Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2005
Case ReportsPerioperative management of a child with severe hypertension from a catecholamine secreting neuroblastoma.
Increased catecholamine secretion from neuroblastomas can occasionally be demonstrated, but severe hypertension is uncommon. We report the perioperative management of a 5 year old child with stage III adrenal neuroblastoma who presented with malignant hypertension and high norepinephrine and dopamine levels. Hypertensive crises occurred during anesthesia for surgical biopsy and during chemotherapy. After blood pressure control using phenoxybenzamine and enalapril, doxazosin was used successfully as the preoperative alpha-adrenergic receptor antagonist for surgical tumor resection.
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Paediatric anaesthesia · Jul 2005
Letter Case ReportsModified airway mask as an aid for fibroptic tracheal intubation.
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Paediatric anaesthesia · Jun 2005
Comparative StudyA noninvasive estimation of mixed venous oxygen saturation using near-infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patients.
Near-infrared spectroscopy (NIRS) is a noninvasive optical monitor of regional cerebral oxygen saturation (rSO2). The aim of this study was to validate the use of NIRS by cerebral oximetry in estimating invasively measured mixed venous oxygen saturation (SvO2) in pediatric postoperative cardiac surgery patients. ⋯ Regional cerebral oximetry via NIRS correlates with SvO2 obtained via invasive monitoring. However, the wide limits of agreement suggest that it may not be possible to predict absolute values of SvO2 for any given patient based solely on the noninvasive measurement of rSO2. Near-infrared spectroscopy, using the INVOS 5100 cerebral oximeter, could potentially be used to indicate trends in SVO2, but more studies needs to be performed under varying clinical conditions.
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Paediatric anaesthesia · Jun 2005
Cerebral oxygenation monitoring using near infrared spectroscopy during controlled hypotension.
Controlled hypotension (CH) is used to limit intraoperative blood loss and decrease the need for homologous transfusions. Despite the efficacy of the technique, hypotension has the potential to affect cerebral perfusion and oxygen delivery. There are no data providing a direct measurement of cerebral oxygenation during this technique. ⋯ Our preliminary data with a measurement of cerebral oxygenation demonstrates the safety of CH within the accepted mean blood pressure recommendations of 55-65 mmHg.