Paediatric anaesthesia
-
Paediatric anaesthesia · Feb 2013
Case ReportsMeningococcemia and heparin-induced thrombocytopenia: a dangerous combination.
We present a dramatic case of a patient presenting with disseminated intravascular coagulation related to meningococcal sepsis who developed heparin-induced thrombocytopenia following heparin administration during continuous renal replacement therapy. Association of these two prothrombotic conditions led to severe limbs ischemia and finally to bilateral legs amputation. We stress the importance of suspect heparin-induced thrombocytopenia in intensive care unit patients, especially when an improvement of other coagulation parameters is observed, and heparin therapy was started.
-
Paediatric anaesthesia · Feb 2013
Endoscopic airway findings in children with or without prior endotracheal intubation.
Airway alterations found after endotracheal intubation are usually associated with mechanical trauma from the tube. However, no studies are available concerning alterations in airways that have never been intubated before. It was the aim of the study to compare endoscopic findings in the larynx and trachea of children who had undergone prior endotracheal intubation with findings in children who had not been intubated before. ⋯ Endoscopic airway alterations can be observed in about one-quarter of children presenting for routine surgery without prior intubation. Except for glottic granulomas, the abnormalities are found with similar frequency in patients with and without prior intubation. No relevant airway damage from short-term endotracheal intubation was found.
-
Paediatric anaesthesia · Feb 2013
The validity of the Computer Face Scale for measuring pediatric pain and mood.
The aim was to assess the validity of the Computer Face Scale. ⋯ The results support the validity of the Computer Face Scale. The mean ratings of pain and mood followed the expected pattern from pre- to postsurgery, and there was a significant association between ratings obtained by different methods. The Computer Face Scale provides a simple-to-use scale with more resolution and electronic capture, which may provide advantages in numerous clinical and research applications.
-
Paediatric anaesthesia · Feb 2013
Comparative StudyCuff filling volumes for pediatric classic laryngeal mask airways: comparison of clinical end points versus adjusted cuff pressure.
Clinical end points are often used to guide inflation and adequacy of cuff seal after laryngeal mask airway placement. However, clinical end points for cuff inflation have been shown to have significantly higher intracuff pressure. The adjusted cuff pressure between 55 and 60 cm H(2)O causes significantly better seal of laryngeal mask airway. We prospectively assessed the cuff pressures generated by cuff inflation guided by clinical end points, and the actual volume of air required to achieve cuff pressures between 55 and 60 cm H(2)O for sizes 1-2.5 reusable classic laryngeal mask airway. ⋯ Lower cuff volumes are required to achieve a pressure of 60 cm H(2)O than those required if clinical end points are used as a sole guide for determining cuff inflation for patients receiving pediatric laryngeal mask airways.