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Pediatric sedation

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https://www.readbyqxmd.com/read/29677389/population-pharmacokinetics-of-intramuscular-and-intravenous-ketamine-in-children
#1
Christoph P Hornik, Daniel Gonzalez, John van den Anker, Andrew M Atz, Ram Yogev, Brenda B Poindexter, Kee Chong Ng, Paula Delmore, Barrie L Harper, Chiara Melloni, Andrew Lewandowski, Casey Gelber, Michael Cohen-Wolkowiez, Jan Hau Lee
Ketamine is an N-methyl D-aspartate receptor antagonist used off-label to facilitate dissociative anesthesia in children undergoing invasive procedures. Available for both intravenous and intramuscular administration, ketamine is commonly used when vascular access is limited. Pharmacokinetic (PK) data in children are sparse, and the bioavailability of intramuscular ketamine in children is unknown. We performed 2 prospective PK studies of ketamine in children receiving either intramuscular or intravenous ketamine and combined the data to develop a pediatric population PK model using nonlinear mixed-effects methods...
April 20, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29673611/the-cost-effectiveness-and-utility-of-a-quick-mri-for-the-evaluation-of-intra-abdominal-abscess-after-acute-appendicitis-in-the-pediatric-patient-population
#2
Tiffany J Zens, Andrew P Rogers, Erica L Riedesel, Charles M Leys, Daniel J Ostlie, Michael A Woods, Kara G Gill
INTRODUCTION: Contrast-enhanced CT remains the first-line imaging for evaluating postoperative abscess (POA) after appendicitis. Given concerns of ionizing radiation use in children, we began utilizing quick MRI to evaluate POA and summarize our findings in this study. MATERIALS AND METHODS: Children imaged with quick MRI from 2015 to 2017 were compared to children evaluated with CT from 2012 to 2014 using an age and weight matched case-control model. Radiation exposure, size and number of abscesses, length of exam, drain placement, and patient outcomes were compared...
March 6, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29668546/induction-dosage-of-propofol-for-repeated-sedations-in-children-with-hematological-disorders
#3
Alessandra Moretto, Alberto Zanella, Valentina Ciceri, Matteo Rota, Vittorio Scaravilli, Virginia Beltrama, Mariagrazia Bosatra, Antonio Pesenti
Pediatric patients with hematologic malignancies require several procedural sedations by means of propofol infusion. We retrospectively analyzed the medical records of leukemic pediatric patients who had undergone procedural sedations at an Italian tertiary referral center (San Gerardo Hospital, Monza) from January 2011 to November 2013. We retrieved the following: demographics; diagnosis; chemotherapy phase; use of corticosteroids; induction dosage of propofol, fentanyl and/or ketamine; and the type of procedure...
April 17, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29656945/ketamine-versus-ketamine-pluses-atropine-for-pediatric-sedation-a-meta-analysis
#4
REVIEW
Jiaxiao Shi, Ang Li, Zhijian Wei, Yang Liu, Cong Xing, Hongyu Shi, Han Ding, Dayu Pan, Guangzhi Ning, Shiqing Feng
OBJECTIVES: The application of atropine for pediatric sedation in the emergency department remains controversial. Our objective was to perform a comprehensive review of the literature and assess the clinical indexes in groups with and without atropine use. METHODS: PubMed, EMBASE, and the Cochrane Library were searched for randomized and non-randomized studies that compared ketamine and ketamine plus atropine for pediatric sedation. The risk ratio with 95% confidence interval was calculated using either a fixed- or random-effects model according to the value of I2 ...
April 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29655484/oral-pentobarbital-suspension-for-children-sedation-during-mr-imaging
#5
J Schlatter, S Kabiche, N Sellier, J-E Fontan
OBJECTIVES: The efficacy and safety of an oral pentobarbital suspension for sedation during pediatric MR imaging were assessed. METHODS: Data were recorded from October 2016 to January 2017. The exact dose of oral pentobarbital suspension was given for each child with an oral syringe. Parameters recorded included the patient's age and weight, the time required to sedate, the duration of sedation, the time required to discharge, and quality of MR imaging. The adverse effects were recorded...
April 11, 2018: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/29652686/massive-macroglossia-after-posterior-cranial-fossa-surgery-a-case-report
#6
Jennifer F Ha, Lisa N Vitale, Marie A Pfarr, Yu Kawai, David A Zopf
A 16-year-old boy with Chiari 1 malformation presented for an elective suboccipital craniectomy and C1 laminectomy. His intraoperative course was uneventful. At the conclusion of the procedure, he met extubation criteria and followed commands. After extubation, he developed progressive upper airway obstruction and became obtunded. He was reintubated via videolaryngoscopy, which showed edema not only to the tongue, but also to the posterior pharynx and blisters over the vocal folds and epiglottis. The patient was transferred to the pediatric intensive care unit intubated and sedated...
