Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2012
Role of ultrasound compared to age-related formulas for uncuffed endotracheal intubation in a pediatric population.
It is often difficult to determine the correct size of endotracheal tubes (ETT) needed for intubating pediatric patients. Therefore, we evaluated the role of ultrasound in pediatric patients to compare the correct size of an uncuffed (ETT) with the minimal transverse diameter of the subglottic airway (MTDSA) measured by ultrasound and with tube size predicted by different age-related formulas. ⋯ Measuring MTDSA by ultrasound facilitates selection of the appropriate ETT in pediatric patients and may reduce the number of reintubations.
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Informed consent prior to anesthesia is an important part of the pediatric pre-anesthetic consultation. This study aimed to observe and identify the number and nature of the anesthesia risks considered and communicated to parents/guardians and children during the pediatric informed consent process on the day of elective surgery. ⋯ The pediatric anesthesia risk discussion is very variable. Trainees tend to discuss more specific risks than consultants and a patient's previous experience of anesthesia was associated with a more limited discussion of anesthesia risk.
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Paediatric anaesthesia · Aug 2012
Single-lung ventilation with carbon dioxide hemipneumothorax: hemodynamic and respiratory effects in piglets.
Video-assisted thoracoscopic surgery (VATS) has become a standard procedure in pediatric surgery. To facilitate surgical access, the dependent lung has to collapse using intrathoracic carbon dioxide insufflation and/or single-lung ventilation. These procedures can induce hemodynamic deteriorations in adults. The potential impacts of single-lung ventilation in combination with capnothorax on hemodynamics in infants have never been studied before. ⋯ Despite a decrease in CI and preload parameters, the combination of single-lung ventilation and low-pressure capnothorax was well tolerated in piglets and could justify further clinical studies to be performed in infants and children focusing on hemodynamic and respiratory changes during VATS.
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Coaxial tomography (CT) and magnetic resonance imaging (MRI) scans are so much part of neurological investigation these days and provide such detailed information that even thorough neurological clinical examination may be neglected. The investigations in common use forty years ago were pneumoencephalography, ventriculography in babies with hydrocephalus, and carotid angiography with the injection of X-ray contrast to outline the arteries.