Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2019
Randomized Controlled TrialManual versus pressure-controlled facemask ventilation during the induction of general anaesthesia in children: a prospective randomised controlled study.
Pressure-controlled face mask ventilation during paediatric induction reduces gastric insufflation compared with manual ventilation.
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Paediatric anaesthesia · Apr 2019
Observational StudyThe heart rate variability-derived Newborn Infant Parasympathetic Evaluation (NIPE™) Index in pediatric surgical patients from 0 to 2 years under sevoflurane anesthesia-A prospective observational pilot study.
The heart rate variability-derived Newborn Infant Parasympathetic Evaluation (NIPE™) Index is a continuous noninvasive tool to assess pain and discomfort in infants <2 years. Initial studies focused on pain monitoring in the neonatal intensive care unit environment. ⋯ In infants anesthetized with sevoflurane, NIPE values <50 might be indicative of insufficient antinociception. The results of this observational pilot study might suggest that the NIPE could be a better measure of the nociception/antinociception balance than heart rate.
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Paediatric anaesthesia · Apr 2019
Observational StudySaving sevoflurane: Automated gas control can reduce consumption of anesthetic vapor by one-third in pediatric anesthesia.
Many modern anesthetic machines offer automated control of anesthetic vapor. The user simply sets a desired end-tidal concentration and the machine will manipulate the vaporizer and gas flow rates to obtain and maintain the preset target. Greater efficiency, and more accurate delivery of anesthetic vapor have been documented across multiple machines within the adult setting however, there is little evidence for their use in children. ⋯ Maquet's Flow-i automatic gas control mode reduced use of sevoflurane an average of one-third in a pediatric anesthesia setting.
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Paediatric anaesthesia · Apr 2019
Observational StudyThe impact of a quality improvement project to standardize pain, agitation, and withdrawal assessments on the use of morphine and midazolam in the Pediatric Intensive Care Unit.
This study aims to assess the impact of a quality improvement initiative to increase assessments of pain, agitation, and iatrogenic withdrawal syndrome, on the use of sedative and analgesic medication in a pediatric intensive care unit. ⋯ Implementation of a multifaceted QI project was successful at increasing standardized assessments of pain and agitation, and was associated with a significant reduction in midazolam use. We also observed a decrease in morphine use without increasing rates of severe pain. Incidence of iatrogenic withdrawal syndrome and cost were unchanged.
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Paediatric anaesthesia · Apr 2019
A new way to determine correct depth of central venous catheter insertion using a real-time ultrasound-guided insertion technique in pediatric patients.
Several formulae or methods are reported to predict the ideal central venous catheter insertion depth. However, they are complicated and often unsuitable in cases requiring rapid management. ⋯ This study successfully determined a visually simple and practical bar graph to predict the ideal central venous catheter depth inserted using only the real-time ultrasound-guided insertion technique for the right internal jugular vein, left supraclavicular, and right supraclavicular approaches.