Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2013
Intrathecal morphine reduces blood loss during idiopathic scoliosis surgery: retrospective study of 256 pediatric cases.
This retrospective cohort study was designed to assess the impact of intrathecal morphine compared with no intrathecal morphine on blood loss and on hemodynamic stability during surgery for pediatric idiopathic scoliosis correction. ⋯ These data demonstrate that intrathecal morphine in pediatric surgical scoliosis correction significantly decreases intra-operative blood loss and transfusions and enhances blood pressure stability.
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Paediatric anaesthesia · Mar 2013
Earlier detection of coagulopathy with thromboelastometry during pediatric cardiac surgery: a prospective observational study.
Earlier detection of coagulopathy in pediatric cardiac surgery patients. ⋯ The results suggest that intraoperative TEM analyses can be accelerated by analyzing HEPTEM/FIBTEM on CPB before hemoconcentration and by analyzing clot firmness already after 10 min.
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Paediatric anaesthesia · Mar 2013
Retrospective cohort analysis of a single dose of aprotinin use in children undergoing cardiac surgery: a single-center experience.
The great difference in side effects of aprotinin was noted in adult and pediatric fields in recent reports because aprotinin was suspended for safety reasons. The aim of this study is to describe associations between aprotinin using and red blood cells transfusion, renal injury, and mortality in pediatric with cardiac surgery. ⋯ Except reducing postoperative bleeding, we did not find other benefits of aprotinin. However, much higher postoperative creatinine levels, longer duration of mechanical ventilation, not less postoperative RBCs transfusion, and a 0.55% increased clinical mortality (although not statistically significant) were found in the aprotinin populations.
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Paediatric anaesthesia · Mar 2013
Ulinastatin as a neuroprotective and anti-inflammatory agent in infant piglets model undergoing surgery on hypothermic low-flow cardiopulmonary bypass.
Infants are potentially more susceptible to brain injury mediated via cell death attributed to cardiopulmonary bypass (CPB) especially with prolonged hypothermic low flow (HLF). We hypothesized that a human urinary protease inhibitor (ulinastatin), by its anti-inflammatory effect, would reduce central nervous system (CNS) injury during HLF. ⋯ In our study, HLF CPB on infant piglets resulted in brain injury, and ulinastatin might reduce the extent of such injury.
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Paediatric anaesthesia · Mar 2013
Surfactant deactivation in a pediatric model induces hypovolemia and fluid shift to the extravascular lung compartment.
Surfactant deficiency is the pivotal abnormality in Neonatal and Acute Respiratory Distress Syndrome. Surfactant deactivation can produce hypoxemia, loss of lung compliance, and pulmonary edema, but its circulatory consequences are less understood. ⋯ Hypovolemia develops early after surfactant deactivation, in part due to the resulting fluid shift from the intravascular compartment to the lungs.