Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2021
Associations of perioperative characteristics with motor function in preschool children born with esophageal atresia.
Children born with esophageal atresia experience long-term neurodevelopmental deficits, with unknown origin. ⋯ Motor function in 5-year-old esophageal atresia patients was impaired and negatively associated with the number of postoperative days of endotracheal intubation and positively associated with high blood pressure. Prospective studies with critical perioperative monitoring and monitoring during stay at the intensive care unit are recommended.
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Paediatric anaesthesia · Aug 2021
Predicting hypotension during anaesthesia: variation in pulse oximetry plethysmography predicts propofol-induced hypotension in children.
The development of hypotension on administration of intravenous propofol is common and independently associated with adverse outcomes. Identifying patients with a high risk for anesthesia-induced hypotension may help anesthesiologists prepare for such an event. ⋯ High preoperative respiratory variation of pulse oximetry plethysmographic waveform and pleth variability index were both independently associated with propofol-induced hypotension in children.
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Paediatric anaesthesia · Aug 2021
The Covid-19 pandemic first wave in Sweden: a national registry study of the effects on pediatric anesthesia and surgery.
The COVID-19 pandemic is pushing healthcare systems to their limits. Dramatic reductions in the adult elective surgery are ubiquitous, but corresponding changes in pediatric services are not well described. The Swedish Perioperative Registry contains data on all anesthetic procedures in Sweden, and therefore, provides a unique opportunity to analyze the effect of the pandemic on the pediatric anesthesia capacity on a national level. We hypothesized that there would be a significant reduction in pediatric elective procedures. The aim was to determine the effects on pediatric surgical and anesthetic services during the first wave of the COVID-19 pandemic in Sweden. ⋯ We conclude that the impact of COVID-19 on pediatric surgical procedures in Sweden during the first wave of the pandemic was dramatic, but elective services were restored a few months after the peak.
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Paediatric anaesthesia · Aug 2021
Pediatric Mediastinal Mass Algorithm: A Quality Improvement Initiative to Reduce Time from Presentation to Biopsy.
Mediastinal masses in children may present with compression of the great vessels and airway. An interdisciplinary plan for rapid diagnosis, acute management, and treatment prevents devastating outcomes and optimizes care. Emergency pretreatment with steroids or radiation is more likely to be administered when care is variable, which may delay and complicate diagnosis and treatment. Strategies to standardize care and expedite diagnosis may improve acute patient safety and long-term outcomes. ⋯ Implementation of a diagnostic and management algorithm coordinating care among multidisciplinary teams significantly reduced time to biopsy for children presenting with mediastinal mass and may result in decreased use of emergent pretreatment.
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Paediatric anaesthesia · Aug 2021
To relieve pain or avoid opioid-related risk? A comparison of parents' analgesic trade-off preferences and decision-making in 2019 versus 2013 in a single U.S. pediatric hospital.
Analgesic trade-off preferences, or the relative preference for pain relief vs. risk aversion, shape parents' decisions to give prescription opioids to their children. These preferences may be influenced by personal experiences and societal factors. ⋯ Findings suggest that parents of children scheduled for painful surgery at our pediatric hospital have become more analgesic risk-averse during the past decade. Parents' analgesic trade-off preferences may influence their decisions to administer prescribed opioids after surgery, which may contribute to children's pain outcomes.