Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2012
Observational StudyCerebral regional oxygen saturation (crSO2): are different sensors comparable?
For measurement of cerebral regional oxygen saturation (crSO2) in neonates, one of the frequently used near-infrared spectroscopy devices is the INVOS 5100 with either the neonatal or pediatric sensor. Measurements between adult and pediatric sensors use different algorithms and differ by 10%. There are no published data comparing neonatal and pediatric sensors. ⋯ In a mixed cohort of neonates, crSO2 measurements were identical when using the INVOS 5100 neonatal sensor and the pediatric sensor. We conclude that studies using the INVOS 5100 neonatal or pediatric sensor are well comparable.
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Paediatric anaesthesia · Nov 2012
Provisional unicentric experience with an electronic incident reporting form in pediatric anesthesia.
To present and compare with literature our experience with an electronic anesthesia-related incident reporting form as a quality control measure at Gaslini Children's Hospital over a 19-month period. ⋯ Infants were at the highest risk to experience adverse events. Although experimental electronic incident reporting proved to be feasible, there is reason to suspect that there was underreporting of near misses. Overreporting of near miss events may be enhanced by easier and more straightforward reporting forms as well as by better education for anesthetic providers about the importance of recognizing and reporting near misses.
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Paediatric anaesthesia · Nov 2012
Duration of exposure to cranial vault surgery: associations with neurodevelopment among children with single-suture craniosynostosis.
To evaluate associations between neurodevelopment and exposure to surgery and anesthetic agents in children with single-suture craniosynostosis (SSC). ⋯ Average neurodevelopmental scores were lower among children experiencing longer surgeries and higher exposures to inhaled anesthesia. These associations may be due to anesthesia exposure, nonspecific effects of surgery, or unmeasured variables that correlate with surgery duration. Further study of potential causal mechanisms is warranted.
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Paediatric anaesthesia · Nov 2012
Changes in tissue oxygenation following caudal epidural blockade in infants and children.
Adequate tissue oxygenation is required for effective white blood cell function and bactericidal activity. Decreased tissue oxygenation has been shown to be a risk factor for perioperative wound infections. Regional anesthetic techniques result in a functional sympathetic block and may increase tissue oxygenation. The purpose of the current study is to prospectively evaluate changes in tissue oxygenation using a non-invasive near-infrared spectroscopy (NIRS) device following caudal epidural block in infants and children. ⋯ There was a statistically significant increase in tissue oxygenation as measured by NIRS following caudal anesthesia in infants and children. Although the magnitude of the change was less, this study confirms the results of previous studies in adults showing an increase in tissue oxygenation following regional blockade.
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Paediatric anaesthesia · Nov 2012
A prospective audit of safety issues associated with general anesthesia for pediatric cardiac magnetic resonance imaging.
Cardiac MRI (CMR) is increasingly used for surgical planning and serial monitoring of children with congenital heart disease (CHD). For small children, general anesthesia (GA) is required. We describe our experience of the safety of GA for pediatric CMR, using data collected prospectively over 3 years. ⋯ Although the majority of cases were safe and without incident, the complication rate in children with CHD receiving a GA for CMR is higher than in the general pediatric population. This reinforces the need for a senior, multidisciplinary team to be involved in the care of these children during imaging.