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sedation children post operative cardiac

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
Cristiana Garisto, Zaccaria Ricci, Lorenzo Tofani, Simona Benegni, Chiara Pezzella, Paola Cogo
BACKGROUND: Dexmedetomidine is a selective agonist of α2 receptors that induces hypnotic, sedative and mild analgesic effect. The aim of our study was to test the effects of dexmedetomidine in combination with opioids and benzodiazepines compared to benzodiazepine-opioids alone. METHODS: A randomized controlled trial was conducted. Patients (children >30 days and <24 months undergoing correction of complex congenital heart diseases -CHD-) were randomized to receive 0...
March 7, 2018: Minerva Anestesiologica
Grace E Larson, Stephen McKeever
BACKGROUND: Pain and sedation protocols are suggested to improve the outcomes of patients within paediatric intensive care. However, it is not clear how protocols will influence practice within individual units. OBJECTIVES: Evaluate a nurse led pain and sedation protocols impact on pain scoring and analgesic and sedative administration for post-operative cardiac patients within a paediatric intensive care unit. METHODS: A retrospective chart review was performed on 100 patients admitted to a tertiary paediatric intensive care unit pre and post introduction of an analgesic and sedative protocol...
January 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Jonathan Mathers, Bernardita Troncoso Solar, Louise Harding, Naima Smeulders, Helen Hume-Smith
OBJECTIVE: To assess the frequency and severity of cardiac dysrhythmias and identify any intraoperative or postoperative complications in children undergoing extracorporeal shock wave lithotripsy (ESWL). METHODS: All children coming to our institution for ESWL from June 2014 to January 2015 were prospectively enrolled in an observational cohort study. Intraoperative cardiac dysrhythmias and perioperative and postoperative complications were recorded. RESULTS: In total, 21 children aged 1-18 years were enrolled receiving a total of 26 treatments...
November 2015: Urology
S R Prasad, Parimala Prasanna Simha, A M Jagadeesh
AIMS AND OBJECTIVES: To compare the efficacy of sedation and time taken for extubation using dexmedetomidine and fentanyl sedation in post-operative paediatric cardiac surgical patients. METHODS: A prospective randomized double-blind study involving 60 children undergoing open heart surgery was conducted. The patients were divided into two groups, each involving 30 patients. One group received fentanyl at 1 μg/kg/h (Group A) and the other received dexmedetomidine at 0...
November 2012: Indian Journal of Anaesthesia
Mariana R J Cury, Francisco E Martinez, Ana P C P Carlotti
PURPOSE: We aimed to test the convergent validity of the COMFORT scale and the Cardiac Analgesic Assessment Scale (CAAS) and to evaluate changes in physiological parameters over time in response to a painful procedure in neonates and infants following cardiac surgery. METHODS: From October 2006 to May 2008, 16 children were prospectively evaluated over 1-3 days after cardiac surgery while they remained on mechanical ventilation and received infusions of sedatives and analgesics...
February 2013: Postgraduate Medical Journal
Monika Olischar, Andrew J Davidson, Katherine J Lee, Rod W Hunt
BACKGROUND: Studies of children who undergo major non-cardiac surgery in the neonatal period are needed so that subsequent abnormal neurodevelopment can be better understood. OBJECTIVE: It was the aim of our study to describe the influence of analgesic and sedative medication on the predominant background pattern and the development of sleep-wake cycling (SWC), as measured on amplitude-integrated electroencephalography (aEEG), in newborn infants born ≥ 32 weeks' gestation after major non-cardiac surgery...
2012: Neonatology
Kimberly N Le, Brady S Moffett, Elena C Ocampo, John Zaki, Emad B Mossad
PURPOSE: To evaluate the impact of dexmedetomidine on early extubation in post-operative pediatric cardiac patients compared to patients on standard sedation regimens without dexmedetomidine. METHODS: Retrospective study comparing dexmedetomidine infusion (DEX) to our standard sedation regimens (control). RESULTS: A total of 269 patients were included (control: n = 180; DEX: n = 89). The mean duration of DEX was 34 ± 2 h. Extubation was achieved in the operating room in 42% of the control group and 42% of the DEX group...
April 2011: Intensive Care Medicine
R Phillip Dellinger, Mitchell M Levy, Jean M Carlet, Julian Bion, Margaret M Parker, Roman Jaeschke, Konrad Reinhart, Derek C Angus, Christian Brun-Buisson, Richard Beale, Thierry Calandra, Jean-Francois Dhainaut, Herwig Gerlach, Maurene Harvey, John J Marini, John Marshall, Marco Ranieri, Graham Ramsay, Jonathan Sevransky, B Taylor Thompson, Sean Townsend, Jeffrey S Vender, Janice L Zimmerman, Jean-Louis Vincent
OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding...
January 2008: Intensive Care Medicine
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