Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2017
The provision of pediatric cardiac anesthesia services in Germany: current status of structural and personnel organization.
Anesthesia for pediatric cardiac surgery requires a high level of expert knowledge. There are currently no recommendations and standards for anesthetic management for congenital cardiac surgery in Germany. ⋯ The present study represents the current structural situation for anesthesia at German pediatric cardiac surgery centers.
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Paediatric anaesthesia · Aug 2017
Ultrasound assessment of gastric emptying after breakfast in healthy preschool children.
In current guidelines, 6 hours of fasting is recommended for solids to limit the risk of pulmonary aspiration during anesthesia in children. Ultrasonography has recently been introduced to evaluate gastric volumes in children in the context of preanesthetic fasting. Therefore, in this study, we firstly evaluated the precision of ultrasound assessment of gastric volume in an experimental setting and secondly studied gastric emptying times after a normal breakfast in healthy preschool children using ultrasound. ⋯ The results of the balloon experiment showed a high correlation between balloon antral area and balloon volume. In the preschool child measurements, gastric antral area correlated with fasting time, and the mean gastric emptying time was lower than 4 hours after breakfast. These results support a more liberal perioperative fasting regimen after a light meal or breakfast in routine pediatric anesthesia.
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Paediatric anaesthesia · Aug 2017
Randomized Controlled TrialEffects of intraoperative liberal fluid therapy on postoperative nausea and vomiting in children-A randomized controlled trial.
Postoperative nausea and vomiting (PONV) is one of the most distressing complications following surgery. Supplemental perioperative fluid therapy might be an effective strategy to reduce PONV in children. ⋯ Liberal intraoperative fluid therapy was found to be effective in reducing PONV in children undergoing lower abdominal surgery.
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Paediatric anaesthesia · Aug 2017
Randomized Controlled TrialChildhood preoperative anxiolysis: Is sedation and distraction better than either alone? A prospective randomized study.
Preoperative anxiety management receives special attention in pediatric anesthesia. Different pharmacological and nonpharmacological techniques can be employed. This study was designed to assess three different strategies for childhood preoperative anxiolysis: midazolam premedication, midazolam in combination with portable Digital Video-Disk player, or video distraction strategy alone. ⋯ Both pharmacological premedication and video distraction are effective strategies for controlling preoperative childhood anxiety. The combination of midazolam and Digital Video-Disk player was not better than either alone.
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Paediatric anaesthesia · Aug 2017
Preoperative colonization in pediatric cardiac surgery and its impact on postoperative infections.
Patients with congenital heart defects are frequently hospitalized before surgery. This exposes them to a high risk for pathogen colonization. There are limited data on colonization prevalence in the pediatric cardiac population, and limited data concerning its potential role in the risk of developing infections after cardiac surgery. ⋯ The results of our study suggest that the impact of preoperative colonization on outcome and postoperative infections may be negligible; larger series are required to clearly define this issue.