Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2011
Correlations between global clotting function tests, duration of operation, and postoperative chest tube drainage in pediatric cardiac surgery.
Systemic coagulation disorders after cardiac surgery represent serious postoperative complications. There have been few reports, however, identifying preoperative coagulation tests that predict postoperative bleeding. The aim of the present study was to investigate the relationship between postoperative hemorrhage and coagulation parameters determined by global coagulation assays, to define potential predictive markers. ⋯ The preoperative CFT and ETP provide useful indices for predicting postoperative chest tube drainage volume. In addition, the duration of surgery also correlated with chest tube drainage and affected ROTEM parameters.
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Paediatric anaesthesia · Aug 2011
Increases in heart rate and systolic blood pressure in anesthetized dogs affected with X-linked muscular dystrophy after cisatracurium administration: a retrospective study.
Most patients affected with Duchenne muscular dystrophy (DMD) present with arrhythmias and cardiomyopathies. Drugs which potentially may induce tachycardia or hypertension could precipitate acute cardiac failure in these patients and should be avoided. ⋯ In this report, increases in HR and SAP could be associated with the administration of cisatracurium in individuals affected with X-linked muscular dystrophy. These cardiovascular changes deserve further investigation.
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Risk in pediatric anesthesia can be conveniently classified as minor or major. Major morbidity includes cardiac arrest, brain damage and death. Minor morbidity can be assessed by clinical audits with small patient samples. ⋯ It is best assessed by very large clinical studies and by review of closed malpractice claims. Both minor and major morbidity occur most commonly in infants and children under three, especially those with severe co-morbidities. Knowledge of risk profiles in pediatric anesthesia is a starting point for the reduction of risk.
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Paediatric anaesthesia · Aug 2011
Intra- and inter-observer reliability using a noninvasive ultrasound cardiac output monitor in healthy anesthetized children.
Accurate and reliable evaluation of cardiac index (CI) in critically ill pediatric patients can optimize their management. Although validated, noninvasive ultrasound measurement techniques have been previously shown to be unreliable because of observer variability. ⋯ This study confirms that the USCOM(®) is relatively easy to use and reliable in healthy children when operated by trained users.