Articles: pediatrics.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Correlation of Transthoracic Echocardiographic Estimates of Right Ventricular Pressure with Right Ventricular Pressure Measurements on Cardiac Catheterization in Children with Pulmonary Hypertension.
Evaluate the correlation of non-invasive echocardiographic estimates of right ventricular systolic pressure with measurements on cardiac catheterization in children with pulmonary hypertension. ⋯ In children with pulmonary hypertension, echocardiographic estimates of right ventricular pressure correlated moderately well with gold standard measurements by cardiac catheterization with stronger correlation in children with suprasystemic right ventricular pressures. This is reassuring for clinicians who must rely on echocardiography for risk stratification before anesthetizing children with pulmonary hypertension.
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Comparative Study
Mechanical power in decelerating flow versus square flow ventilation in pediatric ARDS.
Mechanical power is a summary variable quantifying the risk of ventilator-induced lung injury. The original mechanical power equation was developed using square flow ventilation. However, most children are ventilated using decelerating flow. It is unclear whether mechanical power differs according to mode of flow delivery. This study compared mechanical power in children with acute respiratory distress syndrome who received both square and decelerating flow ventilation. ⋯ Mechanical power was marginally lower in square flow than in decelerating flow, although the clinical significance of this is unclear. Upward of 30% of mechanical power may go toward overcoming resistance, regardless of age. This is nearly three-fold greater resistance compared to what has been reported in adults.
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Journal of anesthesia · Dec 2024
Observational StudyAccuracy of non-invasive core temperature monitoring in infant and toddler patients: a prospective observational study.
Careful perioperative temperature management is important because it influences clinical outcomes. In pediatric patients, the esophageal temperature is the most accurate indicator of core temperature. However, it requires probe insertion into the body cavity, which is mildly invasive. Therefore, a non-invasive easily and continuously temperature monitor system is ideal. This study aimed to assess the accuracy of Temple Touch Pro™ (TTP), a non-invasive temperature monitoring using the heat flux technique, compared with esophageal (Tesoph) and rectal (Trect) temperature measurements in pediatric patients, especially in infants and toddlers. ⋯ Core temperature measurements using TTP in infants and toddlers were more accurate with Tesoph than with Trect. In the future, non-invasive TTP temperature monitoring will help perioperative temperature management in pediatric patients.
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Randomized Controlled Trial
Coaching Program to Address Burnout, Well-Being, and Professional Development in Pediatric Surgery Trainees: A Randomized Controlled Trial.
To assess impact of participation in a positive psychology coaching program on trainee burnout and well-being. ⋯ Despite the stress and challenges of medicine during COVID-19, a virtual positive psychology coaching program provided benefits in well-being and burnout to pediatric surgery trainees. Coaching should be integrated into existing wellness programs to support the acquisition of coping skills that help trainees cope with the stressors they will face during their careers.
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Children are a uniquely vulnerable patient population with restricted abilities for self-advocacy and autonomy, risking infringement upon their dignity. Yet the concept of dignity in pediatrics remains underexplored relative to the adult literature and other outcome measures. ⋯ Relatively few published studies describe dignity in pediatrics. Opportunities exist to broaden scholarship on this topic in partnership with patients, families, and clinicians, with the goal of assessing and strengthening dignity-centered care across the illness course and at the end of life.