Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2015
Comparative StudyNoninvasive cardiac output monitoring using bioreactance-based technique in pediatric patients with or without ventricular septal defect during anesthesia: in comparison with echocardiography.
We evaluated the use of bioreactance-based noninvasive cardiac output (CO) monitoring technique (NICOM(™), CO(NICOM)) in pediatric patients with or without ventricular septal defect (VSD) during anesthesia induction to determine its agreement with the measurements assessed by echocardiography (echo, CO(ECHO)). ⋯ In children without heart defects, the CO measured by NICOM shows a good agreement with the echo during anesthesia induction. The NICOM technique underestimates echo although a strong correlation exists between two methods in children with ventricular septal defect.
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Paediatric anaesthesia · Feb 2015
Observational StudyLumbar punctures in thrombocytopenic children with cancer.
Lumbar punctures (LP) in patients presenting thrombocytopenia are linked to the possibility of bleeding and spinal hematomas. The minimum platelet count required for the safe performance of spinal procedures is still under discussion. Children with some oncology diseases require routinely lumbar punctures; such patients often present thrombocytopenia, making this group an ideal population to study the association between lumbar puncture in thrombocytopenic patients and complications. ⋯ Even in thrombocytopenic patient, an epidural hematoma would be a relatively rare complication following lumbar puncture. Despite the large number of punctures performed on patients with platelet counts below 100,000 mm(-3) (n = 1108), further studies are necessary in order to determine a lower safe platelet count threshold for the performance of lumbar punctures in healthy patients undergoing neuraxial anesthesia.
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Paediatric anaesthesia · Feb 2015
Development of an optimal sampling schedule for children receiving ketamine for short-term procedural sedation and analgesia.
Intravenous racemic ketamine is commonly administered for procedural sedation, although few pharmacokinetic studies have been conducted among children. Moreover, an optimal sampling schedule has not been derived to enable the conduct of pharmacokinetic studies that minimally inconvenience study participants. ⋯ An optimal sampling schedule was developed that allowed assessment of the pharmacokinetic parameters of ketamine among children requiring short-term procedural sedation.
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Paediatric anaesthesia · Feb 2015
Blood transfusion in patients treated with surgery for necrotizing enterocolitis.
Necrotizing enterocolitis (NEC) is a common surgical emergency in premature infants and has high morbidity and mortality. Intraoperative treatment with fluid and transfusions may be difficult. ⋯ Patients having necrotizing enterocolitis with bowel resection are more likely to need preoperative transfusion with packed red blood cells, which may be more necessary when surgery is longer, preoperative hematocrit is lower, and estimated blood loss is higher.
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Paediatric anaesthesia · Feb 2015
Intraoperative apnea in children after buffered 5% povidone-iodine site sterilization for strabismus surgery.
Presurgical preparation for ocular surgery typically utilizes a buffered 5% povidone-iodine preparation solution. It was our observation that a significant number of spontaneously ventilating patients under sevoflurane anesthesia would become apneic upon ophthalmic instillation of this solution. This study was performed to confirm or refute this observation and to determine whether there were any patient variables that might predict this phenomenon. ⋯ Apnea at the time of ocular preparation with buffered 5% povidone-iodine solution is common. The precise mechanism of this response is unknown.