Paediatric anaesthesia
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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.
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Paediatric anaesthesia · Mar 2022
Intraoperative cerebral oxygen saturation and neurological outcomes following surgical management of necrotizing enterocolitis: Predictive factors of neurological complications following neonatal necrotizing enterocolitis: Predictive factors of neurological complications following neonatal necrotizing enterocolitis.
The goal of the present study was to investigate intraoperative factors associated with major neurological complications at 1 year following surgery for necrotizing enterocolitis. ⋯ Intraoperative decrease of cerebral oxygen saturation below ≥36% from baseline is associated with severe neurological complications in neonates undergoing surgery for necrotizing enterocolitis.
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Paediatric anaesthesia · Mar 2022
Case ReportsLocal anesthetic toxicity following erector spinae plane block in a neonate: A case report.
A 6-day-old, 4.0 kg neonate presented with intestinal malrotation, necessitating laparotomy. Intra-operatively, an ultrasound-guided erector spinae plane block was performed under general anesthesia with administration of 1 mg/kg levobupivacaine. ⋯ Intralipid (1.5 ml/kg) was given, with a return to normal hemodynamic parameters. This is the first case report of suspected local anesthetic toxicity in a neonate following an erector spinae plane block.
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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
Observational StudyRecovery characteristics and parental satisfaction in pediatric procedural sedation.
Despite being a standard of care for children undergoing stressful procedures, little data exist on parental perception of pediatric sedation. ⋯ In this study, caregivers' satisfaction with pediatric sedation was high, regardless of the regimen used. Lower parental satisfaction was associated with younger age, irritability after sedation, prolonged sleepiness, hyperactivity, unsteadiness, hallucinations, emesis, and respiratory distress.