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Paediatric and Anaesthesia

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https://www.readbyqxmd.com/read/29695029/paediatric-acute-care-highlights-from-the-paediatric-acute-care-advanced-paediatric-life-support-conference-gold-coast-2017
#1
Stephen Ss Teo, Arjun Rao, Jason Acworth
The Paediatric Acute Care Conference is an annual conference organised by APLS Australia to advance paediatric acute care topics for clinicians in pre-hospital medicine, EDs, acute paediatrics, intensive care and anaesthesia. The Conference 2017 was held at Surfers Paradise, Queensland. We provide a summary of some of the presentations.
April 25, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29666130/does-dexmedetomidine-given-as-a-premedication-or-intraoperatively-reduce-post-hospitalisation-behaviour-change-in-children-a-study-protocol-for-a-randomised-controlled-trial-in-a-tertiary-paediatric-hospital
#2
Paul Lee-Archer, Craig McBride, Rebecca Paterson, Michael Reade, Britta Regli-von Ungern-Sternberg, Deborah Long
INTRODUCTION: It has been reported that post-hospitalisation behaviour change (PHBC) occurs in over 50% of children undergoing a general anaesthetic and manifests as behaviours such as sleep and eating disorders, defiance of authority, nightmares, enuresis and temper tantrums. The effect is usually short-lived (2-4 weeks); however, in 5-10% of children, these behaviours can last up to 12 months. The risk factors for developing PHBC include underlying anxiety in the child or parent, a previous bad hospital experience, emergence delirium and preschool age...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29663461/the-legal-frameworks-that-govern-fetal-surgery-in-the-united-kingdom-european-union-and-the-united-states
#3
REVIEW
Kevin X Cao, Alice Booth, Sebastien Ourselin, Anna L David, Richard Ashcroft
The specialty of fetal surgery or fetal intervention is one of the most exciting emerging fields of modern medicine. It is made possible by decades of major developments in antenatal imaging, obstetric anaesthesia, fetal medicine, paediatric surgery and of course by the bold and novel practitioners willing to take new steps to advance the field. Beginning in the 1970s it has now reached a stage of maturity where there are several established in-utero procedures and countless clinical trials and studies to develop more...
April 16, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29661242/use-applicability-and-reliability-of-depth-of-hypnosis-monitors-in-children-a-survey-among-members-of-the-european-society-for-paediatric-anaesthesiology
#4
Yuen Man Cheung, Gail Scoones, Robert Jan Stolker, Frank Weber
BACKGROUND: To assess the thoughts of practicing anaesthesiologists about the use of depth of hypnosis monitors in children. METHODS: Members of the European Society for Paediatric Anaesthesiology were invited to participate in an online survey about their thoughts regarding the use, applicability and reliability of hypnosis monitoring in children. RESULTS: The survey achieved a response rate of 30% (N = 168). A total of 138 completed surveys were included for further analysis...
April 16, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29643549/low-flow-anaesthesia-underused-mode-towards-sustainable-anaesthesia
#5
REVIEW
Madhusudan Upadya, P J Saneesh
Any technique that employs a fresh gas flow that is less than the alveolar ventilation can be classified as low-flow anaesthesia. The complexities involved in the calculation of uptake of anaesthetic agents during the closed-circuit anaesthesia made this technique less popular. However, the awareness of the dangers of theatre pollution with trace amounts of the anaesthetic agents and the prohibitively high cost of the new inhalational agents, have helped in the rediscovery of low-flow anaesthesia. Moreover, the time has arrived for each of us, the practicing anaesthesiologists, to move towards the practice of low-flow anaesthesia, to achieve lesser theatre and environmental pollution and also to make anaesthesia more economical...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29601302/drug-error-in-paediatric-anaesthesia-current-status-and-where-to-go-now
#6
Brian J Anderson
PURPOSE OF REVIEW: Medication errors in paediatric anaesthesia and the perioperative setting continue to occur despite widespread recognition of the problem and published advice for reduction of this predicament at international, national, local and individual levels. Current literature was reviewed to ascertain drug error rates and to appraise causes and proposed solutions to reduce these errors. RECENT FINDINGS: The medication error incidence remains high. There is documentation of reduction through identification of causes with consequent education and application of safety analytics and quality improvement programs in anaesthesia departments...