April 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29628576/comparison-of-intranasal-dexmedetomidine-compared-to-midazolam-as-a-premedication-in-pediatrics-with-congenital-heart-disease-undergoing-cardiac-catheterization
#7
Medhat M Messeha, Gamal Zakaria El-Morsy
Background: The intranasal route is a reliable way to administer preanesthetics and sedatives to children. The aim of this study was to compare the anxiolytic and sedative effect of intranasal dexmedetomidine and midazolam as a premedication in pediatrics with simple congenital heart disease undergoing cardiac catheterization. Patients and Methods: Sixty children 3-6 years old of either sex with simple congenital heart disease undergoing cardiac catheterization were randomly allocated into two groups: Dexmedetomidine group who received intranasal dexmedetomidine (0...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29618177/pediatric-colonoscopy-the-changing-patterns-and-single-institutional-experience-over-a-decade
#8
REVIEW
Jae Hong Park
The safety and effectiveness of pediatric colonoscopy for lower gastrointestinal tract diseases have been established in Korea for about 30 years. Both diagnostic and therapeutic colonoscopies have had many advances in terms of operator skill and experience and are now being performed by most pediatric gastroenterologists. Pediatric colonoscopy is different in many aspects from that of adults, such as expected diagnoses, patient management, bowel preparation, selection criteria for sedation, and instrument selection...
March 2018: Clinical Endoscopy
https://www.readbyqxmd.com/read/29618173/sedation-in-pediatric-esophagogastroduodenoscopy
#9
REVIEW
Seak Hee Oh
Pediatric esophagogastroduodenoscopy (EGD) has become an established diagnostic and therapeutic modality in pediatric gastroenterology. Effective sedation strategies have been adopted to improve patient tolerance during pediatric EGD. For children, safety is a fundamental consideration during this procedure as they are at a higher risk of severe adverse events from procedural sedation compared to adults. Therefore, a detailed risk evaluation is required prior to the procedure, and practitioners should be aware of the benefits and risks associated with sedation regimens during pediatric EGD...
March 2018: Clinical Endoscopy
https://www.readbyqxmd.com/read/29613935/the-use-of-emergency-physicians-to-deliver-anesthesia-for-orthopaedic-surgery-in-austere-environments-the-expansion-of-the-emergency-physician-s-general-anesthesia-syllabus-to-orthopaedic-surgery
#10
Ogedad Pierre, John F Lovejoy, Robert Stanton, Richard Skupski, Harold Previl, Jerry Bernard, Lia Losonczy, Mark Walsh
BACKGROUND: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29605369/frequency-specific-auditory-brainstem-response-testing-with-age-appropriate-sedation
#11
Yael Levit, Dror Mandel, Idit Matot
OBJECTIVE: Auditory brainstem response (ABR) testing is the gold-standard procedure for hearing evaluation in pediatric patients who cannot complete a behavioral hearing test. The amount of audiological information obtained depends on the quality of the patient's sleep during the test. In this retrospective database review, we aimed to assess the amount and the characteristics of the audiological information obtained in ABR testing in pediatric patients with age-appropriate sedation. METHODS: A retrospective chart review was conducted on 501 consecutive ABR sedation sessions performed between January 2014 and June 2016 at the Tel Aviv Medical Center...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29596300/quantitative-assessment-of-thyroid-submandibular-and-parotid-glands-elasticity-with-shear-wave-elastography-in-children
#12
Hatice Arioz Habibi, Emine Sebnem Memis Durmaz, Vusale Qarayeva, Sedat Giray Kandemirli, Ayse Kalyoncu Ucar, Mine Aslan, Gozde Apaydin, Sebuh Kurugoglu, Ibrahim Adaletli
Tissue elasticity is becoming a more commonly used parameter in evaluation of parenchyma in inflammatory diseases. Considering the changes in the thyroid and salivary glands with adolescence, determination of mean elasticity ranges with a function of age is necessary to apply ultrasound elastography more widely in the pediatric population.The thyroid, submandibular, and parotid glands of 127 healthy volunteers (66 males, 61 females; mean age = 10.3 ± 3.9 years; range = 3-17 years) were evaluated with shear-wave elastography...
March 29, 2018: Ultrasound Quarterly
https://www.readbyqxmd.com/read/29595531/sedative-and-analgesic-drug-sequestration-after-a-single-bolus-injection-in-an-ex-vivo-extracorporeal-membrane-oxygenation-infant-circuit
#13
Viviane G Nasr, Jonathan Meserve, Luis M Pereira, David Faraoni, Steve Brediger, Susan Goobie, Ravi Thiagarajan, James A DiNardo
Patient sedation and analgesia on extracorporeal membrane oxygenation (ECMO) is vital for safety and comfort. However, adsorption to the circuit may alter drug pharmacokinetics and remains poorly characterized. This study characterizes drug adsorption of morphine, fentanyl, midazolam, and dexmedetomidine in an ex vivo infant ECMO circuit utilizing polymethylpentene (PMP) membrane oxygenator (MO) with protein-bounded polyvinylchloride (PVC) tubing. Twelve closed-loop ex vivo ECMO circuits were prepared using P...
