Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2020
A Simple Screening Test of Filtration Efficiency for Protecting the Gas Sampling Line from CoronavirusUsing Fluorescent Microspheres.
During the coronavirus pandemic, preventing contamination of the anesthesia machine, critical to avoid cross-contamination between patients, has proven challenging when treating premature infants and neonates. While attaching a HEPA filter to the endotracheal tube will protect the anesthesia machine and the gas sampling line from contamination, this contribution to the dead space makes ventilation of these small patients challenging. Direct filtration of the gas sampling line eliminates this problem; however, appropriate filters are not readily available. ⋯ Although the Food and Drug Administration (FDA) has not approved the Flat Epidural Filter for use as an anesthesia machine gas filter, our simple challenge test suggests that it could be used to effectively filter the anesthesia gas sampling line.
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Paediatric anaesthesia · Nov 2020
Anaesthesia management of laser photocoagulation for retinopathy of prematurity. A retrospective review of perioperative adverse events.
The aim of this study was to report the incidence of perioperative adverse events occurring in infants undergoing diode laser photocoagulation of retinopathy of prematurity and to identify clinical risk factors that may affect the incidence. ⋯ The incidence of perioperative adverse events was not associated with patient's age, current weight, timing, or location of the procedure. Extubating infants at the end of the procedure is however associated with a high rate of apneas and bradycardia, and consideration should be given to keeping low weight infants undergoing prolonged procedures out-of-hours intubated.
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Paediatric anaesthesia · Nov 2020
The anatomical features of an ultrasound-guided Erector Spinae Fascial Plane block in a cadaveric neonatal sample.
Since its inception, the erector spinae plane block has been used for a variety of truncal surgeries with success in both adults and children. However, the anatomical features, route of spread, and dermatomal coverage are still not fully understood in a pediatric population. ⋯ Contrast material was found in the paravertebral, epidural, and intercostal spaces over an average of 5 vertebral levels when using 0.1 mL/kg.
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Bronchial asthma is the most pervasive chronic disease among children in the United States. Pneumonia, an acute pulmonary disorder, is also quite common, affecting individuals with chronic respiratory conditions. Despite the widespread recognition of bronchial asthma as a common, potentially life-threatening disease, its impact on the risk of serious pulmonary infections such as postoperative pneumonia is under-appreciated. We examined the association of bronchial asthma with postoperative pneumonia in a matched cohort of children who underwent inpatient surgical procedures. ⋯ Children with bronchial asthma had a significantly greater risk of postoperative pneumonia. Further studies are needed to understand the mechanisms underlying these associations and determine if perioperative interventions can mitigate this association.
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Paediatric anaesthesia · Nov 2020
Observational StudyThe use of LungUltrasoundcompared to Chest X-raytodiagnose Pneumothorax following the NussProcedure for Pectus Excavatum Repair in Children.
Pectus Excavatum is the most common deformation of the skeletal chest wall, and the Nuss procedure is used to correct this deformation. Residual pneumothorax is a frequent postoperative complication after thoracoscopy. Primary aim of this prospective observational study was to compare the level of agreement among readers using lung ultrasound and chest X-ray. ⋯ Our results support the use of lung ultrasound to diagnose pneumothorax after Nuss procedure. We found that the inter-reader accuracy was better with ultrasound compared to X-ray at our institution.