Paediatric anaesthesia
-
Paediatric anaesthesia · Apr 2006
Case ReportsSuspected malignant hyperthermia in a child with laminin alpha2 (merosin) deficiency in the absence of a triggering agent.
Malignant hyperthermia (MH) is an inherited disorder of the skeletal muscles that can be triggered by many anesthetic agents. MH has different presentations and manifestations that makes it difficult to diagnose. Patients with laminin alpha2 deficiency have never been reported to be susceptible to MH. ⋯ The episode was diagnosed using the MH clinical grading scale and responded well to prompt management with dantrolene. We conclude that patients with laminin alpha2 deficiency may be susceptible to MH, and early suspicion and rapid treatment is vital in the management of MH. Anesthesiologists should be prepared to treat MH in susceptible patients even in the absence of a classical triggering agent.
-
Paediatric anaesthesia · Apr 2006
Comparative StudyHeating capabilities of the Hotline and Autoline at low flow rates.
At low flow rates, fluid warmers using coaxial warming tubes are superior in preventing heat loss. This laboratory investigation was performed in order to compare the heating capabilities of two coaxial fluid warmers. ⋯ Both the Hotline and the Autoline heated infusions sufficiently at low flow rates. However, the heating capability of the Hotline was superior and can further be increased at low flow rates by increasing the room temperature.
-
Paediatric anaesthesia · Apr 2006
Case ReportsManagement of congenital tracheal stenosis--using spontaneous ventilation to facilitate cardiopulmonary bypass.
We present an unusual case of an infant with life-threatening tracheal stenosis scheduled for repair utilizing cardiopulmonary bypass. After repeated attempts at intubation endtidal CO2 was absent. The child was eventually managed with spontaneous breathing sevoflurane via a facemask. The possible causes of absent endtidal CO2 after intubation are discussed.
-
Paediatric anaesthesia · Apr 2006
Case ReportsVideo assisted fiberoptic intubation for temporomandibular ankylosis.
In the era of fiberoptics, securing of the airway under general anesthesia in small children with temporomandibular joint ankylosis without a flexible pediatric fiberoptic endoscope requires considerable skill. We describe the use of an adult flexible fiberoptic laryngoscope with a video camera system to visualize the glottis from one nostril while the tracheal tube was passed from the other nostril.
-
Paediatric anaesthesia · Apr 2006
Case ReportsDelayed ventricular fibrillation following blunt chest trauma in a 4-year-old child.
A 4-year-old boy who was involved in a motor vehicle accident as a pedestrian and suffered blunt chest trauma was admitted to the emergency room. Unpredictable delayed ventricular fibrillation was diagnosed and treated successfully 2 h later. ⋯ At the same time, other possible etiologies of VF such as cardiac pathology or electrolyte and metabolic disorders had been ruled out. Thus, an etiological link between the chest trauma and the subsequent VF could not be ruled out and is in fact plausible despite the late onset.