Paediatric anaesthesia
-
Paediatric anaesthesia · Nov 2020
Dimensional compatibility of balloon-tipped bronchial blockers with the pediatric airway anatomy using different recommendations for age-related size selection.
Age-related recommendations for size selection of bronchial blocker devices are based on a few dated anatomical autopsy and radiological studies determining lower airway dimensions in children. These recommendations are based on anterior-posterior internal bronchial diameters, which are smaller than the more relevant lateral internal bronchial diameters. ⋯ This analysis demonstrates that irrespective of the recommendation for size selection used, neither the two balloon-tipped vascular catheters included nor the Arndt endobronchial blockers are ideal for lung isolation in children are compared with the age-related relevant dimensions of pediatric airway anatomy. A redesign of bronchial blocker equipment with age-related anatomically based high-volume, low-pressure blocker balloons made from ultrathin membranes and with smaller catheters would be desirable.
-
Paediatric anaesthesia · Nov 2020
Anaesthesia management of laser photocoagulation for retinopathy of prematurity. A retrospective review of perioperative adverse events.
The aim of this study was to report the incidence of perioperative adverse events occurring in infants undergoing diode laser photocoagulation of retinopathy of prematurity and to identify clinical risk factors that may affect the incidence. ⋯ The incidence of perioperative adverse events was not associated with patient's age, current weight, timing, or location of the procedure. Extubating infants at the end of the procedure is however associated with a high rate of apneas and bradycardia, and consideration should be given to keeping low weight infants undergoing prolonged procedures out-of-hours intubated.
-
Paediatric anaesthesia · Oct 2020
Checking the basis of intraosseous access - Radiological study on tibial dimensions in the pediatric population.
Malposition of intraosseous needles in pediatric patients is frequently reported. Incorrect needle length and penetration depth related to the puncture site and level are possible causes. ⋯ Puncture level and needle length have a great influence on potential needle tip positions. Infants and toddlers are at highest risk for malpositioning. Due to relevant growth-related differences in tibial anatomy, an age-related and well-reflected approach is crucial to successfully establish intraosseous access.
-
Paediatric anaesthesia · Oct 2020
Randomized Controlled TrialEffects of intraoperative dexmedetomidine on the incidence of acute kidney injuryin pediatric cardiac surgery patients: A randomized controlled trial.
Perioperative dexmedetomidine use has been reported to reduce the incidence of postoperative acute kidney injury after adult cardiac surgery. However, large-scale randomized controlled trials evaluating the effect of dexmedetomidine use on acute kidney injury in pediatric patients are lacking. ⋯ Intraoperative dexmedetomidine did not reduce acute kidney injury incidence in pediatric cardiac surgery patients.