Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2012
Historical ArticleThe early development of pediatric intensive care.
The polio epidemic in Copenhagen in 1952 was a significant stimulus to the development of Intensive Care. Eighty-five percent of the patients with respiratory involvement died despite the use of Cuirass negative pressure ventilators. After some controversy Ibsen, an anesthetist, was consulted. ⋯ Owing to the lack of positive pressure ventilators, this was undertaken by students who contributed 167,000 h of hand ventilation. The mortality decreased to 25%. Anesthetists, having special experience with ventilation, became the leaders in the field as Intensive Care developed.
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Paediatric anaesthesia · Apr 2012
Randomized Controlled Trial Comparative StudyComparison of size 2 i-gel supraglottic airway with LMA-ProSeal™ and LMA-Classic™ in spontaneously breathing children undergoing elective surgery.
We compared size 2 i-gel(®) (Intersurgical Inc.), a relatively new supraglottic airway device for use in spontaneously breathing anesthesized children with two different types of laryngeal mask airway-ProSeal™ laryngeal mask airway (PLMA) and Classic™ laryngeal mask airway (cLMA) for the ease of insertion, oropharyngeal sealing pressures (OSPs), and air leak. The hemodynamic effects on insertion of device and postoperative adverse effects were also noted. ⋯ Pediatric size 2 i-gel is easy to insert and provides higher OSP compared with same size PLMA and cLMA in spontaneously breathing children undergoing elective surgery. It may be a safe alternative to laryngeal mask airways in day care surgeries.
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Paediatric anaesthesia · Apr 2012
Randomized Controlled TrialPressure support ventilation vs spontaneous ventilation via ProSeal™ laryngeal mask airway in pediatric patients undergoing ambulatory surgery: a randomized controlled trial.
To investigate the advantages of using pressure support ventilation (PSV) vs spontaneous ventilation via ProSeal™ laryngeal mask airway in children undergoing ambulatory surgery. ⋯ Pressure support ventilation via ProSeal™ laryngeal mask airway during general anesthesia improves ventilation in pediatric patients undergoing ambulatory surgery. However, this did not translate to a difference in clinical outcome among our study patients.
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Paediatric anaesthesia · Apr 2012
Case ReportsAwake GlideScope intubation in a critically ill pediatric patient.
We report a challenging case of a 10-year-old boy with history of biventricular heart failure, pulmonary hypertension, severe asthma, and obesity with a BMI of 37. He presented to our hospital in acute decompensated heart failure. Our anesthesia team was consulted by the pediatric intensivist for urgent airway management in this rapidly deteriorating, premorbid patient. We describe here the use of the GlideScope(®) in an awake pediatric patient of ASA 4E status with a potentially difficult airway who required to remain in the seated position and thus necessitating a face-to-face approach.