March 29, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29576117/a-neurosteroid-analogue-with-t-type-calcium-channel-blocking-properties-is-an-effective-hypnotic-but-is-not-harmful-to-neonatal-rat-brain
#7
N Atluri, S M Joksimovic, A Oklopcic, D Milanovic, J Klawitter, P Eggan, K Krishnan, D F Covey, S M Todorovic, V Jevtovic-Todorovic
BACKGROUND: More than 4 million children are exposed annually to sedatives and general anaesthetics (GAs) in the USA alone. Recent data suggest that common GAs can be detrimental to brain development causing neurodegeneration and long-term cognitive impairments. Challenged by a recent US Food and Drug Administration (FDA) warning about potentially neurotoxic effects of GAs in children, there is an urgent need to develop safer GAs. METHODS: Postnatal Day 7 (P7) rat pups of both sexes were exposed to six (repeated every 2 h) injections of equipotent hypnotic doses of ketamine or the neuroactive steroid (3β,5β,17β)-3-hydroxyandrostane-17-carbonitrile (3β-OH) for 12 h...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29570481/intraoperative-blood-pressure-levels-in-young-and-anaesthetised-children-are-we-getting-any-closer-to-the-truth
#8
Jurgen C de Graaff
PURPOSE OF REVIEW: Blood pressure is a basic feature of monitoring during anaesthesia. However, it is very unclear what blood pressures are normal during anaesthesia in children. Furthermore, the clinical consequences of low blood pressure are also uncertain. Similarly, it is unclear when to initiate therapy for hypotension during anaesthesia. This review summarizes the most recent development on the interpretation of blood pressure measurements in children and the relation of low blood pressure to clinical outcome...
March 22, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29569453/the-safety-of-paediatric-dentistry-procedures-under-general-anaesthesia-a-five-year-experience-of-a-tertiary-care-center
#9
A K Bartella, C Lechner, M Kamal, J Steegmann, F Hölzle, B Lethaus
AIM: Frequently general anaesthesia (GA) is used to treat noncompliant children. Especially in children with morbid diseases general anaesthesia can be a challenging procedure for anaesthetists. The aim of this paper was to evaluate the risks and adverse reactions with a special focus on the impact of existing medication conditions and syndromes. MATERIALS AND METHODS: and methods Records of children up to 10 years of age, who were admitted for paediatric dentistry procedures under GA from January 2011 to December 2016 at the University Hospital of the University of Aachen (Germany), were reviewed...
March 2018: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/29569452/single-tooth-anaesthesia-a-new-approach-to-the-paediatric-patient-a-clinical-experimental-study
#10
L Giannetti, E Forabosco, E Spinas, D Re, A Murri Dello Diago
AIM: The objective of this study is to assess the efficacy of the STA Wand System with respect to pain and fear reduction in paediatric patients and by using the Single Tooth Anaesthesia (STA) technique. MATERIALS AND METHODS: Patients included children and teenagers between 6 and 17 years of age, who required the administration of local anaesthesia prior to expected treatments. Local anaesthesia was performed by means of the electronic STA Wand System (Milestone scientific...
March 2018: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/29564214/use-of-ketamine-sedation-for-the-management-of-displaced-paediatric-forearm-fractures
#11
Anatole Vilhelm Wiik, Poonam Patel, Joanna Bovis, Adele Cowper, Philip Socrates Pastides, Alison Hulme, Stuart Evans, Charles Stewart
AIM: To determine if ketamine sedation is a safe and cost effective way of treating displaced paediatric radial and ulna fractures in the emergency department. METHODS: Following an agreed interdepartmental protocol, fractures of the radius and ulna (moderately to severely displaced) in children between the age of 2 and 16 years old, presenting within a specified 4 mo period, were manipulated in our paediatric emergency department. Verbal and written consent was obtained prior to procedural sedation to ensure parents were informed and satisfied to have ketamine...
March 18, 2018: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29547425/are-short-subspecialty-courses-the-educational-answer
#12
Faye M Evans, Juan C Duarte, Carolina Haylock Loor, Wayne Morriss
There is an urgent need to train more anesthesia providers in low- and middle-income countries (LMICs). There is also a need to provide more educational opportunities in subspecialty areas of anesthetic practice such as trauma management, pain management, obstetric anesthesia, and pediatric anesthesia. Together, these subspecialty areas make up a large proportion of the clinical workload in LMICs. In these countries, the quality of education may be variable, there may be few teachers, and opportunities for continued learning and mentorship are rare...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29544571/comparison-between-intravenous-boluses-versus-infusion-of-tranexamic-acid-txa-to-reduce-bleeding-in-paediatric-cyanotic-congenital-heart-disease-chd-surgeries
#13
Faisal Junejo, Mohammad Irfan Akhtar, Mohammad Hamid, Syed Shabbir Ahmed, Fauzia Minai, Muneer Amanullah
OBJECTIVE: To compare the intravenous boluses and intravenous continuous infusion of tranexamic acid (TXA) to reduce postoperative bleeding in cyanotic congenital heart disease surgeries. STUDY DESIGN: Single-blinded randomised clinical trial. PLACE AND DURATION OF STUDY: Anaesthesia Department, The Aga Khan University Hospital, Karachi, from July 2016 to April 2017. METHODOLOGY: Sixty patients of cyanotic congenital heart disease, undergoing either palliative or corrective surgery involving cardiopulmonary bypass (CPB), were recruited...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29543615/paediatric-anaesthesia-a-rapidly-evolving-subspecialty
#14
Tom G Hansen
No abstract text is available yet for this article.
