Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2012
Does topical lidocaine before tracheal intubation attenuate airway responses in children? An observational audit.
The use of topical lidocaine, applied to the airways with various administration techniques, is common practice in pediatric anesthesia in many institutions. However, it remains unclear whether these practices achieve their intended goal of reducing the risk of perioperative respiratory adverse events (PRAE) in children undergoing elective endotracheal intubation without neuromuscular blockade (NMB). The relative frequency of PRAE (laryngospasm, coughing, desaturation <95%) associated with no use of topical airway lidocaine (TAL), with TAL sprayed directly onto the vocal cords, and TAL administered blindly into the pharynx was assessed. ⋯ The incidence of desaturation was higher in patients receiving TAL compared with children who did not. This association should perhaps be considered when contemplating the use of this technique.
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Paediatric anaesthesia · Apr 2012
Strengthening handover communication in pediatric cardiac intensive care.
To evaluate knowledge transfer and perceptions using a structured handover process for the postoperative pediatric cardiac patient being admitted to intensive care. The hypothesis being that knowledge transfer could be optimized by the implementation of this handover structure. ⋯ Communication between the operating room and intensive care staff, regarding postoperative pediatric cardiac patients, significantly improved with the implementation of a structured handover.
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Paediatric anaesthesia · Apr 2012
Historical ArticleThe early development of pediatric intensive care.
The polio epidemic in Copenhagen in 1952 was a significant stimulus to the development of Intensive Care. Eighty-five percent of the patients with respiratory involvement died despite the use of Cuirass negative pressure ventilators. After some controversy Ibsen, an anesthetist, was consulted. ⋯ Owing to the lack of positive pressure ventilators, this was undertaken by students who contributed 167,000 h of hand ventilation. The mortality decreased to 25%. Anesthetists, having special experience with ventilation, became the leaders in the field as Intensive Care developed.