Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2014
ReviewEffects of dexmedetomidine on sevoflurane requirement for 50% excellent tracheal intubation in children: a randomized, double-blind comparison.
We investigated the effects of two dexmedetomidine bolus and infusion combinations on the amount of sevoflurane required to produce 50% excellent tracheal intubation conditions (ED50 TI). ⋯ Dexmedetomidine infusion produced a dose-dependent decrease in the ED50 TI of sevoflurane in children.
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Paediatric anaesthesia · Sep 2014
Review Case ReportsThrombotic complications in children from short-term percutaneous central venous catheters: What can we do?
The reported incidence of venous thromboembolism (VTE) in children has increased dramatically over the past decade, and the primary risk factor for VTE in neonates and infants is the presence of a central venous catheter (CVC). Although the associated morbidity and mortality are significant, very few trials have been conducted in children to guide clinicians in the prophylaxis, diagnosis, and treatment of CVC-related VTE. Furthermore, pediatric guidelines for prophylaxis and management of VTE are largely extrapolated from adult data. ⋯ Several other factors show a trend toward altering the incidence of CVC-related VTE formation and may be under the control of the anesthesiologist placing and managing the catheter. In particular, because children with VTE may live decades with its sequelae and chronic vein thrombosis, careful consideration of lessening the risk of VTE is warranted in every child. Further studies are needed to form a clearer understanding of the risk factors, prophylaxis, and management of CVC-related VTE in children and to guide the anesthesiologist in lessening the risk of VTE.