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Pediatric anesthesiology

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https://www.readbyqxmd.com/read/29184439/ultrasound-guided-rectus-sheath-block-caudal-analgesia-or-surgical-site-infiltration-for-pediatric-umbilical-herniorrhaphy-a-prospective-double-blinded-randomized-comparison-of-three-regional-anesthetic-techniques
#1
Lance M Relland, Joseph D Tobias, David Martin, Giorgio Veneziano, Ralph J Beltran, Christopher McKee, Tarun Bhalla
Background: Umbilical hernia repair is a common pediatric surgical procedure. While opioid analgesics are a feasible option and have long been a mainstay in the pharmacological intervention for pain, the effort to improve care and limit opioid-related adverse effects has led to the use of alternative techniques, including regional anesthesia. The current study prospectively compares the analgesic efficacy of three techniques, including caudal epidural blockade, peripheral nerve blockade, and local wound infiltration, in a double-blinded study...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29116973/the-pediatric-anesthesiology-workforce-projecting-supply-and-trends-2015-2035
#2
Matthew K Muffly, Mark Singleton, Rita Agarwal, David Scheinker, Daniel Miller, Tyler M Muffly, Anita Honkanen
BACKGROUND: A workforce analysis was conducted to predict whether the projected future supply of pediatric anesthesiologists is balanced with the requirements of the inpatient pediatric population. The specific aims of our analysis were to (1) project the number of pediatric anesthesiologists in the future workforce; (2) project pediatric anesthesiologist-to-pediatric population ratios (0-17 years); (3) project the mean number of inpatient pediatric procedures per pediatric anesthesiologist; and (4) evaluate the effect of alternative projections of individual variables on the model projections through 2035...
November 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29082218/evaluation-of-radiation-exposure-pattern-and-radiation-absorbed-dose-resulting-from-occupational-exposure-of-anesthesiologists-to-ionizing-radiation
#3
B Maghsoudi, S M J Mortazavi, S Khademi, P Vatankhah
INTRODUCTION: Little information is available concerning the radiation exposure of anesthesiologists, and no such data have previously been collected in Iran. This prospective study was performed to determine the amount of radiation exposure of anesthesiologists for the purpose of assessing whether or not dangerous levels of radiation exposures were being reached, and to identify factors that correlate with excessive risk. PARTICIPANTS AND METHODS: The radiation exposure of all anesthesiology residents and the attending of Shiraz University of Medical Sciences during a 3-month period (from June to August 2016) was measured using a film badge with monthly readings...
September 2017: Journal of Biomedical Physics & Engineering
https://www.readbyqxmd.com/read/29076261/informed-consent-in-pediatric-anesthesiology
#4
Katherine R Gentry, Katherine Lepere, Douglas J Opel
BACKGROUND: Informed consent for pediatric anesthesia is unique because it is (1) obtained from surrogates (ie, parents) rather than from the patient and (2) sought after parents have authorized the surgical intervention. There are limited data on how pediatric anesthesia informed and consent discussions are conducted. The purpose of this study was to characterize the content of preanesthesia informed consent discussions and assess their impact on parent recall and understanding. METHODS: We conducted a cross-sectional observational study at a tertiary pediatric hospital...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28990685/national-trends-in-otolaryngology-intern-curricula-following-accreditation-council-for-graduate-medical-education-changes
#5
Kevin J Kovatch, Rebecca S Harvey, Mark E P Prince, Marc C Thorne
OBJECTIVES/HYPOTHESIS: In 2016, Accreditation Council for Graduate Medical Education (ACGME) requirements for curriculum and resident experiences were modified to require entering postgraduate year (PGY)-1 residents to spend 6 months of structured education on otolaryngology-head and neck surgery (ORL-HNS) rotations. We aimed to determine how ORL-HNS training programs have adapted curricula in response to 2016 ACGME curriculum requirement changes. STUDY DESIGN: Survey study...
October 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28922234/consensus-statement-by-the-congenital-cardiac-anesthesia-society-milestones-for-the-pediatric-cardiac-anesthesia-fellowship
#6
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/28911897/perioperative-point-of-care-ultrasound-in-pediatric-anesthesiology-a-case-series-highlighting-intraoperative-diagnosis-of-hemodynamic-instability-and-alteration-of-management
#7
Adam C Adler
No abstract text is available yet for this article.
April 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28889155/comparison-of-3-different-regional-block-techniques-in-pediatric-patients-a-prospective-randomized-single-blinded-study
#8
Levent Sahin, Mahmut H Soydinc, Elzem Sen, Omer Cavus, Mehrican Sahin
To compare the analgesic efficiencies of caudal blocks, ultrasound (US)-guided transversus abdominis plane (TAP) blocks, and ilio-inguinal/ilio-hypogastric (II/IH) blocks performed to provide postoperative analgesia in pediatric patients undergoing unilateral lower abdominal surgery. Methods: This prospective, randomized, single-blinded study was conducted in the Department of Pediatric Surgery, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey from July 2013 to January 2015. The doses used were as follows: 0...
