Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2011
Randomized Controlled TrialChildren on phenobarbital monotherapy requires more sedatives during MRI.
Phenobarbital induces specific hepatic cytochrome P-450 enzyme pathways causing increased clearance of hepatically metabolized drugs. In this study, we investigated the duration and additional anesthetic requirement during Magnetic resonance imaging (MRI) in epileptic children with or without phenobarbital monotherapy. ⋯ We suggest that the variability in response to the initial sedative agents during MRI requires titration of additive sedation with ketamine in epileptic children on phenobarbital monotherapy.
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Paediatric anaesthesia · Oct 2011
Comparative StudyComparison of point-of-care testing (POCT): i-STAT(®) international normalized ratio (INR) vs reference laboratory INR in pediatric patients undergoing major surgery.
The aim of the study was to compare international normalized ratio (INR) results obtained by point-of-care testing (i-STAT® device) with the reference laboratory INR in children undergoing major surgery with expected significant blood loss. ⋯ In the perioperative setting, point-of-care INR testing in children using the i-STAT® device is a reliable and easy-to-handle method for INR values ≤2.0, while INR values >2.0 might be underestimated.
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Paediatric anaesthesia · Oct 2011
Postoperative adverse respiratory events in preschool patients with inhaled foreign bodies: an analysis of 505 cases.
To identify the risk factors associated with postoperative adverse respiratory events in preschool-aged children with inhaled foreign bodies (FBs) undergoing rigid bronchoscopy. ⋯ Preoperative respiratory impairment may develop the patients with FBs into postoperative adverse respiratory events.
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Paediatric anaesthesia · Oct 2011
Perioperative management of children undergoing craniofacial reconstruction surgery: a practice survey.
To assess current practices in the management of children undergoing craniofacial surgery and identify areas of significant practice variability with the intent to direct future research. ⋯ Significant variability exists in the management of children undergoing these procedures; further study is required to determine the optimal management strategies. Clinical trials assessing the utility of central venous pressure and other hemodynamic monitoring modalities would enable evidence-based decision-making for monitoring in these children. The development of institutional transfusion thresholds should be encouraged, as there exists a body of evidence supporting their efficacy and safety.