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Pediatric Anesthesia

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186 papers 100 to 500 followers Interesting articles regarding the practice of Paediatric Anaesthesia
By Ignacio Galvez Paediatric Consultant Anaesthetist with an interest in research, teaching, difficult airway and regional anaesthesia
Constance S Houck, Amy E Vinson
Almost 30 years ago, the American Academy of Pediatrics Committee on Fetus and Newborn coauthored a policy statement strongly advocating for the use of anaesthesia in all neonates stating 'local or systemic pharmacologic agents now available permit relatively safe administration of anesthesia or analgesia to neonates undergoing surgical procedures and that such administration is indicated according to the usual guidelines for the administration of anesthesia to high-risk, potentially unstable patients'. With current techniques and advanced monitoring, preterm and full-term infants routinely undergo surgical procedures under general anaesthesia to repair congenital defects that were lethal in years past...
July 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
Deshui Yu, Linji Li, Weiguo Yuan
Mounting animal studies have demonstrated that almost all the clinically used general anesthetics could induce widespread neuroapoptosis in the immature brain. Alarmingly, some published findings have reported long-term neurocognitive deficits in response to early anesthesia exposure which deeply stresses the potential seriousness of developmental anesthetic neurotoxicity. However, the connection between anesthesia induced neuroapoptosis and subsequent neurocognitive deficits remains controversial. It should be noted that developmental anesthesia related neurotoxicity is not limited to neuroapoptosis...
March 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Yang Li-Qiao, Zhang Jian-Wei, Li Jing-Jie, Zhang Cheng-Mi
BACKGROUND: This study aimed to investigate the risk factors of intraoperative anesthesia adverse events (IAAEs) in children with laryngeal diseases. METHODS: We retrospectively recruited 118 children with laryngeal diseases who underwent surgical therapy. Based on medical history and preoperative imaging diagnosis, the baseline data, including sex, age, weight, onset age, the number of operation, the degree of airway obstruction, the nature of disease, the location of disease, complications, tracheotomy, and trachea intubation, were defined and recorded...
November 2016: Journal of Clinical Anesthesia
James J Cummings, Richard A Polin
The use of supplemental oxygen plays a vital role in the care of the critically ill preterm infant, but the unrestricted use of oxygen can lead to unintended harms, such as chronic lung disease and retinopathy of prematurity. An overly restricted use of supplemental oxygen may have adverse effects as well. Ideally, continuous monitoring of tissue and cellular oxygen delivery would allow clinicians to better titrate the use of supplemental oxygen, but such monitoring is not currently feasible in the clinical setting...
August 2016: Pediatrics
Khaled R Al-Zaben, Ibraheem Y Qudaisat, Aboud N Alja'bari, Omar A Ababneh, Al-Motassem M Yousef, Abdulrahman M Al-Shudifat
STUDY OBJECTIVES: The aim of this study was to compare the effects of caudal and intravenous (IV) dexmedetomidine (1 μg/kg) on postoperative analgesia after caudal bupivacaine in pediatric patients undergoing lower abdominal and perineal surgeries. DESIGN: A randomized controlled double-blind study. SETTING: University-affiliated teaching hospital. PATIENTS: Seventy-five American Society of Anesthesiologists I children, aged 1 to 6 years...
September 2016: Journal of Clinical Anesthesia
(no author information available yet)
Injury is still the number 1 killer of children ages 1 to 18 years in the United States ( Children who sustain injuries with resulting disabilities incur significant costs not only for their health care but also for productivity lost to the economy. The families of children who survive childhood injury with disability face years of emotional and financial hardship, along with a significant societal burden. The entire process of managing childhood injury is enormously complex and varies by region...
August 2016: Pediatrics
Marc Gewillig, Stephen C Brown
The Fontan operation was first performed in 1968. Since then, this operation has been performed on thousands of patients worldwide. Results vary from very good for many decades to very bad with a pleiad of complications and early death. A good understanding of the physiology is necessary to further improve results. The Fontan connection creates a critical bottleneck with obligatory upstream congestion and downstream decreased flow; these two features are the basic cause of the majority of the physiologic impairments of this circulation...
July 15, 2016: Heart: Official Journal of the British Cardiac Society
Frank Weber, Gijsbert H M Honing, Gail P Scoones
BACKGROUND: Hypotension during general anesthesia in neonates and infants is considered to contribute to poor neurological outcome. AIM: The aim of this retrospective analysis was to determine the incidence of hypotension after induction of anesthesia and sustained hypotension (>10 min) during the anesthesia, and to determine factors contributing to the development of (sustained) hypotension. METHOD: We performed a retrospective analysis of 1091 electronic anesthesia records from children <1 year...
August 2016: Paediatric Anaesthesia
Justin B Long, Anita S Joselyn, Tarun Bhalla, Joseph D Tobias, Gildasio S De Oliveira, Santhanam Suresh
BACKGROUND: Currently, there is limited evidence to support the safety of neuraxial catheters in neonates. Safety concerns have been cited as a major barrier to performing large randomized trials in this population. The main objective of this study is to examine the safety of neuraxial catheters in neonates across multiple institutions. Specifically, we sought to determine the incidence of overall and individual complications encountered when neuraxial catheters were used for postoperative analgesia in neonates...
June 2016: Anesthesia and Analgesia
Y Buller, C Sims
Fasting guidelines for children are well established. Despite these guidelines, previous studies have shown children are often fasted for prolonged periods before anaesthesia, potentially causing discomfort and distress. Moreover, recent publications indicate shorter fasting times for oral clear fluids in children may be safe. We audited fasting times of children having elective surgery at a local large private hospital that provides care for both adults and children. We gave feedback and education to our caregivers, then repeated the audit...
