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Pediatric sedation

Ryutaro Matsuura, Sachiko Goto, Shuhei Sato, Noriaki Akagi, Seiji Tahara
We validated a navigator-echo-triggered sequence that drives magnetization before cardiac-gated inversion recovery T1 turbo field echo acquisition, in the sedated free-breathing pediatric population. Cardiac magnetic resonance imaging was performed on sedated infants with single ventricle. We calculated the signal-to-noise ratios and contrast-to-noise ratios of 2 groups of images obtained using respiratory triggering with and without navigator echo. All images were then visually assessed by 2 observers. The signal-to-noise ratio and the contrast-to-noise ratio were significantly higher with than without navigator echo (p<0...
June 2018: Acta Medica Okayama
M A Riedijk, D M J Milstein
OBJECTIVE: Procedural sedation with propofol is widely used in the pediatric population. A well-known side effect of propofol is a decrease of peripheral vascular resistance resulting in hypotension, but little is known about the effects on the microcirculation in humans. We aimed to evaluate the effects of propofol on the sublingual microcirculatory perfusion by continuous video imaging in pediatric patients undergoing procedural sedation. METHODS: Patients admitted to the Pediatric Intensive Care Unit for procedural sedation were recruited...
June 16, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Shobhit Jain
There has been an increasing use of pediatric procedural sedation and analgesia over the past 20 years, along with numerous medical and technological developments. Sedation can facilitate the smooth completion of otherwise stressful procedures, but it also can be associated with life-threatening complications. Pediatric practitioners need to be familiar with the basic tenets of providing safe and optimal sedation outside the operating room. This review focuses on the current understanding of sedation-related classification, guidelines, and medications, and discusses some special considerations for procedural sedation in common clinical settings...
June 1, 2018: Pediatric Annals
Gerdien A Zeilmaker-Roest, Joost van Rosmalen, Monique van Dijk, Erik Koomen, Nicolaas J G Jansen, Martin C J Kneyber, Sofie Maebe, Greet van den Berghe, Dirk Vlasselaers, Ad J J C Bogers, Dick Tibboel, Enno D Wildschut
BACKGROUND: Morphine is worldwide the analgesic of first choice after cardiac surgery in children. Morphine has unwanted hemodynamic and respiratory side effects. Therefore, post-cardiac surgery patients may potentially benefit from a non-opioid drug for pain relief. A previous study has shown that intravenous (IV) paracetamol is effective and opioid-sparing in children after major non-cardiac surgery. The aim of the study is to test the hypothesis that intermittent IV paracetamol administration in children after cardiac surgery will result in a reduction of at least 30% of the cumulative morphine requirement...
June 13, 2018: Trials
Amy J Schwinghammer, Machelle D Wilson, Brent A Hall
OBJECTIVES: Methadone is often used in pediatric patients to prevent or treat opioid withdrawal after prolonged sedation. Prolonged corrected QT interval is an important adverse effect of methadone because it can progress to torsades de pointes, a potentially fatal dysrhythmia. The prevalence of corrected QT interval prolongation and contributing risk factors are not well defined in hospitalized pediatric patients receiving methadone. The study purpose was to identify the frequency and risk factors of corrected QT interval prolongation in hospitalized pediatric patients receiving methadone...
June 11, 2018: Pediatric Critical Care Medicine
Kateryna O Khokhlova, Oleksandr A Zdoryk
The physical, chemical, and microbiological stability of a compounded oral solution with the active ingredients herbal tinctures of valerian and motherwort with sedative action for pediatric treatment was studied. Evaluations for physical, chemical, and microbiological stability were performed initially and throughout the storage period. Physical stability of the oral solution was assessed by coloration, clarity, and pH of the solution. The physical appearance of the oral solution did not change throughout the study period...
