Paediatric anaesthesia
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Robinow (fetal face) syndrome is a rare inherited multisystem disorder featuring mesomelic or acromesomelic limb shortening, facial and spinal deformities, hypoplastic genitalia, kidney disease and congenital heart defects. We report the anaesthetic management of a patient with Robinow syndrome presenting for elective surgery and review specific issues of interest in the perioperative workup.
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Paediatric anaesthesia · Oct 2003
Case ReportsGeneral anaesthesia for lobectomy in an 8-year-old child with Kartagener's syndrome.
Kartagener's syndrome (KGS) is an autosomal recessive disorder characterized by the clinical triad of bronchiectasis, sinusitis and dextrocardia (situs inversus). Reports of general anaesthesia in a child with KGS are rare in medical literature. ⋯ Anaesthetic implications of this syndrome are mentioned. Key points in the management of anaesthesia in KGS are discussed.
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Paediatric anaesthesia · Oct 2003
Comparative Study Clinical TrialRemifentanil infusion for cleft palate surgery in young infants.
The residual depressant effect of opioid is a major concern in infants scheduled for cleft palate repair. Remifentanil is associated with a fast and predictable recovery, independent of age. ⋯ Remifentanil-based anaesthesia appeared well suited for primary cleft palate repair in young infants.
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Paediatric anaesthesia · Oct 2003
ReviewChemokines and the inflammatory response following cardiopulmonary bypass--a new target for therapeutic intervention?--A review.
This 10-year Medline search of English-language articles describing experimental and clinical studies on chemokines, cardiopulmonary bypass (CPB) and systemic or multiorgan failure revealed that chemokines are significantly involved in the pathogenesis of post-CPB syndrome. The post-CPB inflammatory response depends upon recruitment and activation of inflammatory cells. Leucocyte recruitment is a well-orchestrated process that involves several protein families, including pro-inflammatory cytokines, adhesion molecules and chemokines. ⋯ The chemokines, which are a cytokine subfamily of chemotactic cytokines, participate in recognizing, recruiting, removing and repairing inflammation. As chemokines target specific leucocyte subsets, antagonism of a single chemokine ligand or receptor would be expected to have a circumscribed effect, thereby endowing the antagonist with a limited side-effect profile. Chemokines should be considered as possible targets for therapeutic intervention.
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Paediatric anaesthesia · Oct 2003
Case ReportsA rare cause of upper airway obstruction in a 5-year-old girl: a laryngeal web.
A case is described of a 5-year-old girl with respiratory distress. She was intubated without difficulty, but developed respiratory distress on extubation. Laryngoscopy/bronchoscopy via a laryngeal mask airway revealed an extensive layngeal web which was removed with laser therapy. The causes and differential diagnosis of laryngeal web are discussed.