Anesthesiology clinics of North America
-
The genetic evaluation of the ryanodine type one receptor (RYR1) gene is unlikely to be a useful screening test of malignant hyperthermia susceptibility. But when significant suspicion of malignant hyperthermia has been raised by well-documented clinical events or strong family history, the genetic evaluation of RYR1 could secure a diagnosis and indicate appropriate treatment for both the index patient and many relatives of all ages, including the youngest.
-
Anesthesiol Clin North America · Dec 2005
ReviewPreoperative psychological preparation of the child for surgery: an update.
Preoperative anxiety is associated with a number of poor postoperative outcomes and with significant parental and child distress before surgery. Preparing children for surgery can prevent many behavioral and physiologic manifestations of anxiety. Psychologic and behavioral interventions and pharmacologic interventions are available to treat preoperative anxiety in children. This article discusses the psychologic preparation of children for surgery.
-
Pediatric anesthesiology has made a significant contribution to child health and will be necessary for progress in the health sciences and outcomes related to child health in the future. It is likely that the practice of pediatric anesthesiology will remain an interesting and rewarding but demanding profession for the next generations of physicians. Despite this favorable professional profile, stiff competition for resources will come from other segments of the health care community. This article outlines a multidimensional strategy for pediatric anesthesiology to sustain its progress as a profession and contribute to the health of our children.
-
As the practice of pediatric cardiac anesthesia continues to grow, anesthesiologists now routinely care for patients ranging in size from less than 2 kg to more than 100 kg. New clinical and laboratory research has enhanced our understanding of the effects of anesthetic drugs on the pediatric myocardium, and improvements in survival statistics for even the smallest and sickest infants have shifted the emphasis to evaluation of quality of life and neurological outcome in pediatric cardiac patients. The use of circulatory support in infants and children, both for rapid resuscitation and for more chronic indications such as bridge to transplantation, also continues to evolve, with the recent introduction of pulsatile and axial pumps for pediatric use. This article reviews anesthetic agents, bleeding and coagulation, neurological monitoring, and mechanical circulatory support in the treatment of infants and children.
-
Anesthesiol Clin North America · Dec 2005
ReviewAnesthesia considerations for pediatric thoracic solid organ transplant.
This article discusses the indications, perioperative management, postoperative complications, and patient outcome of pediatric heart transplantation and pediatric lung transplantation. Special emphasis is placed on the anesthetic considerations relevant for children who are undergoing or have received a solid thoracic organ transplant.