Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2008
Case ReportsNovel use of dexmedetomidine in a patient with pulmonary hypertension.
The presence of pulmonary arterial hypertension (PAH) is a significant predictor of major perioperative cardiovascular complications in patients undergoing cardiac diagnostic or interventional procedure or non cardiac surgery under sedation and/or anesthesia. Factors that precipitate a pulmonary hypertensive crisis include hypoxia, hypercarbia, acidosis, hypothermia, pain and airway manipulations. ⋯ We report the use of dexmedetomidine for sedation and analgesia in a 16 year old patient with significant pulmonary hypertension, pneumonia and impending cardiorespiratory failure. This resulted in avoidance of endotracheal intubation and positive pressure ventilation, with subsequent recovery to discharge home.
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Paediatric anaesthesia · Aug 2008
Internal jugular vein diameter in pediatric patients: are the J-shaped guidewire diameters bigger than internal jugular vein? An evaluation with ultrasound.
This study investigates whether the diameters of right internal jugular vein (RIJV) are suitable for the use of 'big radius curved J-tip' Seldinger wires in pediatric patients. ⋯ The diameter of the IJV in pediatric patients, especially infants, is often smaller than the diameter of the J-tip guidewire curve. We speculate that this may lead to impeded guidewires and failed cannulation. It must also be kept in mind that the Trendelenberg position might not facilitate IJV cannulation in children <2 years of age.