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Pediatric sedation

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https://www.readbyqxmd.com/read/28350723/reasons-for-interfacility-emergency-department-transfer-and-care-at-the-receiving-facility
#1
Joyce Li, Stephanie Pryor, Ben Choi, Chris A Rees, Mamata V Senthil, Nicholas Tsarouhas, Sage R Myers, Michael C Monuteaux, Richard G Bachur
OBJECTIVES: The aims of this study were to (1) assess the reasons for pediatric interfacility transfers as identified by transferring providers and review the emergency medical care delivered at the receiving facilities and (2) investigate the emergency department (ED) care among the subpopulation of patients discharged from the receiving facility. METHODS: We performed a multicenter, cross-sectional survey of ED medical providers transferring patients younger than 18 years to 1 of 4 US tertiary care pediatric hospitals with a subsequent medical record review at the receiving facility...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28342115/ssh-versus-tse-sequence-protocol-in-rapid-mr-examination-of-pediatric-patients-with-programmable-drainage-system
#2
Eva Brichtová, J Šenkyřík
PURPOSE: A low radiation burden is essential during diagnostic procedures in pediatric patients due to their high tissue sensitivity. Using MR examination instead of the routinely used CT reduces the radiation exposure and the risk of adverse stochastic effects. Our retrospective study evaluated the possibility of using ultrafast single-shot (SSh) sequences and turbo spin echo (TSE) sequences in rapid MR brain imaging in pediatric patients with hydrocephalus and a programmable ventriculoperitoneal drainage system...
March 24, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28337075/intranasal-dexmedetomidine-as-a-sedative-for-pediatric-procedural-sedation
#3
Natalie Behrle, Esma Birisci, Jordan Anderson, Sara Schroeder, Abdallah Dalabih
OBJECTIVE: This study seeks to evaluate the efficacy and safety of intranasal (IN) dexmedetomidine as a sedative medication for non-invasive procedural sedation. METHODS: Subjects 6 months to 18 years of age undergoing non-invasive elective procedures were included. Dexmedetomidine (3 mcg/kg) was administered IN 40 minutes before the scheduled procedure time. The IN dexmedetomidine cohort was matched and compared to a cohort of 690 subjects who underwent sedation for similar procedures without the use of dexmedetomidine to evaluate for observed events/interventions and procedural times...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28336579/implementation-of-a-modified-who-pediatric-procedural-sedation-safety-checklist-and-its-impact-on-risk-reduction
#4
Lindsay Kahlenberg, Lindsay Harsey, Mary Patterson, Don Wachsberger, Dave Gothard, Michael Holder, Michael Forbes, Urmila Tirodker
BACKGROUND AND OBJECTIVES: Major adverse events (AEs) related to pediatric deep sedation occur at a low frequency but can be of high acuity. The high volume of deep sedations performed by 3 departments at our institution provided an opportunity to reduce variability and increase safety through implementation of a procedural sedation safety checklist. We hypothesized that implementation of a checklist would improve compliance of critical safety elements (CSEs) (primary outcome variable) and reduce the sedation-related AE rate (secondary outcome variable)...
March 23, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28330689/evaluation-of-methohexital-as-an-alternative-to-propofol-in-a-high-volume-outpatient-pediatric-sedation-service
#5
Nicholas E Jones, Michael S Kelleman, Harold K Simon, Jana A Stockwell, Courtney McCracken, Michael D Mallory, Pradip P Kamat
BACKGROUND: Propofol is a preferred agent for many pediatric sedation providers because of its rapid onset and short duration of action. It allows for quick turn around times and enhanced throughput. Occasionally, intravenous (IV) methohexital (MHX), an ultra-short acting barbiturate is utilized instead of propofol. OBJECTIVE: Describe the experience with MHX in a primarily propofol driven outpatient sedation program and to see if it serves as an acceptable alternative when propofol is not the preferred pharmacologic option...
