Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2014
Performance of anesthesia residents during a simulated prone ventricular fibrillation arrest in an anesthetized pediatric patient.
Exposure to rare pediatric anesthesia emergencies varies depending on the residency program. Simulation can provide increased exposure to these rare events, improve performance of residents, and also aid in standardizing the curriculum. ⋯ Anesthesia residents need additional training in recognizing and treating operative ventricular fibrillation, especially in prone patients and rarely encountered etiologies such as hyperkalemia. Training in the treatment of uncommon pediatric emergencies should be a focal point in anesthesia residency programs.
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Paediatric anaesthesia · Sep 2014
Retrospective evaluation of antimicrobial prophylaxis in prevention of surgical site infection in the pediatric population.
Few studies have been conducted in pediatric patients evaluating efficacy of prophylactic antibiotics for prevention of surgical site infection (SSI). This retrospective study was undertaken to determine the effect of antibiotic prophylaxis in the prevention of SSI in children. ⋯ Proper administration of preoperative antibiotics in pediatric patients is one of the few modifiable and significant factors in prevention of SSI.
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In summary, AKI after pediatric congenital cardiac surgery represents an important diagnostic and therapeutic challenge in the modern day intensive care unit. AKI in the immediate postoperative period not only portends a poor short-term outcome, but also may relate to chronic kidney disease and mortality in the long term. Its association with increased morbidity, cost, and mortality demands the attention of clinicians and researchers. Future studies should employ a standard AKI definition and should focus on both the mitigation and prevention of AKI events.
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Paediatric anaesthesia · Sep 2014
Impact of 6% hydroxyethyl starch 130/0.42 and 4% gelatin on renal function in a pediatric animal model.
Artificial colloids, frequently used to prevent hemorrhagic shock in children, may induce serious renal side effects in critically ill adult patients. The impact of perioperative colloid infusion on the renal function in adults and children remains unclear. ⋯ In this pediatric animal model, the infusion of moderate doses of artificial colloids was not found to have any relevant impact on renal function. Further clinical investigations are necessary to provide a conclusive assessment of the risk for renal impairment after HES and GEL administration during major pediatric surgery.
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Paediatric anaesthesia · Sep 2014
Transthoracic echocardiographic guidance for obtaining an optimal insertion length of internal jugular venous catheters in infants.
There are multiple methods of determining the optimal position of central venous catheter (CVC) tips. The purpose of this study was to assess the feasibility of transthoracic echocardiography (TTE), and compare TTE and height-based method for correct positioning of CVCs in infants undergoing cardiac surgery. ⋯ Transthoracic echocardiography is a practical method for the correct placement of the CVC tip with less variability compared to the height-based method.