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Paediatric and Anaesthesia

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https://www.readbyqxmd.com/read/29187760/the-exit-ex-utero-intrapartum-treatment-procedure-from-the-paediatric-ent-perspective
#1
B Pucher, J Szydlowski, K Jonczyk-Potoczna, J Sroczynski
The main principle of the EXIT procedure is to maintain uteroplacental circulation with neonatal anaesthesia by controlled uterine hypotonia. This enables securing the foetal airways and decompress or resect large neck and mediastinal foetal masses. The authors present their experience with use of the EXIT procedure in 7 foetuses in whom evaluation and management of the airways were performed. In 4 patients, the neck mass was surgically removed in the neonatal period, in 1 the propranolol treatment was introduced...
November 30, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29182126/a-comparison-of-ketamine-sedation-and-general-anaesthesia-for-manipulation-of-paediatric-forearm-fractures
#2
R W Jordan, A Aquilina, D J Westacott, S Cooke
The purpose of the study was to compare the use of ketamine sedation and general anaesthesia for manipulation of paediatric wrist and forearm fractures. A retrospective analysis was performed of patients under 16 years treated at our centre between October 2014 and October 2015. Exclusion criteria were open fractures and fractures with complete displacement. Outcomes measured were fracture reduction, the quality of the cast, fracture redisplacement, further surgical intervention and use of theatre time. 66 children were manipulated over the study period; 31 received ketamine sedation and 35 general anaesthesia...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29174210/ultrasound-guided-spinal-catheter-insertion-in-piglet-preliminary-results
#3
Noemi Romagnoli, Carlotta Lambertini, Domenico Ventrella, Dario Floriano, Alberto Elmi, Francesca Barone, Maria L Bacci
OBJECTIVE: To describe the ultrasound (US) evaluation of the cervical, thoracic and lumbar spinal tracts in piglets and to evaluate the feasibility of the ultrasound guided spinal catheter placement in newborn and paediatric piglets. STUDY DESIGN: Prospective experimental study. ANIMALS: A total of two piglet cadavers (age, 7 and 14 days) and eight commercial crossbreed piglets divided into four groups according to age: 7 (P7), 14 (P14), 21 (P21) and 28 (P28) days...
June 7, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29172310/could-video-glasses-contribute-to-behaviour-management-in-the-21st-century
#4
Abdullah Casaus, Biraj Patel, Laura Brown, Kristian Coomaraswamy
Dental fear in the paediatric population can be a significant barrier to providing optimal dental care. Pharmacological management techniques utilized to manage anxiety, such as conscious sedation and general anaesthesia, are expensive and require specialized equipment with additional staff training. With recent advances in technology, video glasses are an economic and novel distraction technique that may aid in improving behaviour management and facilitate dental treatment. Clinical relevance: Nervous children may find difficulty in accessing care owing to their inability to co-operate and accept dental treatment...
January 2017: Dental Update
https://www.readbyqxmd.com/read/29168575/cuffed-vs-uncuffed-tracheal-tubes-in-children-a-randomised-controlled-trial-comparing-leak-tidal-volume-and-complications
#5
N A Chambers, A Ramgolam, D Sommerfield, G Zhang, T Ledowski, M Thurm, M Lethbridge, M Hegarty, B S von Ungern-Sternberg
Cuffed tracheal tubes are increasingly used in paediatric anaesthetic practice. This study compared tidal volume and leakage around cuffed and uncuffed tracheal tubes in children who required standardised mechanical ventilation of their lungs in the operating theatre. Children (0-16 years) undergoing elective surgery requiring tracheal intubation were randomly assigned to receive either a cuffed or an uncuffed tracheal tube. Assessments were made at five different time-points: during volume-controlled ventilation 6 ml...
November 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29168220/number-needed-to-suffer-replying-to-comments-on-my-paper
#6
Per-Arne Lönnqvist
I would like to reply to the issues raised by the letter from Dr Barrington (1) on my Different View article on disability-free survival and number needed to suffer (2). However, first of all I would like to provide some important background on my interest in this area.First, I worked in NICU care for more than 10 years before focusing on paediatric anaesthesia and I am the proud father of premature triplets born at 31+4 weeks. As such, I have also been a parent who has witnessed NICU care three times for three months, including surfactant replacement, mechanical ventilation, surgical ductus ligation, sepsis and necrotising entercolitis treated by nil-by-mouth, total parenteral nutrition and antibiotics...
