Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2015
Case ReportsMethylene blue treatment for resistant shock following renal transplantation.
We report a case of a 19-year-old female with a history of hyperoxaluria type 1 and renal failure. The patient presented for a second renal transplantation 17 years after her first combined liver and kidney transplantation. Postoperative shock was highly resistant to fluids and required massive pharmacologic hemodynamic support. Vasoplegic shock was the presumed diagnosis, and methylene blue was utilized as a rescue therapy, with a rapid hemodynamic response and no apparent side effects.
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Paediatric anaesthesia · Nov 2015
A pilot and feasibility study of the plasma and tissue pharmacokinetics of cefazolin in an immature porcine model of pediatric cardiac surgery.
Surgical site infection (SSI) prevention for children with congenital heart disease is imperative and methods to assess and evaluate the tissue concentrations of prophylactic antibiotics are important to help maximize these efforts. ⋯ The cefazolin dosing used in this study achieves plasma and tissue concentrations that should be effective against methicillin-sensitive Staphylococcus aureus but may not be effective against some gram-negative pathogens. The timing of the cefazolin administration prior to incision and a second dose given during cardiopulmonary bypass may be important factors for achieving goal tissue concentrations.
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Paediatric anaesthesia · Nov 2015
A survey of practice patterns in the use of laryngeal mask by pediatric anesthesiologists.
Laryngeal mask is frequently the airway device of choice in routine general anesthesia for many procedures in children. Several studies have described the use of laryngeal masks in unconventional situations. This survey was undertaken to assess how laryngeal masks are being used by pediatric anesthesiologists. ⋯ Pediatric anesthesiologists are using laryngeal masks in both routine and challenging/unconventional situations. Although many of the uses for laryngeal masks are not explicitly stated in the manufacturer guidelines, literature and current practice support the use of laryngeal masks in several of these scenarios.
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Paediatric anaesthesia · Nov 2015
Changes of epidural blood flow after epidural administration of epinephrine in young rats.
For caudal epidural analgesia, the needle is inserted at a site where vessels are abundant. To avoid complications related to intravascular administration of the local anesthetic, epinephrine is usually added, but there is no evidence about the safety of epidural administration of epinephrine in pediatric patients. The objective of this study was to assess the changes in epidural blood flow after epidural injection of epinephrine in young rats. ⋯ Administration of epinephrine into the epidural space was safe in young rats. While reduction of epidural blood flow was observed, there was no spinal ischemia.