Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2014
Observational StudyMarked changes in platelet count and function following pediatric congenital heart surgery.
Reduced hemostatic capacity is common following congenital heart surgery using cardiopulmonary bypass (CPB). The etiology is multifactorial with dilutional coagulopathy, as well as platelet adhesion and activation in the CPB circuit and oxygenator. The purpose of the present study was to evaluate platelet count and function in children following CPB. ⋯ Both platelet count and platelet function were significantly reduced after CPB in children undertaken correctional heart surgery. Duration of CPB and hypothermia was associated with significant changes in platelet function.
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Paediatric anaesthesia · Apr 2014
Retrospective audit of unplanned admissions to pediatric high dependency and intensive care after surgery.
Unplanned admissions to intensive care after surgery are a recommended clinical indicator of patient safety in the perioperative period and are validated to reflect both surgical and anesthesia-related complications. ⋯ The rate of unplanned admission to HDU/PICU is low and is comparable to previously published data. The high number of admissions following procedures involving a shared airway may represent patient-related factors and the case mix at this hospital. However, such a finding has prompted a combined ENT and anesthetic review of the care pathway for children with problems following airway instrumentation.
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Paediatric anaesthesia · Apr 2014
Is there an alternative to continuous opioid infusion for neonatal pain control? A preliminary report of parent/nurse-controlled analgesia in the neonatal intensive care unit.
Continuous opioid infusion (COI) remains the mainstay of analgesic therapy in the neonatal intensive care unit (NICU). Parent/nurse-controlled analgesia (PNCA) has been accepted as safe and effective for pediatric patients, but few reports include use in neonates. This study sought to compare outcomes of PNCA and COI in postsurgical neonates and young infants. ⋯ Results suggest PNCA may be a feasible and effective alternative to COI for pain management in postsurgical infants in the NICU. Results also suggest PNCA may provide more individualized care for this vulnerable population and in doing so, may potentially reduce opioid consumption; however, more studies are needed.