November 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#7
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29130583/endoscopic-retrograde-cholangio-pancreatography-in-the-management-of-biliary-complications-after-paediatric-liver-transplantation
#8
Sivaramakrishnan Venkatesh Karthik, Seng-Hock Quak, Marion M Aw
BACKGROUND: The published paediatric experience with Endoscopic retrograde cholangio-pancreatography (ERCP) in the diagnosis and management of biliary complications following liver transplantation (LT) is limited. AIMS: We describe our experience with ERCP in the management of children following LT who presented with biliary complications, over a 20 year period (1995-2014). METHODS: The retrospectively reviewed data is summarized descriptively...
November 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29120939/clinical-signs-and-electroencephalographic-patterns-of-emergence-from-sevoflurane-anaesthesia-in-children-an-observational-study
#9
Laura Cornelissen, Carolina Donado, Johanna M Lee, Norah E Liang, Ian Mills, Andrea Tou, Aykut Bilge, Charles B Berde
BACKGROUND: Few studies have systematically described relationships between clinical-behavioural signs, electroencephalographic (EEG) patterns and age during emergence from anaesthesia in young children. OBJECTIVE: To identify the relationships between end-tidal sevoflurane (ETsevoflurane) concentration, age and frontal EEG spectral properties in predicting recovery of clinical-behavioural signs during emergence from sevoflurane in children 0 to 3 years of age, with and without exposure to nitrous oxide...
November 8, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29114412/methylene-tetrahydrofolate-reductase-deficiency-the-hidden-risk-in-paediatric-anaesthesia
#10
Zeynep Nur Orhon, Emine Nursen Koltka, Sevil Tüfekçi, Çiğdem Buldağ, Alperen Kısa, Çiğdem Ulukaya Durakbaşa, Melek Çelik
Objective: Methylene tetrahydrofolate reductase (MTHFR) deficiency is an autosomal recessive disorder that results in increased homocysteine levels in the body. Hyperhomocysteinemia causes a predisposition to venous and arterial thrombosis and ischaemic insults. The incidence of the deficiency is around 40% in some countries. In this study, we aimed to evaluate the effects of anaesthetic agents in children with MTHFR deficiency. Methods: Twelve paediatric patients with an MTHFR enzyme deficiency who underwent surgery in a ten-month period in a single centre were retrospectively evaluated...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29082904/a-study-of-intubating-conditions-sevoflurane-versus-propofol-suxamethonium-in-children
#11
Morayo M Salawu, Elizabeth O Ogboli-Nwasor, Shola S Jamgbadi, Fidelia N Akpa
BACKGROUND: Endotracheal intubation is an integral part of general anaesthesia in children, and the choice of induction agents and technique may affect the ease of intubation and thus the outcome of paediatric patients. We compared the ease of endotracheal intubation following sevoflurane and propofol-suxamethonium induction using Helbo-Hansen score. PATIENTS AND METHODS: A prospective, randomized double-blinded comparative study conducted on sixty-six children (two groups of 33 each) between the ages of 3-10 years undergoing different elective surgeries...
July 2017: Nigerian Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29082007/assessing-the-global-reach-and-value-of-a-provider-facing-healthcare-app-using-large-scale-analytics
#12
Vikas O'Reilly-Shah, George Easton, Scott Gillespie
BACKGROUND: The rapid global adoption of mobile health (mHealth) smartphone apps by healthcare providers presents challenges and opportunities in medicine. Challenges include ensuring the delivery of high-quality, up-to-date and optimised information. Opportunities include the ability to study global practice patterns, access to medical and surgical care and continuing medical education needs. METHODS: We studied users of a free anaesthesia calculator app used worldwide...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29056227/intravenous-regional-anaesthesia-bier-s-block-for-pediatric-forearm-fractures-in-a-pediatric-emergency-department-experience-from-2003-to-2014
#13
Ivan S Y Chua, S L Chong, Gene Y K Ong
STUDY OBJECTIVES: To evaluate the efficacy (length of stay in the emergency department and failure rate of Bier's block) and safety profile (death and major complications) of Bier's block in its use for manipulation and reduction of paediatric forearm fractures. METHODS: This is a retrospective cohort study of pediatric patients in KKWomen's and Children's Hospital Children's Emergency Department with forearm fractures between Jan 2003 and Dec 2014 who underwent manipulation and reduction using Bier's block...