March 26, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29582455/pediatric-old-world-cutaneous-leishmaniasis-treated-with-oral-fluconazole-a-case-series
#14
Andrea Michelerio, Stefania Barruscotti, Grazia Bossi, Valeria Brazzelli
BACKGROUND: Cutaneous leishmaniasis has an incidence of 0.7-1.2 million cases per year and represents a growing concern in the outpatient dermatologic practice in Europe because of imported cases due to increased travel to risk areas and to immigration phenomena. When dealing with children, the treatment can be challenging because of side effects and pain of classic antimonial therapy leading to poor rates of course completion and requirement of sedation for several children. METHODS: We retrospectively studied three cases of cutaneous leishmaniasis in pediatric patients, between the ages of 3 and 6 years of age, treated with oral fluconazole...
March 26, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29580286/hematoma-block-or-procedural-sedation-and-analgesia-which-is-the-most-effective-method-of-anesthesia-in-reduction-of-displaced-distal-radius-fracture
#15
Ping-Tao Tseng, Tsai-Hsueh Leu, Yen-Wen Chen, Yu-Pin Chen
BACKGROUND: Procedure sedation and analgesia (PSA) is often used to alleviate discomfort and to facilitate fracture reduction for patients with distal radius fracture in emergency departments and clinics, but risks of respiratory distress and needs for different levels of monitoring under PSA are still under concern. Hematoma block (HB) is a simple alternative method of providing rapid pain relief during reduction of distal radius fracture. However, there is still in lack of strong evidence to promote HB over PSA in clinical practice...
March 27, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29575232/the-impact-of-narcotrend%C3%A2-eeg-guided-propofol-administration-on-the-speed-of-recovery-from-pediatric-procedural-sedation-a-randomized-controlled-trial
#16
Frank Weber, Laurence C Walhout, Johanna C Escher
BACKGROUND: Propofol is often used for procedural sedation in children undergoing gastrointestinal endoscopy. Reliable assessment of the depth of hypnosis during the endoscopic procedure is challenging. Processed electroencephalography using the Narcotrend Index can help titrating propofol to a predefined sedation level. AIMS: The aim of this trial was to investigate the impact of Narcotrend Index-guided titration of propofol delivery on the speed of recovery. METHODS: Children, aged 12-17 years, undergoing gastrointestinal endoscopy under procedural sedation, had propofol delivered via target controlled infusion either based on Narcotrend Index guidance (group NI) or standard clinical parameters (group C)...
March 25, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29570916/factors-affecting-propofol-dosage-for-sedation-of-pediatric-oncologic-patients
#17
Tak Kyu Oh, Boram Park, Dong-Eun Lee, Woosik Eom, Sungwoo Kang
BACKGROUND: There is limited reference data for determining the appropriate dose of propofol for individual patients. Therefore, we investigated the factors affecting propofol dosage for pediatric patients who underwent sedation for computed tomography (CT) simulation. METHODS: We retrospectively analyzed the electronic medical records of pediatric patients who underwent CT simulation for proton therapy following a cancer diagnosis at the National Cancer Center (Korea) from May 1, 2012 to April 30, 2016...
March 23, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/29567042/face-and-content-validity-of-variables-associated-with-the-difficult-to-sedate-child-in-the-paediatric-intensive-care-unit-a-survey-of-paediatric-critical-care-clinicians
#18
Ruth M Lebet, Lisa A Asaro, Athena F Zuppa, Martha A Q Curley
BACKGROUND: Clinicians recognise that some critically ill children are difficult-to-sedate. It may be possible to identify this clinical phenotype for sedation response using statistical modelling techniques adopted from machine learning. This requires identification of a finite number of variables to include in the statistical model. OBJECTIVE: To establish face and content validity for 17 candidate variables identified in the international literature as characteristic of the difficult-to-sedate child phenotype...
March 19, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29560077/higher-mallampati-scores-are-not-associated-with-more-adverse-events-during-pediatric-procedural-sedation-and-analgesia
#19
Maya S Iyer, Raymond D Pitetti, Melissa Vitale
Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Medical governing bodies have proposed guidelines for PSA performed by NAs, but these recommendations rarely suggest using Mallampati scores in pre-PSA evaluations...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29557601/sedation-and-analgesia-in-patients-on-mechanical-ventilation-in-pediatric-intensive-care-units-in-argentina
#20
Pedro Taffarel, German Bonetto, Facundo Jorro Barón, Claudia Meregalli
INTRODUCTION: Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV). OBJECTIVE: To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina. MATERIAL AND METHODS: Descriptive, crosssectional, multi-center study conducted by means of e-mailed surveys...
April 1, 2018: Archivos Argentinos de Pediatría
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