Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2018
Work of breathing for cuffed and uncuffed pediatric endotracheal tubes in an in vitro lung model setting.
Although cuffed paediatric endotracheal tubes increase work-of-breathing and inspiratory pressures, this is easily compensated for by pressure support ventilation with automatic tube compensation, and so has limited clinical significance.
pearl -
Paediatric anaesthesia · Sep 2018
Case ReportsAnesthetic considerations for scoliosis surgery in a patient with recessive severe/lethal form of osteogenesis imperfecta.
Osteogenesis imperfecta is a heterogeneous genetic disorder characterized by bone fragility, with disease ranging from mild fractures to death in utero. We describe a child with autosomal recessive osteogenesis imperfecta type VIII (severe or lethal phenotype), who successfully underwent posterior spinal fusion, was extubated on postoperative day 1 and discharged home 25 days later. Recently identified recessive forms of osteogenesis imperfecta are associated with severe/lethal phenotype. Special consideration is needed in scoliosis surgery, with challenges arising from prone positioning, neurophysiology monitoring, and blood loss.
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Paediatric anaesthesia · Sep 2018
Feasibility of autologous intraoperative blood collection and retransfusion in small children with complex congenital heart defects undergoing cardiopulmonary bypass.
Allogeneic blood product transfusion is common in pediatric patients undergoing cardiopulmonary bypass although it is associated with an increased risk for adverse events. Furthermore, numerous donor exposures may affect future blood transfusion needs and human leukocyte antigen matching for patients who may ultimately require cardiac transplantation. Autologous intraoperative blood collection and retransfusion is a known method of blood preservation, but has not been extensively practiced in pediatric patients. In this study we assess the feasibility of this blood conservation technique in small children with complex congenital heart defects undergoing cardiopulmonary bypass. ⋯ The use of autologous intraoperative blood collection and retransfusion is a feasible option for small children with complex congenital heart defects undergoing cardiopulmonary bypass. Study patients received significantly fewer donor exposures without an increase in postoperative bleeding. Children who require multiple cardiac surgeries or eventually transplantation could benefit from this blood conservation technique.
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Paediatric anaesthesia · Sep 2018
Case ReportsIntraoperative anesthetic management of an infant with a bridging bronchus: A case report.
A newborn infant was diagnosed with an imperforate anus, and colostomy was performed one day after birth. He exhibited repeated episodes of poor oxygenation during intubation, and a CT scan revealed a bridging bronchus. ⋯ This led to normal oxygenation, even while in the prone position. The surgery was completed without any complications.