October 16, 2017: Injury
https://www.readbyqxmd.com/read/29054560/transcultural-adaptation-into-spanish-of-the-induction-compliance-checklist-for-assessing-children-s-behaviour-during-induction-of-anaesthesia
#14
Carmen Jerez-Molina, Juan J Lázaro-Alcay, Ana M Ullán-de la Fuente
OBJECTIVE: Cross-cultural adaptation into Spanish of the Induction Compliance Checklist (ICC) for assessing children's behaviour during induction of anaesthesia. METHOD: A descriptive cross-sectional observational study was conducted on a sample of 81 children aged 2 to 12 years operated in an ambulatory surgery unit of a paediatric hospital in Barcelona. Adaptation by translation-back translation of the tool and analysis of the scale's validity and reliability...
October 17, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/29051328/how-does-sevoflurane-induction-followed-by-a-ketamine-maintenance-infusion-affect-intraocular-pressure-establishment-of-an-anaesthetic-protocol-for-paediatric-glaucoma-examinations-under-anaesthesia
#15
Jessica Gwendoline van der Walt, Francois Roodt, Christopher Tinley
Accurate measurement of intraocular pressure (IOP) is essential in paediatric glaucoma management. Children require serial measurements and examination under anaesthesia (EUA). Most anaesthetic agents reduce IOP, and the ideal time to measure IOP under anaesthesia is questionable. STUDY PURPOSE: To determine the effect of sevoflurane induction, followed by intravenous ketamine infusion on IOP, in children undergoing EUA for glaucoma or suspected glaucoma, and to establish the earliest time point at which reliable, repeatable IOP measurements can be obtained under anaesthesia...
October 19, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29045577/drug-safety-in-paediatric-anaesthesia
#16
J Kaufmann, A R Wolf, K Becke, M Laschat, F Wappler, T Engelhardt
No abstract text is available yet for this article.
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29028915/point-of-care-paediatric-gastric-sonography-can-antral-cut-off-values-be-used-to-diagnose-an-empty-stomach
#17
J J Moser, A M Walker, A O Spencer
Background: Gastric sonography is emerging as a valuable clinical point-of-care tool to assess aspiration risk. A recent study proposed that a single cut-off cross-sectional area (CSA) in the supine position could diagnose an empty stomach in the parturient. This study establishes the sensitivity and specificity of a single CSA cut-off measurement in both supine and right lateral decubitus (RLD) positions in the diagnosis of an empty antrum in paediatric patients. Methods: Following induction of anaesthesia, antral sonography was performed in supine and RLD positions in 100 fasted paediatric patients prior to upper endoscopic evaluation...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28971804/a-randomised-trial-to-compare-truview-pcd-%C3%A2-c-mac-%C3%A2-and-macintosh-laryngoscopes-in-paediatric-airway-management
#18
Ranju Singh, Nishant Kumar, Aruna Jain
AIM: To evaluate and compare the Truview PCD and C-MAC laryngoscopes to the standard Macintosh laryngoscope in paediatric patients. METHODS: One hundred and fifty ASA I-II patients in the age group of 1-6 years (10-20 kg) scheduled for elective surgery were randomised into three equal groups for laryngoscopy and intubation with either Truview PCD (Group T), C-MAC (Group C) or Macintosh (Group M) laryngoscopes under general anaesthesia. Percentage of glottic opening (POGO) score, application of external laryngeal manoeuvre, time to intubation, number of attempts at intubation, failed intubations, episodes of desaturation and trauma caused were recorded and statistically analysed...
June 2017: Asian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28970636/post-cardiac-transplant-recipient-implications-for-anaesthesia
#19
REVIEW
Minati Choudhury
The annual heart transplant rate is gradually increasing worldwide. A proportion of this patient population present for an elective or emergency surgery which may or may not be related to the transplanted heart. A MEDLINE search for heart transplant, anaesthesia, adult, paediatric and surgery was conducted to review anaesthetic management for heart transplant recipients. Anaesthesia and perioperative management are different in these cases. A thorough understanding of the physiology of denervated heart, post-transplant morbidities and pharmacology of immunosuppressants is essential for best perioperative management and improved post-operative outcome...
September 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28969320/isoflurane-exposure-for-three-hours-triggers-apoptotic-cell-death-in-neonatal-macaque-brain
#20
K K Noguchi, S A Johnson, G A Dissen, L D Martin, F M Manzella, K J Schenning, J W Olney, A M Brambrink
Background: Retrospective clinical studies suggest there is a risk for neurodevelopmental impairment following early childhood exposure to anaesthesia. In the developing animal brain, including those of non-human primates (NHPs), anaesthetics induce apoptotic cell death. We previously reported that a 5 h isoflurane (ISO) exposure in infant NHPs increases apoptosis 13-fold compared with control animals. However, the majority of paediatric surgeries requiring anaesthesia are of shorter durations...
September 1, 2017: British Journal of Anaesthesia
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