Paediatric anaesthesia
-
Paediatric anaesthesia · Nov 2019
Effects of moderate and severe hypocapnia on intracerebral perfusion and brain tissue oxygenation in piglets.
Hypocapnia is a common alteration during anesthesia in neonates. ⋯ This animal model revealed reduced cerebral blood flow and brain tissue oxygenation during hypocapnia without detectable changes in regional oxygen saturation as measured by NIRS. Changes occurred as early as during moderate hypocapnia.
-
Paediatric anaesthesia · Nov 2019
ReviewEfficacy of oral midazolam for minimal and moderate sedation in pediatric patients: a systematic review.
One of the most widely used options for minimal/moderate sedation in pediatric patients is oral midazolam, as it presents an alternative to less well-accepted routes of administration (eg, intravenous or intranasal) of this well-known efficacious and well-tolerated short-acting benzodiazepine. A systematic review of the literature was conducted in order to identify clinical studies evaluating the effectiveness of oral midazolam for sedation in pediatric patients in the context of premedication before anesthesia or during diagnostic/treatment procedures. The percentage of responders (response rate) after single administration of oral midazolam was evaluated and compared versus placebo in a subset of placebo-controlled studies. ⋯ The analysis of subgroups by context of sedation showed response rates [95% confidence interval] with oral midazolam ranging from 36.7% [21.6%, 54.9%] to 97.0% [94.8%, 98.3%] for anesthetic premedication and from 56.1% [43.1%, 68.4] to 97.8% [86.1%, 99.7%] for medical procedures. The efficacy of midazolam for pediatric minimal/moderate sedation from a dose of 0.25 mg/kg and above was demonstrated. The probability of occurrence of adverse events and over-sedation increases with increasing doses.
-
Paediatric anaesthesia · Nov 2019
ReviewMeasuring behavioral and emotional changes in children following hospitalization: Limitations and future directions.
Psychological and behavioral changes have been observed and documented in children following medical interventions/hospitalizations. The Posthospital Behavior Questionnaire (PHBQ) was created to assess for such changes in youth. ⋯ However, certain limitations to the PHBQ exist that may interfere with its utility. This article advocates for creating an optimized measure with an underlying theoretical framework, clinical cutoffs, and developmental sensitivity in order to better identify and track significant emotional and behavioral changes in youth following hospitalization and surgery.
-
Paediatric anaesthesia · Nov 2019
Case ReportsUnconventional Delivery of Inhaled Nitric Oxide During Endoscopic Laryngeal Tracheal Reconstruction in a Child with Pulmonary Arterial Hypertension: A Case Report.
Endoscopic laryngeal tracheal reconstruction was performed on a child with glottic stenosis and pulmonary arterial hypertension. The surgical repair was performed while delivering inhaled nitric oxide via the ventilating port of a suspension laryngoscope with the patient maintaining spontaneous respirations. The surgery was accomplished without complications.