Paediatric anaesthesia
-
Paediatric anaesthesia · Aug 2004
Comparative StudyCuff compliance of pediatric and adult cuffed tracheal tubes: an experimental study.
Tracheal mucosal damage related to tracheal intubation has been widely described in pediatric and adult patients. High volume-low pressure cuffs (HVLPC) are being advertised as safe to avoid this particularly unpleasant complication. Compliances of these supposed pediatric and adult HVLPC are not mentioned by manufacturers and still remain unknown. ⋯ We conclude that the tested tracheal tube cuffs have low compliance and cannot be defined as high volume-low pressure.
-
Paediatric anaesthesia · Aug 2004
Clinical TrialEndoscopic intratracheal carbon dioxide measurements during pediatric flexible bronchoscopy.
CO2 monitoring is recommended for thoracic telescopic procedures and for spontaneous breathing general anesthesia in children. During flexible bronchoscopy (FB) in children, the various currently available methods of CO2 measurements are limited. The CO2 falls and increases have been reported in FB but it is unknown whether airway lesions predispose to CO2 change. The aim of this study was to describe and validate endoscopic intratracheal CO2 measurements in children undergoing FB under spontaneously breathing GA. ⋯ Midtracheal P(E)CO2 provides a useful estimate of P(a)CO2 for monitoring the respiratory status of children undergoing FB. The presence of airway lesions rather than age is associated with significant increased PCO2 rise.
-
Infants placed on extracorporeal membrane oxygenation (ECMO) or mechanical ventilation often need continuous morphine infusions for pain relief and sedation. The resulting physical dependence requires an additional 2-3-week hospital stay to taper the morphine to avoid withdrawal. Buprenorphine effectively blocks abstinence in dependent adults, and in infants it could accelerate or eliminate the tapering schedule, thereby enabling earlier hospital dismissals. ⋯ Buprenorphine may prove to be a suitable drug for treating opioid withdrawal in human infants.