Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2022
Observational StudyThe response of internal carotid artery blood flow velocity to fluid challenge under general anesthesia in pediatric patients with moyamoya disease: a prospective observational study.
Maintaining cerebral blood flow is important in intraoperative management of moyamoya disease patients. ⋯ The internal carotid artery blood flow velocity did not increase in pediatric patients with moyamoya disease under general anesthesia, despite fluid challenge and corresponding changes in the blood pressure and cardiac output. Intraoperative hemodynamic management to improve the cerebral blood flow in these patients requires further investigation.
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Paediatric anaesthesia · Dec 2022
A Standardized Approach to Airway Management During Abbé Flap Reconstruction.
The Abbé flap is a two-staged procedure to address upper lip tightness, creating a surgically closed mouth during the first stage. Airway manipulation and management in the setting of a surgically closed mouth presents a challenge from an anesthetic standpoint. ⋯ The proposed standardized approach to airway management during Abbé flap reconstruction was safe and effective in this limited series of patients.
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Paediatric anaesthesia · Dec 2022
Identifying the optimal blood pressure for cerebral autoregulation in infants after cardiac surgery by monitoring cerebrovascular reactivity - A pilot study.
Advances in the treatment of pediatric congenital heart disease have increased survival rates. Despite efforts to prevent neurological injury, many patients suffer from impaired neurodevelopmental outcomes. Compromised cerebral autoregulation can increase the risk of brain injury following pediatric cardiac surgery with cardiopulmonary bypass. Monitoring autoregulation and maintaining adequate cerebral blood flow can help prevent neurological injury. ⋯ Postoperative noninvasive autoregulation monitoring after cardiac surgery in children can be reliably and safely performed using the hemoglobin volume index and cerebral oxygenation index and provides robust data. This monitoring can be used to identify individual hemodynamic targets to optimize autoregulation, which differs from those recommended in the literature. Further evaluation of this subject is needed.