March 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28325486/mri-utilization-and-the-associated-use-of-sedation-and-anesthesia-in-a-pediatric-aco
#6
Joshua C Uffman, Dmitry Tumin, Vidya Raman, Arlyne Thung, Brent Adler, Joseph D Tobias
BACKGROUND AND OBJECTIVES: MRI is commonly used in the pediatric population and often requires sedation or general anesthesia to complete. This study used data from a pediatric accountable care organization (ACO) to investigate trends in MRI utilization and in the requirement for anesthesia to complete MRI examinations. METHODS: The Partners for Kids (PFK) ACO claims database was queried for MRI examination encounters involving patients 0 to 18 years old from 2009 to 2014, with utilization expressed as encounters per 10,000 PFK members-months...
March 15, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28306197/pediatric-upper-airway-dimensions-using-three-dimensional-computed-tomography-imaging
#7
Tariq M Wani, Mahmood Rafiq, Salman Talpur, Lahbib Soualmi, Joseph D Tobias
INTRODUCTION: Computed tomography- (CT) and magnetic resonance imaging (MRI)-based measurements have recently suggested that the narrowest dimension of the pediatric airway is the subglottic region. These data are contrary to the previously held tenets of a funnel- or conical-shaped airway. The current study evaluates airway volumes and shapes using three-dimensional CT images of the air way column in spontaneously breathing children. METHODS: The study included CT-based radiological images of the neck in children who required imaging unrelated to airway symptomatology...
March 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28300357/pilot-randomized-controlled-trial-on-early-and-late-remote-ischemic-preconditioning-prior-to-complex-cardiac-surgery-in-young-infants
#8
Gonzalo Garcia Guerra, Ari R Joffe, Rob Seal, Ernest Phillipos, Maggie Wong, Elham Khodayari Moez, Irina A Dinu, Jonathan P Duff, David Ross, Ivan Rebeyka, Charlene M T Robertson
BACKGROUND: Remote ischemic preconditioning involves providing a brief ischemia-reperfusion event to a tissue to create subsequent protection from a more severe ischemia-reperfusion event to a different tissue/organ. The few pediatric remote ischemic preconditioning studies in the literature show conflicting results. AIM: We conducted a pilot randomized controlled trial to determine the feasibility of conducting a larger trial and to gather provisional data on the effect of early and late remote ischemic preconditioning on outcomes of infants after surgery for congenital heart disease...
April 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28298787/caudal-levobupivacaine-supplemented-with-caudal-or-intravenous-clonidine-in-children-undergoing-infraumbilical-surgery-a-randomized-prospective-double-blind-study
#9
Laxmi Ramya Potti, Yatish Bevinaguddaiah, S Archana, Vinayak Seenappa Pujari, C Manjunath Abloodu
BACKGROUND: Caudal analgesia is the most popular regional anesthesia technique in pediatric population for intraoperative and postoperative analgesia. Clonidine, an α2 agonist, prolongs analgesia without causing significant respiratory depression after systemic or neuraxial administration. However, the most beneficial route of its administration is still controversial. Thus, we compared the effects of caudal and intravenous (i.v) clonidine on postoperative analgesia produced by caudal levobupivacaine in children undergoing infraumbilical surgery...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298782/comparison-of-oral-clonidine-oral-dexmedetomidine-and-oral-midazolam-for-premedication-in-pediatric-patients-undergoing-elective-surgery
#10
Sarika Kumari, Nidhi Agrawal, G Usha, Vandana Talwar, Poonam Gupta
BACKGROUND: Midazolam has been commonly used orally for premedication in children. A search for a better alternative continues to overcome its side effects. Recently alpha-2 agonists, clonidine, and dexmedetomidine have been used for premedication in children. AIM: To study and compare the efficacy of oral clonidine, oral dexmedetomidine, and oral midazolam for premedication in pediatric surgical patients. SETTINGS AND DESIGN: This prospective, randomized, double blind study was conducted in a tertiary care hospital...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296782/the-safety-and-efficacy-of-dexmedetomidine-remifentanil-in-children-undergoing-flexible-bronchoscopy-a-retrospective-dose-finding-trial
#11
Xia Li, Xue Wang, Shuguang Jin, Dongsheng Zhang, Yanuo Li
