Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2022
Practice what you teach: an approach to integrate airway education for experienced anesthesia clinicians.
The COVID-19 pandemic has disrupted clinician education. To address this challenge, our divisional difficult airway program (AirEquip) designed and implemented small-group educational workshops for experienced clinicians. Our primary aim was to test the feasibility and acceptability of a small-group, flexible-curriculum skills workshop conducted during the clinical workday. Secondary objectives were to evaluate whether our workshop increased confidence in performing relevant skills and to assess the work-effort required for the new program. ⋯ It is feasible and acceptable to incorporate expert-led skills training into the clinical workday. Alongside conferences and large-format instruction, this modality enhances the way we are able to share knowledge with our colleagues. This concept can likely be applied to other skills in various clinical settings.
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Paediatric anaesthesia · Sep 2022
Carotid Doppler ultrasonography as a method to predict fluid responsiveness in mechanically ventilated children.
The aim of this study was to investigate whether respiratory variations in carotid and aortic blood flows measured by Doppler ultrasonography could accurately predict fluid responsiveness in critically ill children. ⋯ Analysis of respiratory changes in carotid and aortic blood flows are accurate methods for predicting fluid responsiveness in children under invasive mechanical ventilation.
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Paediatric anaesthesia · Sep 2022
Observational StudyTarget insertion depth of nasopharyngeal temperature probes in children: A prospective observational study analyzing magnetic resonance images.
Core temperature monitoring is indispensable to prevent children from perioperative thermal perturbations. Although nasopharyngeal measurements are commonly used in anesthesia and considered to reflect core temperature accurately, standardized target depths for probe insertion are unknown in children. ⋯ Height-based formulas could be a valuable proxy for the insertion depth of nasopharyngeal temperature probes. Further clinical trials are necessary to investigate their measurement accuracy.
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Paediatric anaesthesia · Sep 2022
Case ReportsDiagnostic and therapeutic application of thoracic epidural in a child with intractable cardiac arrhythmias. A case report.
A 3-year-old boy presented with episodes of uneasiness and transient loss of consciousness. Atrial tachyarrhythmias with rapid ventricular rate was diagnosed and initially unsuccessfully treated with oral antiarrhythmic drugs. Subsequent Holter monitoring revealed ventricular arrhythmias. ⋯ Initially, sympathectomy was achieved using a continuous high thoracic epidural block and was performed to ascertain the efficacy of the thoracic sympathectomy. This successfully reduced the ventricular arrhythmias and the need for antiarrhythmic agents. The epidural infusion was also used for pain relief following the subsequent surgical sympathectomy.
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Paediatric anaesthesia · Sep 2022
Observational StudyA prospective observational study of video laryngoscopy guided coaching in the PICU.
There are limited data on the use of video laryngoscopy for pediatric patients outside of the operating room. ⋯ Implementation of video laryngoscopy as a supervising device with standardized coaching language was feasible with high level of adherence, yet not associated with an increased occurrence of any adverse tracheal intubation-associated events and oxygen desaturation.