Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2009
Long-term posttraumatic effects of intraoperative awareness in children.
The consequences of intraoperative awareness in children have received little empirical attention to date. Previous studies suggest that children are less likely to be distressed than adults in the short term, but long-term consequences have only been studied retrospectively. ⋯ Although no children had clinically significant symptoms, the small numbers and failure to follow-up all children limit any conclusions with respect to true incidence of posttraumatic stress disorder in children who have had an awareness event.
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Paediatric anaesthesia · Dec 2009
Anesthesia for children with hyperleukocytosis a retrospective review.
Hyperleukocytosis (a white cell count in peripheral blood >100 x 10(9) l(-1)) is a well-recognized medical emergency. Rates of morbidity associated with anesthesia in hyperleukocytotic patients have not been previously described. This retrospective study describes the perioperative morbidity and mortality of children who present acutely with hyperleukocytosis. ⋯ Children with leukemia-related hyperleukocytosis often require general anesthesia at the time of presentation and are at significant perioperative risk. Respiratory adverse events are very common and mandate close postanesthesia care.
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Paediatric anaesthesia · Dec 2009
Alveolar recruitment strategy and PEEP improve oxygenation, dynamic compliance of respiratory system and end-expiratory lung volume in pediatric patients undergoing cardiac surgery for congenital heart disease.
Optimizing alveolar recruitment by alveolar recruitment strategy (ARS) and maintaining lung volume with adequate positive end-expiratory pressure (PEEP) allow preventing ventilator-induced lung injury (VILI). Knowing that PEEP has its most beneficial effects when dynamic compliance of respiratory system (Crs) is maximized, we hypothesize that the use of 8 cm H(2)O PEEP with ARS results in an increase in Crs and end-expiratory lung volume (EELV) compared to 8 cm H(2)O PEEP without ARS and to zero PEEP in pediatric patients undergoing cardiac surgery for congenital heart disease. ⋯ An alveolar recruitment strategy with relative high PEEP significantly improves Crs, oxygenation, P(a)CO(2)- PETCO(2) difference, and EELV in pediatric patients undergoing cardiac surgery for congenital heart disease.