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Pediatric Anesthesia

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240 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
https://www.readbyqxmd.com/read/29704223/low-thoracic-erector-spinae-plane-block-for-perioperative-analgesia-in-lumbosacral-spine-surgery-a-case-series
#1
Josh P Melvin, Rudolph J Schrot, George M Chu, Ki Jinn Chin
PURPOSE: Severe postoperative pain following spine surgery is a significant cause of morbidity, extended length of facility stay, and marked opioid usage. The erector spinae plane (ESP) block anesthetizes the dorsal rami of spinal nerves that innervate the paraspinal muscles and bony vertebra. We describe the use of low thoracic ESP blocks as part of multimodal analgesia in lumbosacral spine surgery. CLINICAL FEATURES: We performed bilateral ESP blocks at the T10 or T12 level in six cases of lumbosacral spine surgery: three lumbar decompressions, two sacral laminoplasties, and one coccygectomy...
April 27, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29666787/cardiac-output-monitoring-in-preterm-infants
#2
REVIEW
Matthew McGovern, Jan Miletin
Maintaining optimal circulatory status is a key component of preterm neonatal care. Low-cardiac output (CO) in the preterm neonate leads to inadequate perfusion of vital organs and has been linked to a variety of adverse outcomes with heightened acute morbidity and mortality and adverse neurodevelopmental outcomes. Having technology available to monitor CO allows us to detect low-output states and potentially intervene to mitigate the unwanted effects of reduced organ perfusion. There are many technologies available for the monitoring of CO in the preterm neonatal population and while many act as useful adjuncts to aid clinical decision-making no technique is perfect...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29628207/inguinal-hernia-in-preterms-in-neonatal-intensive-care-units-optimal-timing-of-herniorrhaphy-and-necessity-of-contralateral-exploration-in-unilateral-presentation
#3
Joong Kee Youn, Hyun-Young Kim, Yeon-Ju Huh, Ji-Won Han, Soo-Hong Kim, Chaeyoun Oh, Ah Hae Jo, Kwi-Won Park, Sung-Eun Jung
BACKGROUND: We sought to determine the optimal timing of IH repair in preterms and the need for routine contralateral exploration. METHODS: Medical records of 3690 pediatric patients who underwent unilateral IH repair between January 1998 and December 2009 were reviewed. We assessed medical record review and telephone interviews. In total, 1990 patients were enrolled in the study. Early, early-delayed, and late repair were defined as herniorrhaphy performed within 7 days of diagnosis, later than 7 days of diagnosis, and after discharge from the NICU, respectively...
February 24, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29713814/prenatal-intervention-for-the-management-of-congenital-diaphragmatic-hernia
#4
REVIEW
Mariatu A Verla, Candace C Style, Oluyinka O Olutoye
Congenital diaphragmatic hernia (CDH) is the result of incomplete formation of the diaphragm that occurs during embryogenesis. The defect in the diaphragm permits the herniation of abdominal organs into the thoracic cavity contributing to the impairment of normal growth and development of the fetal lung. In addition to the hypoplastic lung, anomalies of the pulmonary arterioles worsen the pulmonary hypertension that can have detrimental effects in severe cases. Most cases of CDH can be effectively managed postnatally...
April 30, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29629477/a-method-to-accurately-estimate-the-catheter-length-needed-for-a-tunneled-central-catheter-placement
#5
Mihir Chaudhary, Olajire Idowu, Sunghoon Kim
A typical method of placing a tunneled central catheter utilizes C-arm fluoroscopy for insertion and estimation of the length of the catheter needed. We describe a new technique to estimate the length more accurately using a C-arm fluoroscope.
June 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29616201/cannulation-for-neonatal-and-pediatric-extracorporeal-membrane-oxygenation-for-cardiac-support
#6
REVIEW
Chris Harvey
The use of extracorporeal membrane oxygenation (ECMO) has increased over recent years providing respiratory and cardiac support. Optimal cannula placement is essential for successful patient outcomes. Multiple cannulation strategies may be employed depending on the age/weight of the patient and their underlying condition. This article discusses cannulation technique focusing on the cannulation of pediatric and neonatal patients for cardiac support on ECMO.
