Paediatric anaesthesia
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Paediatric anaesthesia · Sep 2018
Feasibility of autologous intraoperative blood collection and retransfusion in small children with complex congenital heart defects undergoing cardiopulmonary bypass.
Allogeneic blood product transfusion is common in pediatric patients undergoing cardiopulmonary bypass although it is associated with an increased risk for adverse events. Furthermore, numerous donor exposures may affect future blood transfusion needs and human leukocyte antigen matching for patients who may ultimately require cardiac transplantation. Autologous intraoperative blood collection and retransfusion is a known method of blood preservation, but has not been extensively practiced in pediatric patients. In this study we assess the feasibility of this blood conservation technique in small children with complex congenital heart defects undergoing cardiopulmonary bypass. ⋯ The use of autologous intraoperative blood collection and retransfusion is a feasible option for small children with complex congenital heart defects undergoing cardiopulmonary bypass. Study patients received significantly fewer donor exposures without an increase in postoperative bleeding. Children who require multiple cardiac surgeries or eventually transplantation could benefit from this blood conservation technique.
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Paediatric anaesthesia · Sep 2018
Case ReportsIntraoperative anesthetic management of an infant with a bridging bronchus: A case report.
A newborn infant was diagnosed with an imperforate anus, and colostomy was performed one day after birth. He exhibited repeated episodes of poor oxygenation during intubation, and a CT scan revealed a bridging bronchus. ⋯ This led to normal oxygenation, even while in the prone position. The surgery was completed without any complications.
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Paediatric anaesthesia · Sep 2018
Case ReportsPediatric tracheomalacia and the perioperative anesthetic management of thoracoscopic posterior tracheopexy.
Tracheomalacia is a broad term used to describe an abnormally compliant trachea that can lead to exaggerated collapse and obstruction with expiration. We describe the perioperative management of a complex pediatric patient undergoing a posterior tracheopexy which is a relatively new surgical treatment, with a novel surgical approach-thoracoscopy. This procedure has competing surgical and anesthetic needs and presents unique challenges to the physicians involved in caring for these patients. We also review the current literature on pediatric tracheomalacia and examine the newest treatment options to highlight the potential anesthetic challenges and pitfalls associated with management.
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Paediatric anaesthesia · Sep 2018
Association between children's emotional/behavioral problems before adenotonsillectomy and postoperative pain scores at home.
Children undergoing adenotonsillectomy are at risk of severe postoperative pain and sleep problems. Little is known about the specific child risk factors for these problems. ⋯ Following adenotonsillectomy, children often experienced moderate to severe pain and sleep problems during the first 3 days at home. Preoperative internalizing problems and parental need for information were independently associated with increased pain at home. Screening for these problems can help to identify vulnerable children and adapt the perioperative analgesic strategy accordingly (which includes preparation, information, and prescription of pain analgesics).
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Paediatric anaesthesia · Sep 2018
Case ReportsVolatile anesthesia for a child with LPIN1 gene mutation and recurrent rhabdomyolysis.
We report the case of a boy with LPIN1 gene mutation presenting for adenotonsillectomy who was successfully managed with preoperative saline and glucose infusion followed by balanced anesthesia including sevoflurane. The anesthetic planning is described as there is no modern literature to guide the perioperative management of these children.