Flexible bronchoscopy is more and more used for diagnosis and management of various pulmonary diseases in pediatrics. As poor coordination of children, the procedure is usually performed under general anesthesia with spontaneous or controlled ventilation to increase children and bronchoscopists' safety and comfort. Previous studies have reported that dexmedetomidine (DEX) could be safely and effectively used for flexible bronchoscopy in both adulate and children. However, there is no trial to evaluate the dose-finding of safety and efficacy of dexmedetomidine-remifentanil (DEX-RF) in children undergoing flexible bronchoscopy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28288298/detection-of-respiratory-adverse-events-in-pediatric-dental-patients-sedated-with-0-75mg-kg-of-midazolam-and-oxygen-by-continuous-pretracheal-auscultation-a-prospective-randomized-controlled-trial
#12
Mostafa Somri, Ibrahim Matter, Christopher Hadjittofi, Naser Hoash, Bian Moaddi, Johnny Kharouba, Constantinos A Parisinos, Benjamin Peretz
PURPOSE: Sedation is becoming more commonplace for pediatric patients undergoing minor procedures. Fortunately, electronic monitors have contributed to a reduction in the associated respiratory adverse events (RAEs). To test the hypothesis that adding the pretracheal stethoscope (PTS) to standard monitoring methods (SMMs) may improve RAE detection in sedated pediatric dental patients, the frequency of RAEs detected by SMMs (i.e. visual observation, capnography, and pulse oximetry) was compared to that detected by SMMs alongside continuous PTS auscultation...
2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28283018/tramadol-vs-dexmedetomidine-for-emergence-agitation-control-in-pediatric-patients-undergoing-adenotonsillectomy-with-sevoflurane-anesthesia-prospective-randomized-controlled-clinical-study
#13
Nurdan Bedirli, Mehmet Akçabay, Ulku Emik
BACKGROUND: This study was designed to compare the efficacy of an intraoperative single dose administration of tramadol and dexmedetomidine on hemodynamics and postoperative recovery profile including pain, sedation, emerge reactions in pediatric patients undergoing adenotonsillectomy with sevoflurane anesthesia. METHODS: Seventy-seven patient, aged 2-12, undergoing adenotonsillectomy with sevoflurane anesthesia was enrolled in this study. Patients were randomly assigned to receive either intravenous 2 mg/kg tramadol (Group T; n = 39) or 1 μg/kg dexmedetomidine (Group D; n = 38) after intubation...
March 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28274900/comparative-study-between-the-use-of-melatonin-and-a-solution-with-melatonin-tryptophan-and-vitamin-b6-as-an-inducer-of-spontaneous-sleep-in-children-during-an-auditory-response-test-an-alternative-to-commonly-used-sedative-drugs
#14
Antonio Della Volpe, Antonietta De Lucia, Clementina Pirozzi, Vincenzo Pastore
OBJECTIVE: An elective investigation into the early diagnosis of deafness in children under the age of 4-5 years is performed using auditory evoked potentials of auditory brainstem responses (ABRs). In case of pediatric patients, the major difficulty includes being examined during spontaneous sleep, which is complicated to obtain, especially in the age range of 12 to 72 months. Recently, melatonin has been used as a "sleep inducer" in diagnostic tests with positive results. Our aim was to evaluate the use of melatonin and of a solution containing melatonin, tryptophan, and vitamin B6 as an inducer of spontaneous sleep on repeated ABR analyses as well as to evaluate the reduction in analyses with sedative drugs in case of uncooperative patients...
March 9, 2017: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/28274251/knowledge-and-factors-associated-with-pain-management-for-hospitalized-children-among-nurses-working-in-public-hospitals-in-mekelle-city-north-ethiopia-cross-sectional-study
#15
Remla Miftah, Weyzer Tilahun, Atsde Fantahun, Seid Adulkadir, Kahsu Gebrekirstos
BACKGROUND: American Nurses Association reflects, the role of the nurse in pain management encompasses the entire nursing process, assessment of pain, plans pharmacological and non-pharmacological pain management strategies, implements the plan, and evaluates the response of the patient to the interventions. Pediatric pain management has been left largely unaddressed due to factors like limited resources, inadequate training, as well as cultural diversity and language barriers which made sick and injured children not to receive basic pain care...