March 14, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29534778/unmasking-the-borderline-coarctation-the-utility-of-isoproterenol-in-the-paediatric-cardiac-catheterisation-laboratory
#15
Neil D Patel, Patrick M Sullivan, Cheryl M Takao, Sarah Badran, Joseph Ahdoot, Frank F Ing
BACKGROUND: One indication for intervention in coarctation of the aorta is a peak-to-peak gradient >20 mmHg. Gradients may be masked in patients under general anaesthesia and may be higher during exercise. Isoproterenol was given during cardiac catheterisation to simulate a more active physiologic state. OBJECTIVES: We aimed to describe the haemodynamic effects of isoproterenol in patients with coarctation and the impact of intervention on the elicited gradients...
March 14, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29492954/accuracy-of-near-patient-vs-inbuilt-spirometry-for-monitoring-tidal-volumes-in-an-in-vitro-paediatric-lung-model
#16
S Morgenroth, J Thomas, V Cannizzaro, M Weiss, A R Schmidt
Spirometric monitoring provides precise measurement and delivery of tidal volumes within a narrow range, which is essential for lung-protective strategies that aim to reduce morbidity and mortality in mechanically-ventilated patients. Conventional anaesthesia ventilators include inbuilt spirometry to monitor inspiratory and expiratory tidal volumes. The GE Aisys CS2 anaesthesia ventilator allows additional near-patient spirometry via a sensor interposed between the proximal end of the tracheal tube and the respiratory tubing...
March 1, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29484172/apnoeic-oxygenation-by-nasal-cannula-during-airway-management-in-children-undergoing-general-anaesthesia-a-pilot-randomised-controlled-trial
#17
Lafi Olayan, Abdulaleem Alatassi, Jaimin Patel, Sherran Milton
Background: Airway management is a core clinical skill in anaesthesia. Pre-oxygenation prior to induction of anaesthesia is a standard practice to prevent desaturation. Apnoeic oxygenation in adults is effective and prolongs the time to desaturation. The effectiveness of apnoeic oxygenation in the adult is well documented; however, evidence in the paediatric is lacking. Therefore, the aim of this study was to investigate the effectiveness of apnoeic oxygenation during airway management in children...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29480502/dental-treatment-and-caries-prevention-preceding-treatment-under-general-anaesthesia-in-healthy-children-and-adolescents-a-retrospective-cohort-study
#18
M Grindefjord, J Persson, L Jansson, G Tsilingaridis
AIM: This was to examine healthy children and adolescents treated under general anaesthesia (GA) and a matched control group not receiving GA to compare treatment and preventive care received prior to GA treatment. METHODS: This retrospective cohort study included 71 healthy subjects and 213 age- and gender-matched control subjects. The treatment group had been consecutively referred from the Public Dental Health Service (PDS) in Stockholm to the Department of Paediatric Dentistry, Eastman Institute, Stockholm during 2006-2007...
February 26, 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/29476940/anxiety-during-inhalation-induction-in-paediatrics-sitting-versus-supine-position-a-randomised-trial
#19
Benjamin Cohen, Aude Thévenin, Bénédicte Mille-Zemmoura, Joseph Moënne-Loccoz, Francis Remérand, Marc Laffon
STUDY OBJECTIVE: We evaluated if the sitting or supine positions affect anxiety levels induced by the application of a facemask in children. DESIGN: Prospective, randomised study. SETTING: Paediatric hospital, operating room. PATIENTS: Two to twelve years old children, 1-3 ASA status, undergoing inhalation anaesthesia for elective surgery. INTERVENTION: Children were randomly assigned to a sitting or supine position...
February 21, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29471256/consensus-research-priorities-for-paediatric-status-epilepticus-a-delphi-study-of-health-consumers-researchers-and-clinicians
#20
Jeremy Furyk, Robin Ray, Kerriane Watt, Stuart R Dalziel, Ed Oakely, Mark Mackay, Gabriel Dabscheck, Kate Riney, Franz E Babl
PURPOSE: Status epilepticus (SE) is a paediatric emergency with significant morbidity and mortality. Recommendations beyond first line care are not based on high quality evidence. Emergency physicians and neurologists are key stakeholders in managing this condition. A collaborative, widely consulted approach to identifying priorities can help direct limited research funds appropriately. The objectives of this study are to identify consensus research priorities in paediatric SE among experts and health consumers...
February 5, 2018: Seizure: the Journal of the British Epilepsy Association
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