Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2012
Comparative StudyThe 'Can't Intubate Can't Oxygenate' scenario in Pediatric Anesthesia: a comparison of different devices for needle cricothyroidotomy.
Little evidence exists to guide the management of the 'Can't Intubate, Can't Oxygenate' (CICO) scenario in pediatric anesthesia. ⋯ Cannula tracheotomy in a model comparable to the infant airway is difficult and not without complication. Cannulae of 14- and 18-gauge appear to offer similar performance. Successful aspiration is the key predictor of appropriate cannula placement. The Quicktrach Child was not used successfully in this model. Further work is required to compare possible management strategies for the CICO scenario.
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Paediatric anaesthesia · Dec 2012
Epidural blood patches are effective for postdural puncture headache in pediatrics--a 10-year experience.
Postdural puncture headache (PDPH) is a relatively common complication after lumbar punctures (LP). If conservative treatment is not sufficient within a few days and the symptoms are severe, an epidural blood patch (EBP) may be performed. ⋯ If PDPH symptoms are severe and are not relieved with conservative treatment, EBP is a highly effective procedure in pediatric patients.
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Paediatric anaesthesia · Dec 2012
Randomized Controlled Trial Comparative StudyA randomized trial comparing the Ambu ® Aura-i ™ with the air-Q ™ intubating laryngeal airway as conduits for tracheal intubation in children.
To assess the clinical performance of the Ambu Aura-i (Aura-i) in children. ⋯ Both devices served as effective conduits for fiberoptic-guided tracheal intubation. The limitation of the narrower proximal airway tube of the size 1.5 Aura-i should be considered if cuffed tracheal tubes are to be utilized.
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Paediatric anaesthesia · Dec 2012
Randomized Controlled Trial Comparative StudyTracheal extubation of deeply anesthetized pediatric patients: a comparison of sevoflurane and sevoflurane in combination with low-dose remifentanil.
We aimed to observe the emergence characteristics of children tracheally extubated in deep anesthesia with sevoflurane or sevoflurane in combination with low-dose remifentanil. ⋯ Low-dose remifentanil in combination with sevoflurane provided rapid recovery and was safe for deep tracheal extubation in deep anesthesia in pediatric patients.
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Paediatric anaesthesia · Dec 2012
Randomized Controlled TrialEmergency airway access in children--transtracheal cannulas and tracheotomy assessed in a porcine model.
In the rare scenario when it is impossible to oxygenate or intubate a child, no evidence exists on what strategy to follow. ⋯ In a piglet model, we found no significant difference in success rates or time to insert a jet ventilation cannula or an intravenous catheter transtracheally, but the incidence of complications was high. In the same model, we found a 97% success rate for performing an emergency tracheotomy within 4 min with a low rate of complications.