Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2022
Observational StudyValidation of a new combined transcutaneous tcPCO2 and tcPO2 sensor in children in the operating theater.
Arterial blood gas analysis is the gold standard for monitoring of Pa CO2 and PaO2 during mechanical ventilation. However, continuous measurements would be preferred. Transcutaneous sensors continuously measure blood gases diffusing from the locally heated skin. These sensors have been validated in children mostly in intensive care settings. Accuracy in children during general anesthesia is largely unknown. ⋯ This study showed good agreement between Pa CO2 and tcPCO2 in children of all ages during general anesthesia. Both transcutaneous and endtidal CO2 measurements showed good accuracy. TcPO2 is only accurate under 6 months of age.
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Paediatric anaesthesia · Mar 2022
Randomized Controlled TrialSingle bolus dexmedetomidine versus propofol for treatment of pediatric emergence delirium following general anesthesia.
Pediatric emergence delirium is a psychomotor disorder occurring in the early postanesthetic stage. There is no clear consensus regarding its treatment; however, dexmedetomidine and propofol have both been shown to be effective. ⋯ A single bolus of 0.5 μg.kg-1 of dexmedetomidine was more effective than a single bolus of 1 mg.kg-1 of propofol in treating emergence delirium during the early postanesthetic stage.
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Paediatric anaesthesia · Mar 2022
Impact of the COVID-19 pandemic on the 2020 pediatric anesthesiology fellowship application cycle: A survey of program directors.
The COVID-19 pandemic created a situation with an urgent need to produce a virtual system for the 2019-2020 pediatric anesthesiology fellowship cycle. With fellowship interviews beginning in April 2020, there was minimal time for programs to adapt. Each program rapidly developed its own platform, expectations, materials, and process for interviews-all while under the stress of managing the unfolding patient care, financial, and leadership crises of the unfolding pandemic. ⋯ These results demonstrate that virtual interviews are a viable alternative to traditional interviews and can be completed without many technological complications. PDs were overall satisfied with virtual interviews, despite not having appropriate time to plan and coordinate, and would be interested in continuing this option into the future. There are areas where improvements can be made and with appropriate planning could look to mitigate some of the areas where virtual interviews fall short of traditional interviews. In combination with our previously published survey of applicants (Paediatr Anaesth. 2021;31(9):968-976), these data form a more complete picture of virtual interview best practices going forward.
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Paediatric anaesthesia · Mar 2022
A novel approach to operating room readiness for airborne precautions using simulation-based clinical systems testing.
The emergence of the COVID-19 disease as a global pandemic caused major challenges and strained busy operating room environments. This required institutions to rethink current system functioning and urgently develop safe medical practices and protocols. ⋯ This study demonstrated a flexible methodology that effectively integrated simulation-based training and systems tests to train staff and detect latent safety threats in the new workflows and provide recommendations for mitigation. While COVID was the specific prompt, this approach can be applicable in diverse clinical settings for training medical staff, testing system function, and mitigating potential latent safety threats.