May 2018: International Journal of Pharmaceutical Compounding
Niekla Survia Andiesta, Maimunah A Hamid, Kkc Lee, Allan Pau
BACKGROUND: In 2012, nearly 4000 children in Malaysia were referred to hospital pediatric dental services due to dental caries. Recent research has reported the effectiveness of dental home visits in preventing caries development in young children. Dental home visits (DHVs) are described as an ongoing relationship between the dentist and their patients, providing all aspects of a preventive oral health care program in the presence of the parents at home. OBJECTIVE: The objective of this study is to evaluate the cost-effectiveness of dental home visits and oral health information, in the form of educational leaflets, in preventing new caries development in young children, compared to those receiving only educational leaflets over a period of two years...
June 6, 2018: JMIR Research Protocols
Liza Bialy, Amy C Plint, Stephen B Freedman, David W Johnson, Janet A Curran, Antonia S Stang
BACKGROUND: A growing body of literature supports patient and public involvement in the design, prioritization and dissemination of research and evidence based medicine. The objectives of this project were to engage patients and families in developing a prioritized list of research topics for Pediatric Emergency Medicine (PEM) and to compare results with prior research prioritization initiatives in the ED (emergency department) setting. METHODS: We utilized a systematic process to combine administrative data on frequency of patient presentations to the ED with multiple stakeholder input including an initial stakeholder survey followed by a modified Delphi consensus methodology consisting of two web-based surveys and a face-to-face meeting...
June 6, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Shadi Hamouri, Faisal Swesi, Nathan Michael Novotny
BACKGROUND: Headscarf use is becoming more common throughout the world. Many articles describe the problem of aspirated headscarf pins but few if any give technical details for retrieval or innovative methods of removal if traditional bronchoscopy fails particularly in the pediatric population. Herein, we describe our method of deep sedation with laryngeal mask airway (LMA) and flexible bronchoscopy (FB) and retrieval with a stepwise algorithm if traditional FB fails. METHODS: A retrospective review of pediatric patients with aspirated headscarf pins was performed...
June 6, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Abdulsamet Erden, Ezgi Deniz Batu, Berkan Armagan, Hafize Emine Sönmez, Alper Sarı, Selcan Demir, Emre Bilgin, Esra Fırat, Levent Kılıc, Yelda Bilginer, Omer Karadag, Sedat Kiraz, Umut Kalyoncu
Aim/purpose: Our aim was to investigate the association between blood groups and colchicine resistance in familial Mediterranean fever (FMF) patients. METHODS: This is a single-center, cross-sectional study. Between January and December 2016, 385 FMF patients were assessed by the Adult and Pediatric Rheumatology outpatient clinics and 297 patients had blood groups (ABO and Rh) results. The patients were grouped into two groups: colchicine-responsive patients (Group CR) and colchicine-unresponsive patients (Group CUR)...
June 6, 2018: Biomarkers in Medicine
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
May 30, 2018: Paediatric Anaesthesia
William Bylund, Liam Delahanty, Maxwell Cooper
Ketamine is often used for pediatric procedural sedation due to low rates of complications, with allergic reactions being rare. Immediately following intramuscular (IM) ketamine administration, a three-year-old female rapidly developed facial edema and diffuse urticarial rash, with associated wheezing and oxygen desaturation. Symptoms resolved following treatment with epinephrine, dexamethasone and diphenhydramine. This case presents a clinical reaction to ketamine consistent with anaphylaxis due to histamine release, but it is uncertain whether this was immunoglobulin E mediated...
November 2017: Clinical practice and cases in emergency medicine
Patricia D Scherrer, Amber P Rogers, Pradip P Kamat
No abstract text is available yet for this article.
