Paediatric anaesthesia
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Paediatric anaesthesia · Oct 2018
Substitution of artificial colloids for fresh frozen plasma in pediatric cardiopulmonary bypass surgery.
In many centers, fresh frozen plasma is generally used as the main component of pump prime in pediatric cardiopulmonary bypass. However, many factors have resulted in stringent control of plasma transfusion and prompted the study of safe and efficient substitutes. ⋯ In the general pediatric patients undergoing elective cardiac surgery, substitution of gelatin for fresh frozen plasma in cardiopulmonary bypass is feasible.
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Paediatric anaesthesia · Oct 2018
Clinical and echocardiographic risk factors for extubation failure in infants with congenital diaphragmatic hernia.
Infants after surgical correction of congenital diaphragmatic hernia are at high risk for extubation failure, but little is known about contributing factors. Therefore, our study aimed to analyze clinical and echocardiographic parameters. ⋯ Our results demonstrate that extubation failure in infants with a congenital diaphragmatic hernia is associated with several clinical and echocardiographic risk factors.
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Paediatric anaesthesia · Oct 2018
Observational StudyAutonomic cardiac regulation after general anesthesia in children.
General anesthesia dramatically decreases the activity of the autonomic nervous system. Most of the hypnotic agents used to induce anesthesia inhibit sympathetic cardiovascular regulation and baroreflex control in a dose-dependent manner, lowering cardiac adaptability during the operation. The consequence of this effect in children during and after surgery has never been studied to date. ⋯ Autonomic nervous function normalizes rapidly (within 12 hours) in prepubertal children. This study indicates that general anesthesia does not seem to increase the long-term risk of autonomic dysfunction in these patients.
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Paediatric anaesthesia · Oct 2018
Observational StudyUltrasound assessment of the prevalence of increased gastric contents and volume in elective pediatric patients: A prospective cohort study.
Though pulmonary aspiration of gastric contents occurs mainly in the setting of emergency surgery, it may also occur in children scheduled for elective surgery without any obvious clinical risk factor. Increased gastric content volume is one the predisposing factors for pulmonary aspiration that could affect such children and may be identified using ultrasound examination of the gastric antrum. ⋯ According to our results, only 1% of elective children had potentially increased risk for pulmonary aspiration. Further studies should be performed in order to define the target population of elective children for which ultrasound assessment of gastric content should be performed prior to general anesthesia.