Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2021
ReviewAdultcongenital heart disease and anesthesia:an educational review.
Prognosis has dramatically improved among children with congenital heart disease (CHD), and the median survival for severe CHD is currently 25 years (ie, into adulthood). However, additional cardiac surgeries are often necessary in adults with CHD, whose unique cardiovascular anatomy and physiology necessitate specialized management by experts in adult CHD (ACHD) during the perioperative period. ACHD is characterized by a combination of congenital cardiac lesions, intervention-related anomalies that have developed over time, comorbidities caused by long-standing CHD, and comorbidities related to various syndromes and lifestyle factors. The present educational review discusses the transition from pediatric to adult cardiac care, comorbidities that develop as a result of ACHD, the assessments necessary for patients with ACHD prior to both cardiac and noncardiac surgeries, and the key ACHD lesions relevant to perioperative management.
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Paediatric anaesthesia · Feb 2021
Anesthetic Management of Pediatric Patients Undergoing Intrathecal Nusinersen Administration for Treatment of Spinal Muscular Atrophy: A Single Center Experience.
Spinal muscular atrophy is a group of autosomal recessive inherited neurological disorders secondary to a genetic mutation that leads to progressive muscle weakness and atrophy. Recently approved by the Food and Drug Administration, Nusinersen is the first treatment specifically for spinal muscular atrophy. This drug must be administered intrathecally, as it does not cross the blood-brain barrier. ⋯ The anesthetic plan for Nusinersen injections must be individualized to the patient's specific needs and clinical manifestations of the disease. When carefully tailored to each patient, anesthetic care is safe and successful.
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Paediatric anaesthesia · Feb 2021
ReviewThe Pediatric Craniofacial Collaborative Group (PCCG) Consensus Conference Methodology.
This article describes the methodology used for the Pediatric Craniofacial Collaborative Group (PCCG) Consensus Conference. ⋯ Experts in pediatric craniofacial surgery and anesthesiology are developing recommendations on behalf of the Pediatric Craniofacial Collaborative Group for perioperative management of patients undergoing open cranial vault surgery for craniosynostosis and identifying future research priorities.
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Paediatric anaesthesia · Feb 2021
Case ReportsInhaled Sedation with Sevoflurane in Critically Ill Children During Extracorporeal Membrane Oxygenation.
Sedation can be challenging in critically ill children. Inhaled anesthetics such as sevoflurane have proved to be useful in difficult or long-term sedation. ⋯ Sedation was successfully achieved in both patients, and patients' contribution to breathing was possible even with deep sedation. There were not any side effects during sevoflurane treatment or after withdrawal.