January 2016: Anaesthesia and Intensive Care
N Najafi, F Veyckemans, A Van de Velde, J Poelaert
BACKGROUND: Children with respiratory morbidities are at increased risk of developing adverse respiratory events while undergoing deep sedation. Dexmedetomidine possesses sedative properties with minimal respiratory depression. This report aimed to determine the usability of dexmedetomidine in children with significant respiratory morbidities who require deep sedation. METHODS: Medical records of children with ASA classification III who had at least three characteristics of respiratory morbidities and who received dexmedetomidine sedation for magnetic resonance imaging (MRI) between January 2014 and May 2015 were retrospectively reviewed...
August 2016: Acta Anaesthesiologica Scandinavica
Leigh White, Alice Halpin, Marianne Turner, Laurent Wallace
BACKGROUND: Ultrasound is a well-validated adjunct to central venous cannulation; however, previous reviews of ultrasound-guided radial artery cannulation have been inconclusive. The aim of this study was to assess the use of ultrasound in radial artery cannulation in adult and paediatric populations. METHODS: A systematic search of five major databases for all relevant articles published until November 2015 was conducted. Randomized controlled trials of radial artery cannulation with and without ultrasound guidance were included...
May 2016: British Journal of Anaesthesia
Mohammed H Elkomy, David R Drover, Kristi L Glotzbach, Jeffery L Galinkin, Adam Frymoyer, Felice Su, Gregory B Hammer
The objective of this study was to characterize morphine glucuronidation in infants and children following cardiac surgery for possible treatment individualization in this population. Twenty children aged 3 days to 6 years, admitted to the cardiovascular intensive care unit after congenital heart surgery, received an intravenous (IV) loading dose of morphine (0.15 mg/kg) followed by subsequent intermittent IV bolus doses based on a validated pain scale. Plasma samples were collected over 6 h after the loading dose and randomly after follow-up doses to measure morphine and its major metabolite concentrations...
January 2016: AAPS Journal
Jason Gien, John P Kinsella
OBJECTIVE: To determine whether right-to-left shunting across the ductus arteriosus (DA) in patients with congenital diaphragmatic hernia (CDH) with suprasystemic pulmonary hypertension (PH) results in differences between preductal and postductal arterial blood gas (ABG) measurements. DESIGN: Demographics, baseline echocardiographic parameters and differences in simultaneous right upper extremity (preductal) and umbilical artery (postductal) ABG samples were determined in newborns with PH and CDH...
July 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Myra H Wyckoff, Khalid Aziz, Marilyn B Escobedo, Vishal S Kapadia, John Kattwinkel, Jeffrey M Perlman, Wendy M Simon, Gary M Weiner, Jeanette G Zaichkin
No abstract text is available yet for this article.
November 2015: Pediatrics
Pramod S Puligandla, Julia Grabowski, Mary Austin, Holly Hedrick, Elizabeth Renaud, Meghan Arnold, Regan F Williams, Kathleen Graziano, Roshni Dasgupta, Milissa McKee, Monica E Lopez, Tim Jancelewicz, Adam Goldin, Cynthia D Downard, Saleem Islam
OBJECTIVE: Variable management practices complicate the identification of optimal strategies for infants with congenital diaphragmatic hernia (CDH). This review critically appraises the available evidence to provide recommendations. METHODS: Six questions regarding CDH management were generated. English language articles published between 1980 and 2014 were compiled after searching Medline, Cochrane, Embase and Web of Science. Given the paucity of literature on the subject, all studies irrespective of their rank in the levels of evidence hierarchy were included...
November 2015: Journal of Pediatric Surgery
Jung Min Ko
Recent research has demonstrated that genetic alterations or variations contribute considerably to the development of congenital heart disease. Many kinds of genetic tests are commercially available, and more are currently under development. Congenital heart disease is frequently accompanied by genetic syndromes showing both cardiac and extra-cardiac anomalies. Congenital heart disease is the leading cause of birth defects, and is an important cause of morbidity and mortality during infancy and childhood. This review introduces common genetic syndromes showing various types of congenital heart disease, including Down syndrome, Turner syndrome, 22q11 deletion syndrome, Williams syndrome, and Noonan syndrome...
September 2015: Korean Circulation Journal
Dianne L Atkins, Stuart Berger, Jonathan P Duff, John C Gonzales, Elizabeth A Hunt, Benny L Joyner, Peter A Meaney, Dana E Niles, Ricardo A Samson, Stephen M Schexnayder
No abstract text is available yet for this article.
November 2015: Pediatrics
Allan R de Caen, Marc D Berg, Leon Chameides, Cheryl K Gooden, Robert W Hickey, Halden F Scott, Robert M Sutton, Janice A Tijssen, Alexis Topjian, Élise W van der Jagt, Stephen M Schexnayder, Ricardo A Samson
No abstract text is available yet for this article.
November 2015: Pediatrics
Jeffrey M Perlman, Jonathan Wyllie, John Kattwinkel, Myra H Wyckoff, Khalid Aziz, Ruth Guinsburg, Han-Suk Kim, Helen G Liley, Lindsay Mildenhall, Wendy M Simon, Edgardo Szyld, Masanori Tamura, Sithembiso Velaphi
No abstract text is available yet for this article.
November 2015: Pediatrics
2015-11-02 08:30:28
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