September 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28887926/developing-an-extracorporeal-membrane-oxygenation-program
#9
REVIEW
Julia Jones-Akhtarekhavari, Thomas A Tribble, Joseph B Zwischenberger
The development of a successful extracorporeal membrane oxygenation (ECMO) program requires an institutional commitment and the multidisciplinary cooperation of trained specialty personnel from nursing, internal medicine, anesthesiology, pulmonology, emergency medicine, critical care, and surgery and often pediatrics as well. The specialized training necessary to cultivate an integrated team capable of providing life-saving ECMO cannot be underestimated. The development of a successful ECMO program is best suited to a tertiary medical center that is centrally/regionally located and capable of financially supporting the level of expertise required as well as managing the program's overall cost effectiveness...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28872749/outstanding-contribution-to-pediatric-anesthesiology-an-interview-with-dr-robert-h-friesen
#10
Mark D Twite, Richard J Ing, Christopher S Nichols, Myron Yaster
Dr. Robert H. Friesen, (1946-) Professor of Anesthesiology, Children's Hospital Colorado, University of Colorado, Anschutz Medical Campus, has played a pivotal and pioneering role in the development of pediatric and congenital cardiac anesthesiology. His transformative research included the study of the hemodynamic effects of inhalational and intravenous anesthetic agents in the newborn and the effects of anesthetic agents on pulmonary vascular resistance in patients with pulmonary hypertension. As a model clinician-scientist, educator, and administrator, he changed the practice of pediatric anesthesia and shaped the careers of hundreds of physicians-in-training, imbuing them with his core values of honesty, integrity, and responsibility...
October 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28863019/pediatric-anesthesiology-fellows-perception-of-quality-of-attending-supervision-and-medical-errors
#11
Hubert A Benzon, John Hajduk, Gildasio De Oliveira, Santhanam Suresh, Sarah L Nizamuddin, Robert McCarthy, Narasimhan Jagannathan
BACKGROUND: Appropriate supervision has been shown to reduce medical errors in anesthesiology residents and other trainees across various specialties. Nonetheless, supervision of pediatric anesthesiology fellows has yet to be evaluated. The main objective of this survey investigation was to evaluate supervision of pediatric anesthesiology fellows in the United States. We hypothesized that there was an indirect association between perceived quality of faculty supervision of pediatric anesthesiology fellow trainees and the frequency of medical errors reported...
August 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28814365/pediatric-admissions-after-dental-care-under-general-anesthesia-a-retrospective-study-at-a-tertiary-care-center
#12
Anna L Lucy, Roopa P Gandhi, Lilyana Gross, Bryan McNair
PURPOSE: The purpose of this study was to identify factors associated with planned and unplanned pediatric hospital admissions following dental treatment under general anesthesia (DGA) in a tertiary care center. METHODS: Dental and medical records of 100 subjects one to 20 years of age, with a known history of admission after DGA, were reviewed retrospectively for patient-, procedure-, and anesthesia-related factors as well as adverse events following DGA. RESULTS: During the review period (December 3, 2011 to June 30, 2015), 10,371 subjects underwent DGA, of which 100 subjects (less than one percent) required admission...
May 15, 2017: Journal of Dentistry for Children
https://www.readbyqxmd.com/read/28795915/where-teachers-are-few-documenting-available-faculty-in-five-tanzanian-medical-schools
#13
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
Background Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. Objective To describe the availability of faculty in medical schools in Tanzania. Design We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
December 2016: Global Health Action
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#14
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gérard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigué, Laure de Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#15
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#16
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28586779/effect-of-anesthesia-on-the-developing-brain-infant-and-fetus
#17
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/28466618/point-of-care-ultrasound-in-a-department-of-pediatric-and-adolescent-surgery
#18
Efrat Avinadav, Anastasia Almog, Dragan Kravarusic, Emanuelle Seguier, Inbal Samuk, Adrianna Nika, Enrique Freud
BACKGROUND: Point-of-care ultrasound (POCUS) is becoming a common tool for routine use in emergency medicine, anesthesiology and intensive care for diagnostic and interventional purposes. When a portable ultrasound device became available for the department of Pediatric and Adolescent Surgery at the Schneider's Children Medical Center of Israel, we added POCUS assessments to the physician's daily rounds. POCUS is performed by pediatric surgeons trained in basic ultrasonography skills...
November 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28442957/efficacy-and-safety-of-intravenous-thiopental-for-sedation-during-magnetic-resonance-imaging-in-pediatric-patients-a-retrospective-analysis
#19
Yunus O Atalay, Tomak Leman, Joseph Drew Tobias
INTRODUCTION: Although the administration of rectal thiopental for sedation during magnetic resonance imaging (MRI) has been well described, there are limited data regarding its intravenous (IV) use in this clinical scenario. The aim of this study was to investigate the efficiency of IV thiopental for sedation during MRI in the pediatric population. METHODS: A retrospective review was conducted over a 12-month period of pediatric patients who received IV thiopental for sedation during MRI...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#20
Christopher A Iobst, Matthew Stillwagon, Deidre Ryan, Eric Shirley, Steven L Frick
BACKGROUND: Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons...
July 2017: Journal of Pediatric Orthopedics
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