Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2019
Clinical TrialIntra-operative temperature monitoring with cutaneous zero-heat- flux-thermometry in comparison with oesophageal temperature: A prospective study in the paediatric population.
Maintenance of thermal homeostasis is of crucial importance in the anesthetized pediatric patient. Gold-standard methods for central core temperature measurement are however inappropriately invasive and impractical in daily practice. The SpotOn sensor uses zero-heat-flux thermometry technology and claims to bypass the invasiveness of classical methods and still accurately display central core temperatures. Up to date no formal analysis of this method in children has taken place. ⋯ SpotOn revealed itself as accurate as an esophageal temperature probe when estimating central core temperatures under ideal conditions and over a narrow range of temperatures. No adverse effects were observed with the use of the SpotOn sensor.
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Paediatric anaesthesia · Aug 2019
The Effect of Placement of a Support Under the Shoulders on Laryngeal Visualization with a C-Mac Miller Video Laryngoscope in Children Younger than Two Years of Age.
We aimed to evaluate glottis visualization and time to intubation in children younger than 2 years of age during laryngoscopy performed with a C-MAC Miller Video Laryngoscope in a position determined by placing a folded towel under the shoulders to align the oral-pharyngeal and laryngeal axes in the horizontal plane. ⋯ We showed that a folded towel placed under the shoulders in children younger than 2 years of age improves glottis visualization provides ease of use of the C-MAC Miller Video Laryngoscope. Therefore, we think that the placement of a folded towel under the shoulders during the use of a C-MAC Miller Video Laryngoscope may be useful for airway management in children younger than 2 years of age.
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Paediatric anaesthesia · Aug 2019
Assessment of Muscle Oxygenation in Children with Congenital Heart Disease.
Adaptive responses to congenital heart disease result in altered muscle perfusion and muscle metabolism. Such changes may be detectable using noninvasive spectroscopic monitors. ⋯ This study demonstrates that muscle oxygenation is abnormal in children with both cyanotic and acyanotic congenital heart disease. This suggests that noninvasive monitoring of muscle oxygenation may provide valuable information in situations where children with congenital heart disease may be at risk of hemodynamic compromise.
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Paediatric anaesthesia · Aug 2019
Airway management of congenital pulmonary airway malformation resection in neonates and infants: A case cohort study.
Anesthestic management of congenital pulmonary airway malformation has not been well described in the literature. It is not clear whether one-lung ventialtion is indicated during thoracoscopic lobectomy and if so, what is the best technique achieve it. ⋯ From our institution cohort, one-lung ventilation was more commonly used during thoracoscopic resections and was most commonly achieved with endobronchial intubation. Most patients were induced with inhalational anesthesia (sevoflurane), nondepolarizing neuromuscular blocker, and gentle positive pressure ventilation for intubation.
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Paediatric anaesthesia · Aug 2019
Trans- tracheal jet oxygenation: Comparing the efficacy and safety of 2 self- made Y connector devices with the ENK oxygen flow modulator™ in an infant animal model.
Self-made Y-connector jet-oxygenation devices with wide-bore expiratory port have been described but not evaluated in infant models. Little is known about the effect of oxygen flow rates on jet oxygenation via transtracheal cannula. ⋯ Our animal model results suggest that self-made Y-connector jet-oxygenation devices with wide-bore expiratory port are efficacious and perhaps safer than ENK oxygen flow modulator™ in obstructed airways, and jet oxygenation with minimal oxygen flow rates starting at 1 L/kg/min or (age [years] + 4) L/min, whichever lower, should be considered.