Paediatric anaesthesia
-
Paediatric anaesthesia · Nov 2024
Randomized Controlled TrialEffect of high-flow nasal and buccal oxygenation on safe apnea time in children with open mouth: A randomized controlled trial.
High-flow nasal oxygenation is reported to prolong duration of apnea while maintaining adequate oxygen saturation with the mouth closed. Also, buccal oxygenation is known to have similar effects in obese adults. We compared the effect of these two methods on prolongation of acceptable apnea time in pediatric patients with their mouth open. ⋯ High-flow nasal oxygenation is effective in maintaining appropriate arterial oxygen saturation during apnea even in children with their mouth open and is superior to buccal oxygenation. Buccal oxygenation may be a good alternative when high-flow nasal oxygenation is not available.
-
Paediatric anaesthesia · Nov 2024
ReviewClinical experience with remimazolam in pediatric anesthesiology: An educational focused review.
Remimazolam is a novel ultrashort-acting benzodiazepine, which like midazolam, results in sedation, anxiolysis, and amnesia through its agonistic effects on the gamma-amino butyric acid A receptor. As opposed to midazolam, its unique metabolism is via tissue esterases, which results in a rapid elimination with a limited context sensitive half-life and prompt dissipation of its effect when administration is discontinued. ⋯ There are limited data regarding the use of remimazolam in infants and children and its use in this population remains off label as it does not hold FDA-approval in pediatric-aged patients. This narrative outlines the pharmacologic properties of this unique medication, reviews previous published reports of its role in pediatric-aged patients, and discusses dosing parameters and clinical use in this population.
-
Paediatric anaesthesia · Nov 2024
A novel approach to calculate the required volume of air for bronchial blockers in young children.
Bronchial blocker balloons inflated with small volumes of air increase balloon pressure, involving a risk of airway injury especially in young children. However, there are no established guidelines regarding the appropriate volumes of air required to provide safe bronchial occlusion. ⋯ The bronchial blocker cuff should be regarded as a high-pressure balloon. We introduced a new concept for safe bronchial blocker balloon occlusion for one-lung ventilation in small children.
-
Paediatric anaesthesia · Nov 2024
Perioperative Management of Pediatric Combined Heart and Liver Transplantation: A 17 year single center experience.
An increasing number of centers are undertaking combined heart and liver transplantation in adult and pediatric patients with congenital heart disease. ⋯ Perioperative challenges include major perioperative bleeding, unstable hemodynamics, and end organ injury including acute kidney injury and neurological events. Successful outcomes for en bloc combined heart and liver transplantation are possible with careful multidisciplinary planning, communication, patient selection, and integrated peri-operative management.
-
Paediatric anaesthesia · Nov 2024
Letter Case ReportsUltrasound of the gastric antrum prior to deep extubation.