June 2018: Hospital Pediatrics
Ji-Soo Song, Hong-Keun Hyun, Teo Jeon Shin, Young-Jae Kim
BACKGROUND: The findings that not only dental caries but also systemic disease can exert a negative effect on oral health-related quality of life (OHRQoL), and that dental treatment can improve OHRQoL have been confirmed in multiple studies. The purpose of this study is to investigate the impact of dental treatment on OHRQoL of Korean pediatric patients and the differences in OHRQoL between patients with and without systemic disease. METHODS: All the primary caregivers of pediatric patients who underwent dental treatments under either general anesthesia or intravenous deep sedation at Seoul National University Dental Hospital completed abbreviated versions of the Child Oral Health Impact Profile (COHIP-14) and Family Impact Scale (FIS-12) surveys on OHRQOL pre- and post-treatment (average: 2...
May 29, 2018: BMC Oral Health
Timothy P Bukowski
No abstract text is available yet for this article.
May 16, 2018: Journal of Pediatric Urology
Samuel H F Lam, David R Li, Christian E Hong, Gary M Vilke
BACKGROUND: Per rectum (PR) medication delivery is an alternative to traditional oral (PO), intravenous (IV), or intramuscular (IM) administration of medication for procedural sedation of pediatric emergency department patients. However, many emergency physicians are unfamiliar with its use, and there are no widely adopted guidelines or reviews dedicated to this topic. OBJECTIVE: Our aim was to provide emergency physicians with an overview of PR procedural sedation medications in pediatric patients...
May 24, 2018: Journal of Emergency Medicine
Maala Bhatt, David W Johnson, Monica Taljaard, Jason Chan, Nick Barrowman, Ken J Farion, Samina Ali, Suzanne Beno, Andrew Dixon, C Michelle McTimoney, Alexander Sasha Dubrovsky, Mark G Roback
Importance: It is not clear whether adherence to preprocedural fasting guidelines prevent pulmonary aspiration and associated adverse outcomes during emergency department (ED) sedation of children. Objective: To examine the association between preprocedural fasting duration and the incidence of sedation-related adverse outcomes in a large sample of children. Design, Setting, and Participants: We conducted a planned secondary analysis of a multicenter prospective cohort study of children aged 0 to 18 years who received procedural sedation for a painful procedure in 6 Canadian pediatric EDs from July 2010 to February 2015...
May 7, 2018: JAMA Pediatrics
Stephen L Thornton, Lisa Oller, Doyle M Coons
Introduction: This is the 2016 Annual Report of the University of Kansas Health System Poison Control Center (PCC). The PCC is one of 55 certified poison control centers in the United States and serves the state of Kansas 24-hours a day, 365 days a year, with certified specialists in poison information and medical toxicologists. The PCC receives calls from the public, law enforcement, health care professionals, and public health agencies. All calls to the PCC are recorded electronically in the Toxicall® data management system and uploaded in near real-time to the National Poison Data System (NPDS), which is the data repository for all poison control centers in the United States...
May 2018: Kansas Journal of Medicine
Felix Anthony Lubega, Mithrika S DeSilva, Deogratias Munube, Rita Nkwine, Janat Tumukunde, Peter K Agaba, Mary T Nabukenya, Fred Bulamba, Tonny S Luggya
BACKGROUND AND AIMS: Acute pain episodes associated with sickle cell disease (SCD) are very difficult to manage effectively. Opioid tolerance and side effects have been major roadblocks in our ability to provide these patients with adequate pain relief. Ketamine is cheap, widely safe, readily available drug, with analgesic effects at sub-anesthetic doses and has been used in wide range of surgeries, pediatric burns dressing change and cancer related pain however, literature concerning its use in sickle cell crises is still limited in our setting...
January 26, 2018: Scandinavian Journal of Pain
Martha H Wells, Brigid A McCarthy, Chi-Hong Tseng, Clarice S Law
PURPOSE: The purpose of this study was to determine provider and practice characteristics influencing usage of behavior guidance techniques (BGTs). METHODS: A 24-item survey was emailed to 4,117 active AAPD members to identify factors influencing pediatric dentists' use of BGTs. RESULTS: A total of 1,081 surveys were returned, for a 26 percent response rate. The mean age of respondents was 44.7 years old, with recent graduates comprising the largest group (30...
May 15, 2018: Pediatric Dentistry
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