Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2000
Comparative StudyImpact of infusion line compliance on syringe pump performance.
To determine the impact of infusion line compliance on the time to occlusion alarm (occlusion time) and the size of the subsequent occlusion release bolus, we studied three different infusion lines in combination with a 50-ml and 10-ml syringe. The mean occlusion time of the 50-ml syringe amounted to 20.3 +/- 0.28 min and increased to 26.2 +/- 0.19 min with the infusion with the infusion line yeielding the largest compliance (P<0.0001). ⋯ Occlusion times correlated strongly to be calculated estimated compliance of the syringe-infusion line assembly (Pearson's r=0.998, P<0.0001). Infusion line compliance has an important impact on time to occlusion, particularly when using small, low compliant infusion pump syringes.
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Paediatric anaesthesia · Jan 2000
Case ReportsFatal complication from central venous cannulation in a paediatric liver transplant patient.
We report a fatal complication from central venous cannulation in a child undergoing heterotropic liver transplantation. Following the attempted placement of a cannula in the left internal jugular vein, extravasation of blood products via the cannula resulted in haemothorax, hypotension and eventual brain death. Possible causes and strategies for prevention of this complication are discussed.
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Paediatric anaesthesia · Jan 2000
Onset and duration of action of rocuronium in children receiving chronic anticonvulsant therapy.
The onset and time course of action of rocuronium in normal children and children receiving anticonvulsant drugs for prolonged periods was characterized. A single bolus dose of 0.6 mg.kg-1 rocuronium was administered i.v. to seven nonepileptic patients on no medication, and eight patients on chronic anticonvulsant therapy consisting of either phenytoin, carbamazepine, or both who were age and weight matched. Neuromuscular transmission was monitored by the evoked compound electromyography of the thenar muscles using train of four stimulation every 20 s. ⋯ Children receiving chronic anticonvulsant therapy had significantly shorter recovery index than the control group (control 10.4+/-5.1 min, anticonvulsant 4.8+/-1.7 min, P<0.05). Furthermore, the duration of recovery to 10%, 50%, 75% and 100% of baseline T1 values was less in the anticonvulsant drug group. Our data confirm resistance to rocuronium in children on chronic anticonvulsant drugs.
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Paediatric anaesthesia · Jan 2000
Case ReportsAnaesthetic management of liver haemorrhage during laparotomy in a premature infant with necrotizing enterocolitis.
The case of a 680 g premature baby who developed massive spontaneous liver haemorrhage during laparotomy for necrotizing enterocolitis is reported. The infant survived due to rapid and massive fluid administration, including transfusion of large volumes of blood and blood products, in combination with high dose inotropic support and the surgical use of packing with thrombostatic sponges. Good venous access, including two central venous lines, turned out to be very useful.
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Paediatric anaesthesia · Jan 2000
Case ReportsAcute pulmonary haemorrhage in an infant during induction of general anaesthesia.
Pulmonary haemorrhage is a rare, life-threatening complication of anaesthesia. This report describes the anaesthetic management of an infant who developed laryngospasm and pulmonary haemorrhage during general anaesthesia. The infant was subsequently found to have prior exposure to a fungus, Stachybotrys chartarum, which produces mycotoxins that may have produced capillary fragility in the infant's rapidly growing lungs.