Paediatric anaesthesia
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[corrected] Volumetric infusion pumps are widely used in paediatric practice. Tissue extravasation is a hazard. The occlusion pressure limit alarm, although not intended to detect extravasation, is the only warning sign present to indicate flow faults in the infusion systems. ⋯ Occlusion pressure limit alarm cannot reliably detect extravasation especially at sites with high compliance, low flow rates, even at low occlusion limit. Line pressure depends on interplay of site (compliance) and flow rate and is independent of volume extravasated. Users must be aware of the set occlusion pressure limit. Repeated clinical assessment remains vital.
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Paediatric anaesthesia · Nov 2002
Letter Case ReportsHydrothorax: a life threatening complication during thoracotomy.
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Paediatric anaesthesia · Nov 2002
Repeated administration of ketamine may lead to neuronal degeneration in the developing rat brain.
This study was conducted to investigate, in vivo, the dose and duration effects of ketamine administration on neuronal degeneration in the developing rat brain. ⋯ These findings suggest that the duration of ketamine exposure correlates with increased neuronal degeneration in the developing rat brain.
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Paediatric anaesthesia · Nov 2002
Case ReportsDifficult paediatric intubation when fibreoptic laryngoscopy fails.
We report an unusual problem with fibreoptic bronchoscopy in an 8-year-old girl with Negar syndrome. She had a history of difficult airway since birth, and had undergone mandibular distraction for severe obstructive sleep apnoea when she was aged 2 years. Nagar syndrome is a Treacher-Collins like syndrome with normal intelligence, conductive bone deafness and problems with articulation. ⋯ Apparently, the healing of the wounds for the mandibular distraction in the mandibular space on the inside of the rami of the mandible had caused differential fibrosis on either side of the hyoid, leading to a triplane distortion of the larynx with a left shift, clockwise rotation to a 2-8 o'clock direction and a slight tilt towards the left pharyngeal wall. The large epiglottis overlying this had precluded a view of the larynx. Finally, the older technique of breathguided intubation facilitated fibreoptic bronchoscopy to achieve tracheal intubation.