Paediatric anaesthesia
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Paediatric anaesthesia · Mar 2013
Impact of protamine dose on activated clotting time and thromboelastography in infants and small children undergoing cardiopulmonary bypass.
To study the effect of two protamine-dosing strategies on activated clotting time (ACT) and thromboelastography (TEG). ⋯ Automated protamine titration with a protamine dosage based on Pt-EBV can adequately neutralize heparin as assessed by ACT while minimizing prolonging clot initiation time as measured by TEG.
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Paediatric anaesthesia · Feb 2013
Comparative StudyA comparison of three methods that assess tracheal tube leakage: leak conductance, fractional volume loss, and audible assessment.
When intubating a child's trachea with an uncuffed tracheal tube (TT), it is current practice in anesthesia and intensive care to use the leak test to assess TT fit. The aim of this study is to compare three measures of assessing leak around uncuffed tracheal tubes in the PICU. ⋯ On admission to the PICU, values of leak conductance are more strongly associated with audible assessment than with fractional volume loss. Throughout PICU stay, leak conductance is associated with fractional volume loss. This study demonstrates that leak conductance, calculated from routinely available pressure and flow signals, has the potential to represent the characteristics of the leak interface between a TT and the trachea.
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Paediatric anaesthesia · Feb 2013
Oxidative stress markers are not associated with outcomes after pediatric heart surgery.
To investigate whether perioperative serum levels of oxidative stress markers, thiobarbituric acid reactive substances (TBARS), and carbonyl moieties are associated with outcomes in children after heart surgery. ⋯ In conclusion, oxidative stress markers TBARS and carbonyl moieties were not associated with the development of LCOS, the aLOS, or mortality in children after heart surgery with CPB.
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Paediatric anaesthesia · Feb 2013
Pain monitoring in anesthetized children: first assessment of skin conductance and analgesia-nociception index at different infusion rates of remifentanil.
Analgesia and nociception can not be specifically monitored during general anesthesia. Movement of the patient or hemodynamic variations are usually considered as symptoms of insufficient analgesia. The measure of skin conductance (SC) allows an assessment of peripheral sympathetic activity. The analgesia-nociception index (ANI) provides an evaluation of the parasympathetic activity based on heart rate variability. These two non-invasive monitors might allow a better assessment of perioperative nociception. ⋯ ANI might provide a more sensitive assessment of nociception in anesthetized children than hemodynamic parameters or skin conductance.