Paediatric anaesthesia
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The aim of this study was to assess the time needed to trigger an occlusion alarm, and the influence of the type of infusion pump, type and size of the syringe, and the set infusion rate. ⋯ Our results showed that activation of occlusion alarms on both pumps takes a considerable time, and that the mean time to alarm activation was longer with low infusion rates and larger syringes. To reduce occlusion alarm delays smaller sized syringes with low compliance should be used and staff be alerted when using low flow rates with highly concentrated potent drugs.
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Paediatric anaesthesia · Apr 2005
Case ReportsArgatroban for anticoagulation during cardiopulmonary bypass in an infant.
Heparin induced thrombocytopenia (HIT) is a rare, but potentially life-threatening complication of heparin therapy. In patients with HIT, alternative means of anticoagulation are necessary. ⋯ The direct thrombin inhibitor, argatroban, was successfully used. Previous reports regarding the use of argatroban and other nonheparin anticoagulants for anticoagulation are reviewed and suggestions regarding argatroban dosing in infants are presented.
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Paediatric anaesthesia · Mar 2005
Randomized Controlled Trial Clinical TrialSafe and effective sedation and analgesia for bone marrow aspiration procedures in children with alfentanil, remifentanil and combinations with midazolam.
Invasive procedures such as bone marrow aspiration in children may be painful and cause anxiety. We investigated the efficacy and safety of remifentanil (R) alfentanil (A), remifentanil-midazolam (RM), and alfentanil-midazolam (AM) combinations in providing analgesia and sedation for bone marrow aspiration. ⋯ Remifentanil, alfentanil, remifentanil-midazolam, and alfentanil-midazolam combinations are effective in children and can be used safely in bone marrow aspiration which is a brief but painful procedure performed in the pediatric patient group.
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Paediatric anaesthesia · Mar 2005
Anesthesia for pediatric renal transplantation with and without epidural analgesia--a review of 7 years experience.
Few objective data exist describing current anesthesia practice for pediatric renal transplantation. We describe here, the experience from an Australian tertiary pediatric center that has continued an active pediatric renal transplantation program after relocation in 1995. Areas of interest include preoperative status, fluid management, hemodynamic stability, perioperative complications, and the use of epidural analgesia. In particular, the influence of perioperative epidural analgesia on hemodynamic stability is addressed. ⋯ Anesthesia for renal transplantation in pediatric patients at CHW is safe and effective using a selected range of drugs and techniques. Pretransplant medical optimization, careful preoperative assessment, adequate monitoring and precise fluid management together with appropriate postoperative analgesia typify the perioperative care of CHW renal transplant recipients.
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Paediatric anaesthesia · Mar 2005
Recombinant factor VIIa (NovoSeven) as a hemostatic agent after surgery for congenital heart disease.
Postoperative bleeding and blood product requirements can be substantial in children undergoing open-heart surgery, and reexploration is required in 1% of cases. Recombinant activated factor VII (rFVIIa, NovoSeven, NovoNordisk, Denmark) is a hemostatic agent approved for the treatment of hemophilic patients with inhibitors to factor VIII or factor IX. It has also been used with success in other conditions. We present our experience with rFVIIa treatment for uncontrolled bleeding after open-heart surgery in five pediatric patients. ⋯ These cases support the impression that RFVIIa is efficient and safe in correcting hemostasis in children after cardiopulmonary bypass when other means fail. However, the data are still limited, and more extensive research is needed.