Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2005
Recombinant factor VIIa (NovoSeven) as a hemostatic agent after surgery for congenital heart disease.
Postoperative bleeding and blood product requirements can be substantial in children undergoing open-heart surgery, and reexploration is required in 1% of cases. Recombinant activated factor VII (rFVIIa, NovoSeven, NovoNordisk, Denmark) is a hemostatic agent approved for the treatment of hemophilic patients with inhibitors to factor VIII or factor IX. It has also been used with success in other conditions. We present our experience with rFVIIa treatment for uncontrolled bleeding after open-heart surgery in five pediatric patients. ⋯ These cases support the impression that RFVIIa is efficient and safe in correcting hemostasis in children after cardiopulmonary bypass when other means fail. However, the data are still limited, and more extensive research is needed.
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Paediatric anaesthesia · Mar 2005
Case ReportsDexmedetomidine as the primary sedative agent for brain radiation therapy in a 21-month old child.
Dexmedetomidine (Precedex is an alpha2 adrenoceptor agonist which is gaining popularity as a sedative and anesthetic adjuvant. In this case report, dexmedetomidine was used safely and easily to provide sedation for 12 radiation-therapy sessions in a pediatric patient. It provided smooth induction and fast recovery with minimal respiratory depression.
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Paediatric anaesthesia · Mar 2005
Pediatric sedation in North American children's hospitals: a survey of anesthesia providers.
Information about the existence and organization of pediatric sedation services in North America is not available. We conducted a survey to collect this information from anesthesiologists at pediatric institutions and to identify factors perceived as limiting the development of sedation services. ⋯ Propofol use by nonanesthesiologists is common. Addressing the shortage of providers, and allocating resources for credentialing providers will encourage further development of pediatric sedation practice.
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Paediatric anaesthesia · Mar 2005
Case ReportsAnesthesia for children with Wolf-Hirshhorn syndrome: a report and literature review.
Wolf-Hirshhorn is a rare chromosomal defect syndrome. We present two cases of children diagnosed with Wolf-Hirshhorn syndrome, and discuss the ramifications of anesthesia for these patients.
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Paediatric anaesthesia · Mar 2005
Case ReportsPerioperative care of the patient with Williams syndrome.
Williams syndrome, initially described by Williams, Barratt-Boyes, and Lowe in 1961, consists of characteristic dysmorphic features, congenital heart disease, and distinctive behavioral and emotional traits. In addition to acquired and congenital heart disease, manifestations in the renal, endocrine, musculoskeletal, and central nervous system may have implications during the perioperative period. ⋯ The authors present a 7-month-old infant, previously diagnosed with Williams syndrome, who required anesthetic care for repair of subaortic and supravalvular aortic stenosis. The potential perioperative implications of Williams syndrome are discussed.