Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2001
Case ReportsAnaesthetic management and high frequency oscillatory ventilation.
In an effort to decrease morbidity and mortality, newer modes of mechanical ventilation have been introduced into the critical care arena. One such technique, high frequency oscillatory ventilation (HFOV) relies on respiratory rates greater than 150 b.min-1, small tidal volumes, and the maintenance of a constant distending pressure thereby limiting peak inflating pressure and potentially the incidence of barotrauma. ⋯ We present three infants who represent the perioperative applications of HFOV: (i) elective preoperative use to minimize lung movement and interference with surgical exposure during thoracotomy and PDA ligation; (ii) intraoperative application when progressive alterations in respiratory compliance led to ineffective intraoperative ventilation/oxygenation; and (iii) anaesthetic care for a neonate already receiving HFOV. The techniques of HFOV and previous reports of perioperative use are reviewed.
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Paediatric anaesthesia · Jul 2001
Early tracheal extubation after paediatric cardiac surgery: the use of propofol to supplement low-dose opioid anaesthesia.
After institutional approval and parental consent, 103 children, aged 6 months to 18 years, who were undergoing repair of simple and complex congenital heart lesions using cardiopulmonary bypass (CPB) were studied and compared with a group of 135 children who had undergone similar surgery in our institution in the year before. ⋯ We found the propofol regimen to be satisfactory with a shorted ICU stay for these patients.
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Paediatric anaesthesia · Jul 2001
Case ReportsCervical subcutaneous emphysema: an unusual complication of adenotonsillectomy.
Removal of the tonsils and adenoid tissue because of recurrent infection and/or respiratory obstruction is one of the most commonly performed operations. A rare complication during this intervention is subcutaneous surgical emphysema. The awareness of anaesthesiologists and otolaryngological surgeons will protect the patient from serious consequences. We report our experience with this complication and provide a review of the literature.