Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2021
Randomized Controlled TrialComparison of midline catheters and peripherally inserted central catheters to reduce the need for general anesthesia in children with respiratory disease: A feasibility randomized controlled trial.
The optimal intravenous device for antibiotic administration for children with respiratory disease is uncertain. We assessed the feasibility of a randomized controlled trial comparing midline catheters with peripherally inserted central catheters. ⋯ An efficacy trial is feasible with expanded eligibility criteria and intensive staff training when introducing a new device. Midline catheter for peripherally compatible infusions is acceptable to patients and staff, might negate the need for general anesthesia and results in significant cost savings.
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Paediatric anaesthesia · Sep 2021
ReviewPharmacokinetic Concepts for Dexmedetomidine Target-Controlled Infusion Pumps in Children.
Pharmacokinetic parameter estimates are used in mathematical equations (pharmacokinetic models) to describe concentration changes with time in a population and are specific to that population. Simulation using these models and their parameter estimates can enrich understanding of drug behavior and serve as a basis for study design. Pharmacokinetic concepts are presented pertaining to future designs of dexmedetomidine target-controlled infusion pumps in children. ⋯ In addition, the ideal loading dose and rate of delivery to achieve target concentration without adverse cardiovascular effects are reviewed, and finally, dose considerations for obese children, based on contact-sensitive half-time, are introduced. An understanding of context-sensitive half-time changes with age enables anesthetic practitioners to better estimate duration of effect after cessation of dexmedetomidine infusion. Use of these known pharmacokinetic parameters and covariate information for the pediatric patient could readily be incorporated into commercial target-controlled infusion pumps to allow effective and safe open-loop administration of dexmedetomidine in children.
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Paediatric anaesthesia · Sep 2021
ReviewGrow and Advance through Intentional Networking (GAIN): a pilot program to foster connections within the Women's Empowerment and Leadership Initiative (WELI) in the Society for Pediatric Anesthesia.
The Women's Empowerment and Leadership Initiative in the Society for Pediatric Anesthesia was established to support women's efforts to achieve promotion, leadership positions, and equity in pediatric anesthesiology through coaching, mentoring, sponsorship, and networking. Career advancement relies on the establishment of mentoring relationships within institutions and at regional and national levels. Prior to the SARS-CoV-2 (COVID-19) pandemic, networking was primarily conducted at large national meetings. ⋯ Programs like the Women's Empowerment and Leadership Initiative GAIN are critical for advancing our specialty and supporting the well-being of pediatric anesthesiologists. GAIN addresses barriers to professional networking, including during the COVID-19 pandemic.
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Paediatric anaesthesia · Sep 2021
An assessment of opioids on respiratory depression in children with and without obstructive sleep apnea.
Obstructive sleep apnea is a risk factor for respiratory depression following opioid administration as well as opioid-induced hyperalgesia. Little is known on how obstructive sleep apnea status is associated with central ventilatory depression in pediatric surgical patients given a single dose of fentanyl. ⋯ In pediatric surgical patients, obstructive sleep apnea status was not associated with significant differences in central respiratory depression following a single dose of fentanyl (1 mcg/kg). These findings can help determine safe opioid doses in future pediatric obstructive sleep apneapatients.