Paediatric anaesthesia
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Paediatric anaesthesia · Feb 2018
Observational StudyEvidence for increased use of the Society of Pediatric Anesthesia Critical Events Checklist in resource-limited environments: A retrospective observational study of app data.
Electronic decision support tools in anesthesiology practice have great value, including the potential for mobile applications to simplify delivery of best-practice guidelines. ⋯ mHealth apps are invaluable resource in everyday clinical practice. Mobile app analytics and in-app survey data reveal variable penetration and applicability of such technology worldwide. mHealth apps may be particularly impactful in limited-resource areas, such as lower-income environments and rural communities.
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Paediatric anaesthesia · Feb 2018
Compatibility of common IV drugs with 6% hydroxyethyl starch 130/0.42 and 4% gelatin.
Acetate-containing colloid infusion solutions are recommended to recover normovolemia during pediatric anesthesia. Until now, no studies investigating the compatibility with common anesthetic drugs were available. ⋯ Most of the tested drugs did not show observable incompatibility reactions. However, some common drugs are highly incompatible with colloid infusion solutions: gelatin (cefazolin, diazepam, midazolam, phenytoin, vancomycin), hydroxyethyl starch (diazepam, midazolam, phenytoin, thiopental), and NaCl 0.9% (diazepam, ketamine (S), phenytoin, thiopental). These combinations should be avoided in clinical practice in case there are fewer intravenous lines available than needed.
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Paediatric anaesthesia · Feb 2018
Observational StudyCerebrovascular blood pressure autoregulation monitoring and postoperative transient ischemic attack in pediatric moyamoya vasculopathy.
Children with moyamoya vasculopathy are at high risk of perioperative cerebral ischemia or hyperperfusion. Maintaining blood pressure within the range of functional cerebrovascular blood pressure autoregulation might reduce the risk of perioperative neurologic injury. ⋯ Dysfunctional intraoperative autoregulation may increase the risk of TIA in patients with pediatric moyamoya vasculopathy. The blood pressure range that supports autoregulation appears to vary among patients. Using autoregulation monitoring to guide individualized blood pressure goals should be studied as a potential method to reduce perioperative neurologic morbidity in pediatric patients with moyamoya.
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Paediatric anaesthesia · Feb 2018
Observational StudyCharacterization of the functional near-infrared spectroscopy response to nociception in a pediatric population.
Near-infrared spectroscopy can interrogate functional optical signal changes in regional brain oxygenation and blood volume to nociception analogous to functional magnetic resonance imaging. ⋯ Near-infrared spectroscopy detected functional activation to nociception in a broad pediatric population. The near-infrared spectroscopy response appears to represent nociceptive processing because the signals increased with noxious stimulus intensity and duration, and were blocked by analgesics but not paralytics.
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Paediatric anaesthesia · Feb 2018
Perioperative experiences of anesthesia reported by children and parents.
The Sprint National Anaesthesia Project reported feedback from adults but not from children. We developed questionnaires for children and parents, and conducted a survey of perioperative anesthetic experiences in a large pediatric hospital. ⋯ This study shows that the experiences of children and their parents are similar to those of adults reported by the Sprint National Anaesthesia Project. Thirst (and hunger), anxiety, and pain continue to be common problems for many children. This feedback may help direct interventions and research to improve the pediatric patient and parent experience with anesthesia.