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29319604/the-european-society-of-regional-anaesthesia-and-pain-therapy-american-society-of-regional-anesthesia-and-pain-medicine-recommendations-on-local-anesthetics-and-adjuvants-dosage-in-pediatric-regional-anesthesia
#7
Santhanam Suresh, Claude Ecoffey, Adrian Bosenberg, Per-Anne Lonnqvist, Gildasio S de Oliveira, Oscar de Leon Casasola, José de Andrés, Giorgio Ivani
BACKGROUND AND OBJECTIVES: Dosage of local anesthetics (LAs) used for regional anesthesia in children is not well determined. In order to evaluate and come to a consensus regarding some of these controversial topics, The European Society of Regional Anaesthesia and Pain Therapy (ESRA) and the American Society of Regional Anesthesia and Pain Medicine (ASRA) developed a Joint Committee Practice Advisory on Local Anesthetics and Adjuvants Dosage in Pediatric Regional Anesthesia. METHODS: Representatives from both ASRA and ESRA composed the joint committee practice advisory...
February 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29432197/educational-series-in-congenital-heart-disease-echocardiographic-assessment-of-left-to-right-shunts-atrial-septal-defect-ventricular-septal-defect-atrioventricular-septal-defect-patent-arterial-duct
#8
REVIEW
Antigoni Deri, Kate English
This review article will guide the reader through the basics of echocardiographic assessment of congenital left to right shunts in both paediatric and adult age groups. After reading this article, the reader will understand the pathology and clinical presentation of atrial septal defects (ASDs), ventricular septal defects (VSDs), atrioventricular septal defects (AVSDs) and patent arterial duct. Echocardiography is the mainstay in diagnosis and follow-up assessment of patients with congenital heart disease. This article will therefore describe the echocardiographic appearances of each lesion, and point the reader towards specific features to look for echocardiographically...
March 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29669357/oxygenation-of-the-immature-infant-a-commentary-and-recommendations-for-oxygen-saturation-targets-and-alarm-limits
#9
Ola Didrik Saugstad
BACKGROUND: For 70 years, there has been a search for the optimal oxygenation of premature infants. In spite of the lack of evidence, guidelines have successively reduced oxygenation targets during these years. OBJECTIVES: (1) To present a summary of previously published meta-analyses of 5 randomized studies (NeOProM) which tested a low (85-89%) versus a high (91-95%) oxygen saturation target the first weeks after birth on outcome of immature newborn infants. (2) To present international recommendations for oxygenation the first weeks after birth...
2018: Neonatology
https://www.readbyqxmd.com/read/29706443/tunnelled-central-venous-access-devices-in-small-children-a-comparison-of-open-vs-ultrasound-guided-percutaneous-insertion-in-children-weighing-ten-kilograms-or-less
#10
Liam Vierboom, Alexandre Darani, Catherine Langusch, Svs Soundappan, Jonathan Karpelowsky
PURPOSE: Ultrasound-guided (USG) percutaneous insertion of tunnelled central venous access devices (CVADs) has been shown to be safe and effective in adults. However, there have been concerns over the safety of this technique in small children. This paper analyses the safety of USG percutaneous CVAD insertion in the pediatric population weighing ten kilograms or less. METHOD: All surgically inserted CVADs for children weighing ten kilograms or less, between January 2010 and December 2015 at the Children's Hospital at Westmead were retrospectively reviewed...
April 5, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#11
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29315467/a-systematic-review-of-outcomes-in-postoperative-pain-studies-in-paediatric-and-adolescent-patients-towards-development-of-a-core-outcome-set
#12
REVIEW
A Ross, J Young, R Hedin, G Aran, A Demand, A Stafford, J Worley, M Moore, M Vassar
Systematic reviews of postoperative pain in children have called into question the consistency of outcomes measured by clinical triallists as well as the measurement instruments used for assessment. Core outcome set methodology may be a solution to improve standardisation. This study provides an evidence-based foundation for the development of a core outcome set for paediatric postoperative pain studies. We searched ClinicalTrials.gov to identify relevant postoperative pain studies in children. The search yielded 300 registered trials...
March 2018: Anaesthesia
https://www.readbyqxmd.com/read/29285839/role-of-ultrasound-guided-epidural-anesthesia-for-lower-limb-surgery-in-children-with-previously-repaired-meningomyelocele
#13
Vrushali C Ponde, Vinit V Bedekar, Dilip Chavan, Anuya Gursale, Dipal Shah
BACKGROUND: Children that have had a meningomyelocele repair often present for hip and bilateral lower limb surgeries. Due to vertebral, epidural, and nerve root abnormalities, placement of epidural catheter is difficult. AIMS: We aim to describe the potential role of ultrasound in delineating the most appropriate intervertebral space for central neuroaxial blocks in these patients. METHODS: Twelve children with previous meningomyelocele repair, in the age group of 6-12 years posted for hip or bilateral lower limb surgeries were included...
