Paediatric anaesthesia
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Paediatric anaesthesia · Jan 2000
Haemodynamic, acid-base and electrolyte changes during plasma replacement with hydroxyethyl starch or crystalloid solution in young pigs.
We investigated haemodynamic, acid-base and electrolyte changes during almost total plasma replacement with hydroxyethyl starch (HES) and physiological balanced electrolyte solution (PBE) by using a cell saver in ten young pigs. In the PBE group an additional 3550 (444) ml crystalloid solution [Mean (SD)] was infused over the course of the study in order to maintain pulmonary capillary wedge pressure. ⋯ There were only moderate acid-base changes in both groups, but at the end, anion gap was significant lower in HES. In conclusion, maintenance of colloid osmotic pressure close to the physiological range of infants seems to be advantageous during major paediatric surgery.
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Paediatric anaesthesia · Jan 2000
Clinical TrialDuration of action of atracurium when given by infusion to critically ill children.
The aim of the study was to investigate the offset time of atracurium when given by continuous infusion on a paediatric intensive care unit and to look for evidence of tolerance. Over a period of 8 months, 20 mechanically ventilated children had a steady-state infusion of atracurium discontinued to enable the assessment of their level of sedation. The offset time of atracurium was assessed by train-of-four (TOF) stimulation of the ulnar nerve. ⋯ The duration of infusion was negatively correlated with the offset time of atracurium, and this effect was most prominent in children who had received infusions for longer than 48 h. When given by continuous infusion, the offset time of atracurium is very variable between individual patients. Infusions administered for longer than 48 h are associated with a significant reduction in the offset time as a result of increasing tolerance.
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Paediatric anaesthesia · Jan 2000
Anaesthesia for manipulation of forearm fractures in children: a survey of current practice.
Despite recent recommendations that all children presenting for urgent or emergency surgery should be treated as though they have a full stomach, a local audit had shown a wide variation in technique used for anaesthesia in children after trauma. Therefore, a postal questionnaire was sent to 500 anaesthetists regarding their preferred anaesthetic technique for a 6-year-old child requiring manipulation of a forearm fracture. ⋯ Only 19.3% would perform a rapid sequence induction for surgery on the day of injury if the child had not eaten for 6 h before the injury. We conclude that not all anaesthetists believe that rapid sequence induction is necessary for anaesthesia after forearm fractures, despite recent recommendations.
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Paediatric anaesthesia · Jan 2000
Preliminary experience with the Doppler ultrasound guided vascular access needle in paediatric patients.
Percutaneous cannulation of the internal jugular vein (IJV) in infants and children may be technically difficult and can lead to complications. Various techniques exist to achieve successful cannulation and to reduce the rate of complications. ⋯ Successful cannulation was achieved in six out of 10 patients with haematoma complicating the procedure in two patients. We believe this is the first reported use of this device for cannulation of the IJV in this patient group.
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Paediatric anaesthesia · Jan 2000
The topics of international publications on paediatric anaesthesia from 1993 to 1998.
A comprehensive compilation of the current international literature on paediatric anaesthesia is still lacking. It was the aim of this study to identify all publications with a focus on paediatric anaesthesia, and to determine the spectrum of topics, as well as the publication type and language for the period between 1993 and 1998. All articles published in 12 major anaesthesia journals were evaluated and, additionally, a computerized, Internet-based Medline-search was performed using selected keywords. ⋯ In contrast, publications on, for example, 'postanaesthesia care' (6. 3%), and 'organizational aspects of paediatric anaesthesia' (2.2%) were rare. Most articles were written in English (85.1%), and more than 50% reported original data (57.1%). Our results suggest that several topics may be of interest for future research and communication in the field of paediatric anaesthesia and new results should be published in English to reach a large international readership.