Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2015
Nurse-driven pediatric analgesia and sedation protocol reduces withdrawal symptoms in critically ill medical pediatric patients.
While several analgesia and sedation guidelines and protocols have been developed and implemented for adults, there is still little evidence of clinical use of analgesia and sedation protocols and the impact on withdrawal symptoms in critically ill children. ⋯ Implementation of a nurse-driven pASP reduced the total dose of benzodiazepines and the occurrence of withdrawal symptoms significantly.
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Paediatric anaesthesia · Aug 2015
Randomized Controlled Trial Multicenter Study Comparative StudyA randomized multi-institutional crossover comparison of the GlideScope(®) Cobalt Video laryngoscope to the flexible fiberoptic bronchoscope in a Pierre Robin manikin.
The GlideScope Cobalt Video laryngoscope is being used more often in children with challenging laryngoscopy. There are, however, no pediatric trials comparing it to flexible fiberoptic bronchoscopy, the current accepted gold standard. This preliminary manikin study compares the first-attempt intubation success of the GlideScope Cobalt video laryngoscope to the flexible fiberoptic bronchoscope when performed by attending pediatric anesthesiologists at two major pediatric centers. ⋯ There was no difference in first-attempt success of tracheal intubation using VL vs fiberoptic bronchoscopy when performed by attending anesthesiologists at two large pediatric centers. However, institutional differences exist in success rates with VL across the two centers. Results from single-center device evaluations should be verified by multi-center evaluations. A significant proportion of attending anesthesiologists lack experience with advanced airway devices; targeted education may enhance intubation success and patient safety.
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Paediatric anaesthesia · Aug 2015
Patients with single ventricle physiology undergoing noncardiac surgery are at high risk for adverse events.
Patients with single ventricle physiology are at increased anesthetic risk when undergoing noncardiac surgery. ⋯ We observed no mortality during or after noncardiac surgery in a high-risk subgroup of palliated cardiac patients with single ventricle physiology. However, 11.8% of patients had an adverse event associated with their anesthetic.