miroddi, F Facchinetti, R D'Anna, A Santamaria, M C Lenti, A Vannacci, F Calapai, M Perone, G Migliardi, A Alibrandi, M Navarra, G Calapai
Urinary tract infection (UTI) is defined as a common bacterial infection that can lead to significant morbidity such as stricture, fistula, abscess formation, bacteremia, sepsis, pyelonephritis and kidney dysfunction with a mortality rates reported of 1% in men and 3% in women because of development of pyelonephritis. UTIs are more common in women and the 33% of them, requires antimicrobials treatment for at least 1 episode by the age of 24 years. UTIs are the most common infections observed during pregnancy and up to 30% of mothers with not treated asymptomatic bacteriuria may develop acute pyelonephritis which consequently can be associated to adverse maternal and fetal outcomes...
September 4, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28859124/effect-of-general-anesthesia-on-neonatal-aeeg-a-cohort-study-of-patients-with-non-cardiac-congenital-anomalies
#10
Lisanne J Stolwijk, Lauren C Weeke, Linda S de Vries, Maud Y A van Herwaarden, David C van der Zee, Desiree B M van der Werff, Manon J N L Benders, Mona Toet, Petra M A Lemmers
INTRODUCTION: The aim of the current study was to determine the effect of general anesthesia on neonatal brain activity using amplitude-integrated EEG (aEEG). METHODS: A prospective cohort study of neonates (January 2013-December 2015), who underwent major neonatal surgery for non-cardiac congenital anomalies. Anesthesia was administered at the discretion of the anesthetist. aEEG monitoring was started six hours preoperatively until 24 hours after surgery. Analysis of classes of aEEG background patterns, ranging from continuous normal voltage to flat trace in six classes, and quantitative EEG-measures, using spontaneous activity transients (SATs) and interSATintervals (ISI), was performed...
2017: PloS One
https://www.readbyqxmd.com/read/28858899/patients-undergoing-cesarean-delivery-after-exposure-to-oxytocin-during-labor-require-higher-postpartum-oxytocin-doses
#11
Amanda Foley, Ashley Gunter, Kenneth J Nunes, Sajid Shahul, Barbara M Scavone
BACKGROUND: Experts recommend postpartum oxytocin to prevent uterine atony and hemorrhage, but oxytocin may be associated with dose-dependent adverse effects, and the correct dose of postpartum oxytocin has yet to be determined. The effective dose in 90% of patients (ED90) of oxytocin after cesarean delivery may be higher in patients exposed to oxytocin during labor compared to patients unexposed. We therefore undertook this study to compare postpartum oxytocin requirements in patients exposed to oxytocin prior to cesarean delivery versus those not exposed, when all were treated according to a specific institutional protocol...
August 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28843008/sevoflurane-neurotoxicity-in-neonatal-rats-is-related-to-an-increase-in-the-gabaa-r-%C3%AE-1-gabaa-r-%C3%AE-2-ratio
#12
Si-Ning Xie, Hong Ye, Jun-Fa Li, Li-Xin An
Exposure of neonatal rat to sevoflurane leads to neurodegeneration and deficits of spatial learning and memory in adulthood. However, the underlying mechanisms remain unclear. The type A γ-aminobutyric acid receptor (GABAA R) is a target receptor for sevoflurane. The present study intends to investigate the changes in GABAA R α1/α2 expression and its relationship with the neurotoxicity effect due to sevoflurane in neonatal rats. After a dose-response curve was constructed to determine minimum alveolar concentration (MAC) and safety was guaranteed in our 7-day-old neonatal rat pup mode, we conducted two studies among the following groups: (A) the control group; (B) the sham anesthesia group; and (C) the sevoflurane anesthesia group and all three groups were treated in the same way as the model...
August 26, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28837436/are-anesthesia-and-surgery-during-infancy-associated-with-decreased-white-matter-integrity-and-volume-during-childhood
#13
Robert I Block, Vincent A Magnotta, Emine O Bayman, James Y Choi, Joss J Thomas, Karolie K Kimble
BACKGROUND: Anesthetics have neurotoxic effects in neonatal animals. Relevant human evidence is limited. We sought such evidence in a structural neuroimaging study. METHODS: Two groups of children underwent structural magnetic resonance imaging: patients who, during infancy, had one of four operations commonly performed in otherwise healthy children and comparable, nonexposed control subjects. Total and regional brain tissue composition and volume, as well as regional indicators of white matter integrity (fractional anisotropy and mean diffusivity), were analyzed...