March 9, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28267541/free-breathing-high-pitch-80kvp-dual-source-computed-tomography-of-the-pediatric-chest-image-quality-presence-of-motion-artifacts-and-radiation-dose
#16
Boris Bodelle, Constanze Fischbach, Christian Booz, Ibrahim Yel, Claudia Frellesen, Martin Beeres, Thomas J Vogl, Jan-Erik Scholtz
OBJECTIVES: To investigate image quality, presence of motion artifacts and effects on radiation dose of 80kVp high-pitch dual-source CT (DSCT) in combination with an advanced modeled iterative reconstruction algorithm (ADMIRE) of the pediatric chest compared to single-source CT (SSCT). MATERIALS AND METHODS: The study was approved by the institutional review board. Eighty-seven consecutive pediatric patients (mean age 9.1±4.9years) received either free-breathing high-pitch (pitch 3...
April 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28260464/incisional-hernia-after-liver-transplant
#17
Ebru H Ayvazoglu Soy, Mahir Kirnap, Sedat Yildirim, Gokhan Moray, Mehmet Haberal
OBJECTIVES: An incisional hernia seriously burdens the quality of life after liver transplant. The incidence of incisional hernia after liver transplant is reported to be 4% to 20%. Here, we evaluated incisional hernias that occurred after adult liver transplant and incisional hernias intentionally made in infant liver transplant procedures. MATERIALS AND METHODS: Between December 1988 and May 2016, we performed 536 liver transplant procedures in 515 patients. Demographic features, surgical outcomes, and predisposing factors were evaluated...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260348/current-views-of-pediatric-intensive-care-unit-picu
#18
Conghai Fan, Boxiang Qi, Chao Chen
International best practice endorses the use of standardized approaches in the management of pediatric patients in the Pediatric Intensive Care Unit (PICU). There is increasing awareness of the risk of prolonged duration of mechanical ventilation as a consequence of morphine use leading to ventilator associated pneumonia (VAP), extended PICU and hospital length of stay and increased morbidity and mortality. Accordingly a fundamental outcome measure of this study was to determine whether raising awareness of these issues and the introduction of analgesia and sedation guidelines led to a reduction in the amount of analgesics and sedatives administered to PICU patients, while not exposing them to pain and distress...
March 3, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28259866/verification-of-propofol-sulfate-as-a-further-human-propofol-metabolite-using-lc-esi-qqq-ms-and-lc-esi-qtof-ms-analysis
#19
Alexandra Maas, Christoph Maier, Beate Michel-Lauter, Sebastian Broecker, Burkhard Madea, Cornelius Hess
BACKGROUND: Propofol (2,6-diisopropylphenol) is a water-insoluble, intravenous anesthetic that is widely used for the induction and maintenance of anesthesia as well as for endoscopic and pediatric sedation. After admission, propofol undergoes extensive hepatic and extrahepatic metabolism, including direct conjugation to propofol glucuronide and hydroxylation to 2,6-diisopropyl-1,4-quinol. The latter substance subsequently undergoes phase II metabolism, resulting in the formation of further metabolites (1quinolglucuronide, 4quinolglucuronide and 4quinol-sulfate)...
March 1, 2017: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/28258263/evaluation-of-the-role-of-music-as-a-nonpharmacological-technique-in-management-of-child-patients
#20
Neha Gupta, Himanshu Gupta, Prahlad Gupta, Nidhi Gupta
INTRODUCTION: Behavior management and reducing anxiety and pain are very important for success of treatment. Hence, apart from pharmacological management, such as conscious sedation, nonpharmacological interventions like music play a significant role. This study aims to evaluate the effects of music in reducing anxiety, pain, and behavior management. MATERIALS AND METHODS: This study was conducted at the Department of Pedodontics in 2015. It consisted of 60 patients, age ranging from 3 to 7 years, who required dental treatment with local anesthesia...
March 1, 2017: Journal of Contemporary Dental Practice
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