Paediatric anaesthesia
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Paediatric anaesthesia · Aug 2007
ReviewAnalysis of the validation of existing behavioral pain and distress scales for use in the procedural setting.
Assessing procedural pain and distress in young children is difficult. A number of behavior-based pain and distress scales exist which can be used in preverbal and early-verbal children, and these are validated in particular settings and to variable degrees. ⋯ There is a need to validate behavioral pain and distress scales for procedural use in preverbal or early-verbal children.
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Paediatric anaesthesia · Aug 2007
Review Case ReportsB-type natriuretic peptide monitoring in the Pediatric ICU population.
The natriuretic peptide system plays an active role in the regulation of fluid balance and systemic vascular resistance. Assays of these peptides are now available and may be used for both diagnostic and prognostic purposes. Despite its primary use in adults, it may have a diagnostic role in the Pediatric ICU as well. The basic physiology of the natriuretic system is discussed and the potential applications of B-type natriuretic peptide (BNP) monitoring as a diagnostic tool in various clinical scenarios in infants and children in the Pediatric ICU setting is reviewed.
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Paediatric anaesthesia · Aug 2007
Randomized Controlled TrialA ketamine-propofol admixture does not reduce the pain on injection compared with a lidocaine-propofol admixture.
Propofol injection pain is a well-known problem in pediatric anesthesia. Premixture of lidocaine with propofol although effective does not abolish injection pain in all children. Promising results have been reported with pretreatment of the vein with ketamine. The purpose of this prospective, double-blind randomized, clinical trial with active control was to evaluate the efficacy of premixing propofol with ketamine in the prevention of injection pain in children. ⋯ Injection pain was twice as common with ketamine-propofol admixture than with lidocaine-propofol admixture.
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Paediatric anaesthesia · Aug 2007
Comparative StudyComparison of electrical velocimetry and transpulmonary thermodilution for measuring cardiac output in piglets.
Monitoring of cardiovascular function is essential during major pediatric and pediatric cardiac surgery. Invasive monitoring of cardiac output (CO) and oxygen delivery is expensive and sometimes associated with adverse events. Therefore, we investigated the accuracy of a new noninvasive CO monitoring device using electrical velocimetry (EV) in comparison with the more invasive transpulmonary thermodilution (TPTD) method. ⋯ The results show that EV is a safe, simple, noninvasive and cost-effective method for continuous trend monitoring of CO in piglets. The agreement of the EV-CO with TPTD-CO is not good enough to replace the standard method in our animal model. A correction factor for body habitus in piglets may be beneficial.
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Paediatric anaesthesia · Aug 2007
Children with cardiomyopathy: complications after noncardiac procedures with general anesthesia.
Children with cardiomyopathy (CM) often undergo procedures that require general anesthesia (GA) but little is known about anesthesia-related adverse events or postprocedural outcomes. ⋯ The 30-day mortality rate was low but complications were common, especially in patients with severe ventricular dysfunction. For these patients, we recommend early consideration of perioperative intensive care support to optimize cardiovascular therapy and monitoring.