Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2014
Observational StudyPhenylephrine eye drops in pediatric patients undergoing ophthalmic surgery: incidence, presentation, and management of complications during general anesthesia.
Phenylephrine eye drops are widely used as mydriatic agent to reach the posterior segment of the eye. In literature, many reports suggest a systemic absorption of this agent as a source of severe adverse drug reactions. Hence, we reviewed our experience with topical phenylephrine in ophthalmic surgery. ⋯ Two different patterns of side effects occurred. The first one was a cardiovascular derangement with severe hypertension and heart rate alterations; the other one involved exclusively pulmonary circuit causing early edema. These clinical manifestations, their duration, and treatment responses are all explainable by alfa1-adrenergic action of phenylephrine. This hypothetic pathogenesis has been confirmed also by the usefulness of direct vasodilators (anesthetic agents) and by the negative outcome occurred in the past with the use of beta-blockers.
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Paediatric anaesthesia · Apr 2014
Observational StudyMarked changes in platelet count and function following pediatric congenital heart surgery.
Reduced hemostatic capacity is common following congenital heart surgery using cardiopulmonary bypass (CPB). The etiology is multifactorial with dilutional coagulopathy, as well as platelet adhesion and activation in the CPB circuit and oxygenator. The purpose of the present study was to evaluate platelet count and function in children following CPB. ⋯ Both platelet count and platelet function were significantly reduced after CPB in children undertaken correctional heart surgery. Duration of CPB and hypothermia was associated with significant changes in platelet function.
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Paediatric anaesthesia · Apr 2014
Retrospective audit of unplanned admissions to pediatric high dependency and intensive care after surgery.
Unplanned admissions to intensive care after surgery are a recommended clinical indicator of patient safety in the perioperative period and are validated to reflect both surgical and anesthesia-related complications. ⋯ The rate of unplanned admission to HDU/PICU is low and is comparable to previously published data. The high number of admissions following procedures involving a shared airway may represent patient-related factors and the case mix at this hospital. However, such a finding has prompted a combined ENT and anesthetic review of the care pathway for children with problems following airway instrumentation.