Paediatric anaesthesia
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Paediatric anaesthesia · Apr 2024
Randomized Controlled TrialInverse ratio ventilation versus conventional ratio ventilation during one lung ventilation in neonatal open repair of esophageal atresia/tracheoesophageal fistula: A randomized clinical trial.
Maintaining oxygenation during neonatal open repair of esophageal atresia/tracheoesophageal fistula is difficult. Inverse ratio ventilation can be used during one lung ventilation to improve the oxygenation and lung mechanics. ⋯ There may be a role for inverse ratio ventilation with appropriate positive end-expiratory pressure to reduce the incidence of hypoxemia during open repair of esophageal atresia/tracheoesophageal fistula in neonates, further studies are required to establish the safety and efficacy of this technique.
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Paediatric anaesthesia · Feb 2024
Randomized Controlled TrialThe effect of augmented reality on preoperative anxiety in children and adolescents: A randomized controlled trial.
Virtual reality has been shown to be an effective non-pharmacological intervention for reducing anxiety of pediatric patients. A newer immersive technology, that of augmented reality, offers some practical advantages over virtual reality, and also seems to show beneficial effects on anxiety. The main objective of this study was to determine whether augmented reality could reduce preoperative anxiety in pediatric patients undergoing elective day surgeries. A secondary outcome was to document the level of satisfaction from pediatric patients toward augmented reality intervention. ⋯ To our knowledge, this study is the first large randomized controlled trial to provide empirical evidence of reduction in anxiety for children and adolescents using augmented reality prior to induction of general anesthesia.
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Paediatric anaesthesia · May 2024
Randomized Controlled TrialRandomized controlled trial to evaluate the rate of successful neonatal endotracheal intubation performed with a stylet versus without a stylet.
Neonates in intensive care units often require endotracheal intubation and mechanical ventilation. During this intubation procedure, a stylet is frequently used along with an endotracheal tube. Despite the widespread use of a stylet, it is still not known whether its use increases the intubation success rate. This study examined the association between stylet use and the intubation success rate in surgical neonates. ⋯ Endotracheal intubation using a stylet did not significantly improve the success rate of the procedure, however, intubation time significantly varied between groups and in different conditions. The rigidity and curvature provided by the stylet may facilitate the process of intubation when smaller caliber endotracheal tubes are used.
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Paediatric anaesthesia · Jan 2024
ReviewError traps in the perioperative management of children with type 1 diabetes.
Patients with type 1 diabetes mellitus (T1D) require insulin administration at all times to maintain euglycemia and metabolic stability. Insulin administration in the perioperative period is complicated by fasting requirements and perioperative stressors that can change the patient's insulin needs. ⋯ Errors in perioperative insulin administration can lead to hypoglycemia, hyperglycemia, and diabetic ketoacidosis. This article reviews common errors of associated with the perioperative management of patients with T1D, including failure to assess and coordinate patient care preoperatively; failure to understand diabetes management and technology; failure to monitor blood glucose and recognize dysglycemia; and failure to appropriately administer basal insulin.