Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2001
Case ReportsLife threatening cardiopulmonary failure in an infant following protamine reversal of heparin after cardiopulmonary bypass.
Life threatening cardiopulmonary failure following protamine reversal of heparin after cardiopulmonary bypass (CPB) was reported to occur in adults but rarely in children. Atrial septal defect closure was performed in a 6-week-old infant erroneously suspected to suffer from right atrial thrombosis in addition. ⋯ Inhaled nitric oxide, together with high frequency oscillation ventilation supplemented by intravenous prostacycline, enabled complete recovery of cardiopulmonary and neurological function. Life threatening cardiovascular compromise after intravenous protamine can occur even in young infants which then require challenging paediatric critical care.
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Paediatric anaesthesia · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialPropofol as a sole agent for paediatric day care diagnostic ophthalmic procedures: comparison with halothane anaesthesia.
Our aim was to study the feasibility of total intravenous anaesthesia with propofol in spontaneously breathing children undergoing ophthalmic procedures. ⋯ Propofol is a feasible option for paediatric diagnostic ophthalmic procedures with the advantage over halothane of providing complete access to the eye.
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Paediatric anaesthesia · Nov 2001
Randomized Controlled Trial Clinical TrialBispectral index monitoring during infant cardiac surgery: relationship of BIS to the stress response and plasma fentanyl levels.
We evaluated the relationship of the bispectral index (BIS) to commonly used indices of depth of anaesthesia in 19 infants enrolled in a prospective study of the stress response to hypothermic cardiopulmonary bypass. ⋯ We were unable to demonstrate a relationship between the BIS and haemodynamic, metabolic or hormonal indices of anaesthetic depth. Further evaluation of the BIS algorithm is required in neonates and infants.
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Paediatric anaesthesia · Nov 2001
ReviewPerioperative care of children with nerve agent intoxication.
Nerve agents (NA) present a major threat to civilian populations. When a ballistic system is used for spreading poison, multiple trauma, as well as toxic trauma could be caused. Children are more susceptible, due to their smaller physiological reserve. ⋯ This review presents and emphasizes points concerning treatment of a child who suffers from combined multiple and toxic traumas. The review is based on scant knowledge of a database of similar cases of pesticide organophosphate poisoning in children since these compounds are alike. We also extrapolated data from reports concerning episodic civilian exposure to NA.
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Paediatric anaesthesia · Nov 2001
Comparative StudyPostoperative behavioural changes in children: comparison between halothane and sevoflurane.
A questionnaire, modified from the posthospitalization behavioural questionnaire, was sent to all parents of children under 8 years of age who had elective surgery in the hospital of Lahr during the years 1997 and 1998. The parents were asked about long lasting changes (more than 1 week) in their child's behaviour after surgery. ⋯ We found that the children having sevoflurane anaesthesia were more likely to develop behavioural problems postoperatively than with halothane. The rate of postoperative behavioural changes was not influenced by the type of surgery, the sedative premedication used, the induction technique or the use of opioids or nonopioid pain therapy.