Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2009
Comparative StudyCerebral metabolism during deep hypothermic circulatory arrest vs moderate hypothermic selective cerebral perfusion in a piglet model: a microdialysis study.
Few data exist regarding antegrade selective cerebral perfusion (ASCP) and its application in newborn and juvenile patients. Clinical data suggest ASCP alone to be superior to deep hypothermic circulatory arrest (DHCA); however, the effects of moderate hypothermia during ASCP on cerebral metabolism in this patient population are still unclear. ⋯ In this piglet model, both cerebral oxygenation and microdialysis findings suggested a depletion of cerebral energy stores during circulatory arrest in the DHCA18 group, compared to selective cerebral perfusion combined with circulatory arrest in the ASCP27 group.
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Paediatric anaesthesia · Aug 2009
Humidification during high-frequency oscillation ventilation is affected by ventilator circuit and ventilatory setting.
High-frequency oscillation ventilation (HFOV) is an accepted ventilatory mode for acute respiratory failure in neonates. As conventional mechanical ventilation, inspiratory gas humidification is essential. However, humidification during HFOV has not been clarified. In this bench study, we evaluated humidification during HFOV in the open circumstance of ICU. Our hypothesis is that humidification during HFOV is affected by circuit design and ventilatory settings. ⋯ Humidification during HFOV is affected by circuit design and ventilatory settings.
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Paediatric anaesthesia · Aug 2009
Case ReportsAnesthetic management of a neonate with type IV laryngotracheo-esophageal cleft.
Laryngotracheo-esophageal cleft is a rare congenital anomaly that occurs when the trachea and esophagus fail to separate during fetal development. Clinical severity varies greatly in anatomic cleft extent. We report the successful management of the airway of a neonate with type IV laryngotracheo-esophageal cleft for the gastric division surgery by dividing the esophagogastric continuity between the esophageal orifice and the stomach using the balloon catheter and remaining spontaneous breathing through the large cuffed tracheal tube inserted into the esophageal orifice.