Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2021
ReviewSatisfaction measures in pediatric anesthesia and perioperative care.
Patient satisfaction is routinely used to assess the quality of care in medicine. In the field of anesthesia, research has been primarily directed toward developing satisfaction measures in adults with little attention paid to the pediatric population. Satisfaction in pediatric anesthesia and perioperative care is poorly understood. ⋯ In three studies, parental involvement in decision-making was reported to be important as a satisfaction measure of their child's perioperative care. Of the few existing satisfaction measures evaluated, there is no accepted standard in current practice. Future studies identifying the important determinants of satisfaction in pediatric perioperative care, perhaps also using a Delphi approach with parents, might allow for the development of a patient-focused standardized measure in this setting.
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Paediatric anaesthesia · Jul 2021
Meta AnalysisDiagnostic accuracy of stroke volume variation for predicting fluid responsiveness in children undergoing cardiac surgery: a systematic review and meta-analysis.
Stroke volume variation appears to be reliable for predicting fluid responsiveness in adults, and its predictive value in pediatric patients has been recently reported. However, its predictive value in children undergoing cardiac surgery is unclear. ⋯ There was some heterogeneity due to thresholds in the included studies. An evaluation of stroke volume variation may represent a reliable predictor of fluid responsiveness in children undergoing cardiac surgery. After operative cardiac output optimization, the possible impact of goal-directed fluid treatment depending on stroke volume variation on the perioperative outcome in the children population should subsequently be assessed.
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Paediatric anaesthesia · Jun 2021
ReviewAnesthetic management for percutaneous reverse Potts shunt creation in children with refractory idiopathic pulmonary arterial hypertension: a case series.
Percutaneous reverse Potts shunt improves right ventricular function in patients with suprasystemic idiopathic pulmonary arterial hypertension. There are no data regarding the anesthesia in this high-risk procedure. We report our experience of the anesthetic management for the creation of percutaneous reverse Potts shunt in children with suprasystemic idiopathic pulmonary arterial hypertension. ⋯ We recommend using multimodal monitoring with transesophageal echocardiography. The 100% mortality of extracorporeal life support patients, probably too sick to undergo such procedure, may question its usefulness. Further studies should identify suitable candidates for percutaneous reverse Potts shunt creation.
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Paediatric anaesthesia · May 2021
ReviewPerianesthetic neurological adverse events in children: A review of the Wake-Up Safe Database.
Perianesthetic neurological adverse events are rare in children and have been studied in detail in the settings of cardiac surgery and regional anesthesia. Our study aims to characterize perianesthetic neurological adverse events in children in the setting of all types of surgery and diagnostic or interventional procedures, to evaluate anesthesia's role, and to identify factors amenable to prevention. ⋯ Perianesthetic neurological adverse events are rare in children and have a poor outcome. Our study has described pediatric perianesthetic neurological injury in detail and identified contributing factors that can be optimized during various phases of perianesthetic care. This information can be utilized during the informed consent process and to enhance the quality of care in children receiving anesthesia.
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Paediatric anaesthesia · May 2021
ReviewStatistics in Quality Improvement: Measurement and Statistical Process Control.
Data are used in healthcare quality improvement endeavors to measure and determine whether the changes made in the course of the work have made the desired impact. The methods used to analyze data in quality improvement differ slightly from those used in classical statistics. Run charts and statistical process control charts are the most common types of graphical representations used to visualize data collected for quality improvement. This review provides a basic introduction to measurement in quality improvement and explains the use of run charts and statistical process control charts with real-life examples.