March 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29224770/pain-control-following-tonsillectomy-in-children-a-survey-of-patients
#14
Philip R Persino, Lena Saleh, David L Walner
OBJECTIVE: This prospective study aimed to survey pediatric patients and their parents after tonsillectomy to assess their pain management utilization and satisfaction. INTRODUCTION: Tonsillectomy is the second most common surgical procedure performed in pediatric patients. Postoperative recovery is often associated with high levels of pain and severe functional limitations. There is currently no consensus on pain control regimens. Additionally, a recent FDA Black Box Warning on narcotic use has caused more uncertainty in appropriate pain control regimens...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29168156/the-anesthetic-management-of-button-battery-ingestion-in-children
#15
Richard J Ing, Monica Hoagland, Lena Mayes, Mark Twite
PURPOSE: Injuries related to button battery ingestion are common in children. This review provides an outline of the epidemiology, pathophysiology, management, and anesthetic implications in children who have ingested a button battery. SOURCE: A literature search was conducted in the United States National Library of Medicine PubMed database using the terms "button battery ingestion" and "children' and "removal" and "surgery" and "anesthesia"...
March 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29270915/review-of-the-enhanced-recovery-pathway-for-children-perioperative-anesthetic-considerations
#16
REVIEW
Jessica A George, Rahul Koka, Tong J Gan, Eric Jelin, Emily F Boss, Val Strockbine, Deborah Hobson, Elizabeth C Wick, Christopher L Wu
PURPOSE: Enhanced recovery after surgery (ERAS) pathways have been used for two decades to improve perioperative recovery in adults. Nevertheless, little is known about their effectiveness in children. The purpose of this review was to consider pediatric ERAS pathways, review the literature concerned with their potential benefit, and compare them with adult ERAS pathways. SOURCE: A PubMed literature search was performed for articles that included the terms enhanced recovery and/or fast track in the pediatric perioperative period...
May 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29213283/lateral-supratrochanteric-approach-to-sciatic-and-femoral-nerve-blocks-in-children-a-feasibility-study
#17
Andrew A Albokrinov, Ulbolhan A Fesenko, Taras B Huz, Valentyna M Perova-Sharonova
Background: Sciatic and femoral nerve blocks (SNB and FNB) result in effective lower limb analgesia. Classical SNB and FNB require patient repositioning which can cause pain and discomfort. Alternative approaches to sciatic and femoral nerve blocks in supine patients can be useful. Materials and Methods: Neurostimulator-guided SNB and FNB from the lateral supratrochanteric approach were performed. Local anesthetic spread in SNB and FNB after radiographic opacification was analyzed...
2017: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/29210706/clinical-evidence-for-any-effect-of-anesthesia-on-the-developing-brain
#18
Andrew J Davidson, Lena S Sun
A recent U.S. Food and Drug Administration warning advised that prolonged or repeated exposure to general anesthetics may affect neurodevelopment in children. This warning is based on a wealth of preclinical animal studies and relatively few human studies. The human studies include a variety of different populations with several different outcome measures. Interpreting the results requires consideration of the outcome used, the power of the study, the length of exposure and the efforts to reduce the confounding effects of comorbidity and surgery...
April 2018: Anesthesiology
https://www.readbyqxmd.com/read/29252483/writing-research-reports
#19
Daniel I Sessler, Steven Shafer
Clear writing makes manuscripts easier to understand. Clear writing enhances research reports, increasing clinical adoption and scientific impact. We discuss styles and organization to help junior investigators present their findings and avoid common errors.
January 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29265174/the-effect-of-pre-operative-gastric-ultrasound-examination-on-the-choice-of-general-anaesthetic-induction-technique-for-non-elective-paediatric-surgery-a-prospective-cohort-study
#20
A-C Gagey, M de Queiroz Siqueira, C Monard, S Combet, B Cogniat, F-P Desgranges, P Robinson, D Chassard, L Bouvet
Ultrasound examination of the gastric antrum is a non-invasive tool that allows reliable estimation of gastric contents. We performed this prospective cohort study in non-elective paediatric surgery to assess whether gastric ultrasound may help to determine the best anaesthetic induction technique, whether rapid sequence or routine. The primary outcome was the reduction of inappropriate induction technique. A pre-operative clinical assessment was performed by the attending anaesthetist who made a provisional plan for induction...
March 2018: Anaesthesia
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