Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2022
ReviewUnderstanding pediatric ventilation in the operative setting. Part I: Physical principles of monitoring in the modern anesthesia workstation.
The modern anesthesia workstation provides a wealth of information some of which is of particular interest when it comes to optimizing ventilation settings. This knowledge gains even more importance in the therapy of pediatric patients. ⋯ The purpose of this review is to outline the clinical impact, technological background, and reliability of the most relevant information measured and calculated by a modern anesthesia workstation. It aims at translating the technical knowledge into a more competent and vigilant application in the clinical setting.
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Recent studies have identified stable hemodynamics as a contributing factor to improve outcome in pediatric anesthesia. So far, most of the hemodynamic monitoring methods applied in children have been complex to apply and often not satisfactory validated. ⋯ This review will describe the principle behind dynamic capnography measurement of cardiac output and mixed venous oxygen saturation. Additionally, the methods limitations and challenges when applied in children will be delineated.
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Paediatric anaesthesia · Feb 2022
ReviewAerosolized drug delivery in awake and anesthetized children to treat bronchospasm.
Bronchospasm is a common respiratory adverse event in pediatric anesthesia. First-line treatment commonly includes inhaled salbutamol. ⋯ We highlight the unmet need for innovation of orally inhaled drug products to deliver aerosolized medications during pediatric respiratory critical events such as bronchospasm. It is therefore important that clinicians remain up to date with the best clinical practice for aerosolized drug delivery in order to prevent and efficiently treat pediatric patients experiencing life-threatening respiratory emergencies.
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Paediatric anaesthesia · Feb 2022
ReviewPediatric lower respiratory tract infection: Considerations for the anesthesiologist.
Neonatal and childhood infectious diseases continue to be a global health problem. Acute respiratory tract infections are typically classified as upper respiratory tract infection and lower respiratory tract infections. The most common lower respiratory infections in childhood are pneumonia and bronchiolitis. ⋯ Though the global burden of the disease has decreased, the mortality rates still are higher in developing countries. Patients with severe lower respiratory tract infections and their complications are often evaluated for elective or emergency procedures. In this review article, the authors aim to discuss the etiology, pathogenesis, preoperative evaluation of lower respiratory tract infections, and the anesthesia implications pertinent to the practice of anesthesia.
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Paediatric anaesthesia · Feb 2022
ReviewCystic fibrosis in children: A pediatric anesthesiologist's perspective.
Cystic fibrosis is a multi-systemic disease of impaired sodium and chloride transport across epithelial surfaces. Cystic fibrosis is one of the most common autosomal recessive diseases among Caucasian children. However, recent epidemiologic studies suggest that the disease in Hispanic, African American, and Asian American populations may be more common than previously recognized. ⋯ Primary graft dysfunction is the most common cause of early death and can be seen within 48 h of surgery. Median long-term survival after lung transplant remains modest. Chronic lung allograft dysfunction, opportunistic infections, and post-transplant lymphoproliferative disorder are the most common causes of morbidity and mortality among long-term survivors.