Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2007
Comparative StudyComparison of electrical velocimetry and transpulmonary thermodilution for measuring cardiac output in piglets.
Monitoring of cardiovascular function is essential during major pediatric and pediatric cardiac surgery. Invasive monitoring of cardiac output (CO) and oxygen delivery is expensive and sometimes associated with adverse events. Therefore, we investigated the accuracy of a new noninvasive CO monitoring device using electrical velocimetry (EV) in comparison with the more invasive transpulmonary thermodilution (TPTD) method. ⋯ The results show that EV is a safe, simple, noninvasive and cost-effective method for continuous trend monitoring of CO in piglets. The agreement of the EV-CO with TPTD-CO is not good enough to replace the standard method in our animal model. A correction factor for body habitus in piglets may be beneficial.
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Paediatric anaesthesia · Aug 2007
Children with cardiomyopathy: complications after noncardiac procedures with general anesthesia.
Children with cardiomyopathy (CM) often undergo procedures that require general anesthesia (GA) but little is known about anesthesia-related adverse events or postprocedural outcomes. ⋯ The 30-day mortality rate was low but complications were common, especially in patients with severe ventricular dysfunction. For these patients, we recommend early consideration of perioperative intensive care support to optimize cardiovascular therapy and monitoring.
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Paediatric anaesthesia · Jul 2007
Spinal anesthesia in neonates and infants - a single-center experience of 505 cases.
Our aim was to assess the safety and efficacy of spinal anesthesia (SA) in newborns and infants undergoing surgery appropriate for this technique. ⋯ SA is safe and effective in newborns and infants undergoing low abdominal, perineal and orthopedic surgery. In order to save time, our advice is to attempt SA after the surgeon is scrubbed, and minimize surgical teaching activity. The need to deal with a small and sometimes sick patient independent of the type of anesthesia requires the presence of an experienced pediatric anesthesiologist.
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Paediatric anaesthesia · Jul 2007
Ketamine disposition in children presenting for procedural sedation and analgesia in a children's emergency department.
The aim of this study was to describe ketamine pharmacokinetics in children to simulate time-concentration profiles to predict duration of concentrations associated with anesthesia, arousal and analgesia. ⋯ Ketamine 1 mgxkg(-1) i.v. provides satisfactory serum concentrations for children undergoing sedation for painful procedures of <5-min duration and produces concentrations associated with analgesic effect for more than 10 min. Clearance increases with decreasing age in children. The relationship between serum concentration and effect is poorly defined in children.
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Paediatric anaesthesia · Jul 2007
Case ReportsBispectral index monitored balanced anesthesia technique for pheochromocytoma resection.
Balanced anesthesia under bispectral index monitoring was administered to a child undergoing a pheochromocytoma resection. By titration of anesthesia depth, the stress response during resection could be avoided as well as postresection hypotension, without resort to additional pharmacological manipulation.