Paediatric anaesthesia
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Paediatric anaesthesia · Nov 2013
Comparative StudyComparison of bicarbonate-buffered fluid and isotonic saline solution as Cell Saver washing fluids for packed red blood cells.
Massive transfusion (MT) can cause severe electrolyte and acid-base disturbances in neonates and infants due to the unphysiological composition of packed red blood cells (PRBCs). Washing of the PRBCs using Cell Saver systems prior to MT is recommended for this reason. ⋯ Washing of PRBCs with BB-HS rather than NaCl results in a more physiological composition with improvements of electrolyte concentrations, acid-base balance and erythrocyte stability.
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Paediatric anaesthesia · Nov 2013
The perioperative course of factor XIII and associated chest tube drainage in newborn and infants undergoing cardiac surgery.
Perioperative acquired factor XIII deficiency has been looked upon as a potential cause of postoperative bleeding in adult cardiac surgery. ⋯ Factor XIII activity in infants with congenital heart defects is within the lower range of normal adults, independent of patient's age and the presence of cyanosis. Reconstituted blood prime maintains factor XIII activity at sufficient levels during pediatric cardiac surgery. We could not detect a correlation between FXIII and CTD.
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Paediatric anaesthesia · Nov 2013
Direct laryngoscopy after potential difficult intubation in children only predicts standard Cormack and Lehane view to within one grade.
Some techniques used to achieve intubation in children predicted to have a difficult airway do not involve direct laryngoscopy or assessment of the laryngeal grade. Direct laryngoscopy may therefore be performed immediately after intubation to provide a record for future anesthetics. It is unknown whether this postintubation grade accurately reflects the standard laryngeal grade in this group. ⋯ Assessment and documentation of a postintubation laryngeal grade does not appear to provide reliable information for future anesthetics and may even have the potential to be misleading. Any such documentation should always refer to the presence of an endotracheal tube and be interpreted with caution.