Paediatric anaesthesia
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Paediatric anaesthesia · Dec 2008
Randomized Controlled Trial Comparative StudyThe effects of 45 degree head up tilt on the lumbar puncture success rate in children undergoing spinal anesthesia.
There are few studies for procedural techniques of lumbar puncture (LP) for spinal anesthesia in children. There are no controlled studies on the effect of patient positioning. We designed this prospective, randomized study to compare the success rates of LP of the lateral decubitus and lateral decubitus position with a 45 degree head up tilt in children undergoing spinal anesthesia. ⋯ Because of higher success rate, lateral decubitus, knee-chest position with 45 degree head up tilt may be the preferred position for spinal anesthesia in infants.
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Paediatric anaesthesia · Dec 2008
ReviewExtracorporeal membrane oxygenation for postcardiotomy mechanical cardiovascular support in children with congenital heart disease.
Extracorporeal membrane oxygenation (ECMO) is increasingly used to support postcardiotomy cardiorespiratory failure in children with congenital heart disease. We report on survival outcomes and factors associated with survival for postcardiotomy ECMO patients.
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Paediatric anaesthesia · Dec 2008
Effects of dexmedetomidine on propofol and remifentanil infusion rates during total intravenous anesthesia for spine surgery in adolescents.
Total intravenous anesthesia with propofol and a synthetic opioid is a frequently chosen anesthetic technique for posterior spinal fusion. Despite its utility, adverse effects may occur with high or prolonged propofol dosing regimens including delayed awakening. The current study investigated the propofol-sparing effects of the concomitant administration of the alpha(2)-adrenergic agonist, dexmedetomidine, during spinal fusion surgery in adolescents. ⋯ The concomitant use of dexmedetomidine in patients undergoing spinal fusion reduces propofol infusion requirements when compared with those patients receiving only propofol and remifentanil.
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Paediatric anaesthesia · Dec 2008
Effect of elevated PEEP on dynamic variables of fluid responsiveness in a pediatric animal model.
Previous studies have demonstrated that stroke volume variation (SVV), pulse pressure variation (PPV) and global end-diastolic volume (GEDV) can be used to predict the response to fluid administration. Currently, little information is available whether application of different levels of positive end-expiratory pressure (PEEP), especially in infants and neonates, affects their ability to predict fluid responsiveness. The aim of our study was to assess the effect of increasing PEEP levels on the predictive value of SVV, PPV and GEDV with respect to fluid responsiveness. ⋯ In this pediatric animal model, SVV and GEDV were sensitive and specific predictors of fluid responsiveness during increasing PEEP levels.