Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2020
ReviewAnesthetic concerns for pediatric patients in the era of COVID-19.
After a novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was reported in China in December 2019, the disease quickly reached pandemic level. On January 30, 2020, the World Health Organization (WHO) declared that the SARS-CoV-2 outbreak constituted a Public Health Emergency of International Concern. ⋯ Several articles with recommendations on the anesthetic management of adult patients with COVID-19 have been published, but no specific recommendations for pediatric anesthesiologists have been made yet. This article addresses specific concerns for the anesthetic management of the pediatric population with COVID-19.
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Paediatric anaesthesia · Jul 2020
Randomized Controlled TrialLung protective ventilation in infants undergoing cardiopulmonary bypass surgery for congenital heart disease: a prospective randomized controlled trial.
Lung protective ventilation (LPV) has been applied to surgical adults with normal pulmonary function for optimizing mechanical ventilation and reducing postoperative pulmonary complications. Few studies have reported the use of LPV in infants undergoing cardiac surgery with cardiopulmonary bypass (CPB). ⋯ LPV could be used safely in infants undergoing CPB in that it can improve oxygenation, alveolar aeration, and dynamic compliance, and reduce driving pressure, pulmonary shunting, and dead space. Its effect on oxygenation, pulmonary gas exchange, and pulmonary compliance was relatively short, and had less impact on postoperative pulmonary complications and prognosis.
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Paediatric anaesthesia · Jul 2020
Intravenous Dexmedetomidine Sedation for Magnetoencephalography: A Retrospective Study.
Magnetoencephalography (MEG) plays a preponderant role in the preoperative assessment of patients with drug-resistant epilepsy (DRE). However, the magnetoencephalography of patients with drug-resistant epilepsy can be difficult without sedation and/or general anesthesia. Our objective is to describe our experience with intravenous dexmedetomidine as sedation for magnetoencephalography and its effect, if any, on the ability to recognize epileptic spikes. ⋯ Our results suggest that dexmedetomidine-based protocol provides reliable sedation in children undergoing MEG scanning because of the high success rate, limited interictal artifacts, and minimal impacts on spike frequency.
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Paediatric anaesthesia · Jul 2020
Observational StudyThe association between preoperative anaemia and postoperative morbidity in paediatric surgical patients: A secondary analysis of a prospective observational cohort study.
The prevalence of anemia in the South African pediatric surgical population is unknown. Anemia may be associated with increased postoperative complications. We are unaware of studies documenting these findings in patients in low- and middle-income countries (LMICs). ⋯ Preoperative anemia had a high prevalence in a LMIC and was associated with increased postoperative complications. The main limitation of our study is the ability to generalize the results to the wider pediatric surgical population, as these findings only relate to children in whom a preoperative Hb was recorded. Prospective studies are required to determine whether correction of preoperative anemia reduces morbidity and mortality in children undergoing noncardiac surgery.