Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2008
Randomized Controlled TrialA randomized, controlled trial of aprotinin in neonates undergoing open-heart surgery.
Neonates undergoing open-heart surgery are especially at risk for massive bleeding and pronounced inflammation. The efficacy of aprotinin, a serine protease inhibitor, at ameliorating these adverse effects of cardiopulmonary bypass has not been clearly demonstrated in neonates. ⋯ Aprotinin was not shown to be efficacious in neonates undergoing open-heart surgery. It is unclear whether adult aprotinin safety data are relevant to neonates undergoing open-heart surgery.
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Paediatric anaesthesia · Sep 2008
Randomized Controlled Trial Comparative StudyUltrasound-guided supraclavicular vs infraclavicular brachial plexus blocks in children.
Supraclavicular brachial plexus blocks are not common in children because of risk of pneumothorax. However, infraclavicular brachial plexus blocks have been described in paediatric patients both with nerve stimulation and ultrasound (US)-guidance. US-guidance reduces the risk of complications in supraclavicular brachial plexus blocks in adults. ⋯ (i) Ultrasound-guided supraclavicular and infraclavicular brachial plexus blocks are effective in children. (ii) There has been no pneumothorax in 40 US-guided supraclavicular brachial plexus blocks performed by anaesthesiologists already trained in US-guided regional anaesthesia using an IP technique in children > or =5 years old. (iii) In this study, the supraclavicular approach of the brachial plexus was faster to perform than the infraclavicular one.
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Paediatric anaesthesia · Sep 2008
Comparative StudyLongtime performance and reliability of two different PtcCO2 and SpO2 sensors in neonates.
Blood gas monitoring is necessary in treatment of critically ill neonates. Whereas SaO2 can be estimated by pulse oximetry, PaCO2 is still most often assessed from blood samples. ⋯ The TOSCA monitor allows safe estimation of PtcCO2 and SaO2 in neonates. Measurements of PtcCO2 were less reliable with TOSCA compared with conventional monitoring but still allow assessing a trend of ventilation status in newborn patients.