August 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28834913/abdominal-girth-and-vertebral-column-length-aid-in-predicting-intrathecal-hyperbaric-bupivacaine-dose-for-elective-cesarean-section
#14
Chang-Na Wei, Qing-He Zhou, Li-Zhong Wang
Currently, there is no consensus on how to determine the optimal dose of intrathecal bupivacaine for an individual undergoing an elective cesarean section. In this study, we developed a regression equation between intrathecal 0.5% hyperbaric bupivacaine volume and abdominal girth and vertebral column length, to determine a suitable block level (T5) for elective cesarean section patients.In phase I, we analyzed 374 parturients undergoing an elective cesarean section that received a suitable dose of intrathecal 0...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#15
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
July 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28815798/infant-spinal-anesthesia-do-girls-need-a-larger-dose-of-local-anesthetic
#16
Geoff Frawley, Md Hamidul Huque
BACKGROUND: Gender differences in absorption, distribution, and metabolism of a number of anesthetic agents have been identified in adults. Clinically, adult studies suggest women demonstrate slower onset of opioid analgesic effects, lower spinal and epidural dose requirements, and greater sensitivity to neuromuscular blocking agents. Sex-related differences in the pharmacokinetics and pharmacodynamics of local anesthetics in neonates and infants, however, have not been well documented...
August 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28805611/propofol-in-combination-with-remifentanil-for-cesarean-section-placental-transfer-and-effect-on-mothers-and-newborns-at-different-induction-to-delivery-intervals
#17
Liguo Hu, Jianhui Pan, Shantang Zhang, Jinjing Yu, Keqiang He, Shuhua Shu, Ruiting Wang
OBJECTIVE: This study aims to describe the administration of propofol in combination with remifentanil for the induction of general anesthesia during cesarean section (CS). Our aim was to evaluate its impact on the drug concentrations of the maternal and neonatal blood at different induction of anesthesia to delivery (I-D) intervals as well as its effect on newborns. MATERIALS AND METHODS: In this double-blind randomized controlled study, patients undergoing elective CS were administered anesthesia at short (n = 20) or long (n = 20) I-D intervals...
August 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28799968/core-temperature-monitoring-in-obstetric-spinal-anesthesia-using-an-ingestible-telemetric-sensor
#18
Leon du Toit, Dominique van Dyk, Ross Hofmeyr, Carl J Lombard, Robert A Dyer
BACKGROUND: Perioperative hypothermia may affect maternal and neonatal outcomes after obstetric spinal anesthesia. Core temperature is often poorly monitored during spinal anesthesia, due to the lack of an accurate noninvasive core temperature monitor. The aim of this study was to describe core temperature changes and temperature recovery during spinal anesthesia for elective cesarean delivery. We expected that obstetric spinal anesthesia would be associated with a clinically relevant thermoregulatory insult (core temperature decrease >1...
August 9, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28795472/does-ultrasound-guidance-add-accuracy-to-continuous-caudal-epidural-catheter-placements-in-neonates-and-infants
#19
Vrushali C Ponde, Vinit V Bedekar, Ankit P Desai, Kiran A Puranik
BACKGROUND: Caudo-lumbar and caudo-thoracic epidural anesthesia is an established technique that carries a low risk of dural puncture or spinal cord trauma in infants. Traditionally catheter advancement is based on external measurements. However, malpositioning of catheters are known to occur. We hypothesized that caudal-epidural catheters inserted under real-time ultrasound guidance may be more accurate than the accuracy of the measurements traditionally used for their placement. METHODS: We studied 25 patients, aged 2 days to 5 months, posted for abdominal or thoracic surgery, receiving general anesthesia followed by caudo-epidural continuous block...
October 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28780389/atropine-use-may-lead-to-post-operative-respiratory-acidosis-in-neonates-receiving-ductal-ligation-a-retrospective-cohort-study
#20
Szu-Ling Chang, Wen-Li Lin, Chien-Hsiang Weng, Shye-Jao Wu, Hsin-Jung Tsai, Shwu-Meei Wang, Chun-Chih Peng, Jui-Hsing Chang
BACKGROUND: Patent ductus arteriosus (PDA) is one of the most common cardiac conditions in preterm infants. Closure of the PDA in symptomatic patients can be achieved medically or surgically. Atropine is commonly administered in general anesthesia as a premedication in this age group but with limited evidence addressing the effect of its use. Our study examined the association of the use of atropine as a premedication in PDA ligation and the risk of post-operative respiratory complications...
July 20, 2017: Pediatrics and Neonatology
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