Paediatric anaesthesia
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Paediatric anaesthesia · Jun 2013
Observational StudyPlethysmographic variability index (PVI) accuracy in predicting fluid responsiveness in anesthetized children.
Plethysmographic Variability Index (PVI) has been shown to accurately predict responsiveness to fluid loads in adults. The goal of this study was to evaluate PVI accuracy when predicting fluid responsiveness during noncardiac surgery in children. ⋯ This study found both PVI and prechallenge SVI to be accurate when used to predict fluid load response during anesthetized noncardiac surgery in children. However, a third of recorded PVI values were inconclusive.
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Moyamoya syndrome carries a high risk of cerebral ischemia, and impaired cerebrovascular autoregulation may play a critical role. Autoregulation indices derived from near-infrared spectroscopy (NIRS) may clarify hemodynamic goals that conform to the limits of autoregulation. ⋯ NIRS-derived indices may identify hemodynamic goals that optimize autoregulation in pediatric moyamoya.
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Paediatric anaesthesia · Jun 2013
Comparative StudyLeft femoral vein is a better choice for cannulation in children: a computed tomography study.
Central venous catheters are often required in emergency rooms and intensive care and/or those undergoing major surgical procedures. In this study, we aimed to gain a better understanding of the anatomy of the femoral vessel in relation to central venous cannulation. ⋯ The incidence of overlap of the FA over the FV was significantly lower at the left side in pediatric patients. This finding was similar between the patients aged 2-8 years and those aged 9-16 years and may have significant clinical implications. Guiding clinicians to select the left FV of children for cannulation may result in lower arterial puncture rates while accessing the central vein.
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Paediatric anaesthesia · Jun 2013
High-frequency micro-ultrasound for vascular access in young children--a feasibility study by the High-frequency UltraSound in Kids studY (HUSKY) group.
Cannulation of small arteries and veins in young children can be challenging. Although anesthesiologists frequently use ultrasound for placement of central venous lines and nerve blocks, its use for cannulation of small, peripheral vessels is less helpful. Ultrasound systems (7-15 MHz) currently used in clinical practice focus poorly at the sub-10-mm space and thus lack the resolution to allow accurate ultrasound-guided cannulation of small vessels. High-frequency micro-ultrasound (HFMU) is a new technology that allows higher resolution (15-50 MHz) compared with conventional ultrasound. Limited human studies have been performed thus far with HFMU, and none have been performed in young children or for vascular access. ⋯ The experience gained in this feasibility study suggests that HFMU could be a valuable addition to our armamentarium for difficult vascular access in the future.
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Paediatric anaesthesia · Jun 2013
Historical ArticleThe child in hospital--changes in the last 50 years.