Articles: child.
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Paediatric anaesthesia · May 2024
Randomized Controlled TrialDexmedetomidine and magnesium sulfate in preventing junctional ectopic tachycardia after pediatric cardiac surgery.
Junctional ectopic tachycardia (JET) is a serious tachyarrhythmia following pediatric cardiac surgery. It isn't easy to treat and better to be prevented. This study aimed to examine the prophylactic effects of dexmedetomidine, MgSO4, or their combination in reducing JET following pediatric open cardiac surgery. ⋯ Dexmedetomidine alone or combined with MgSO4 had a therapeutic role in the prevention of JET in children after congenital heart surgery.
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The aim of this study was to assess the association between whole blood (WB) and mortality among injured children who received immediate blood transfusion. ⋯ The use of WB was associated with improved survival among injured pediatric patients requiring immediate transfusion.
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High-density electroencephalographic (EEG) monitoring remains underutilized in clinical anesthesia, despite its obvious utility in unraveling the profound physiologic impact of these agents on central nervous system functioning. In school-aged children, the routine practice of rapid induction with high concentrations of inspiratory sevoflurane is commonplace, given its favorable efficacy and tolerance profile. However, few studies investigate topographic EEG during the critical timepoint coinciding with loss of responsiveness-a key moment for anesthesiologists in their everyday practice. The authors hypothesized that high initial sevoflurane inhalation would better precipitate changes in brain regions due to inhomogeneities in maturation across three different age groups compared with gradual stepwise paradigms utilized by other investigators. Knowledge of these changes may inform strategies for agent titration in everyday clinical settings. ⋯ High initial concentration sevoflurane induction causes large-scale topographic effects on the pediatric EEG. Within the minute after unresponsiveness, this dosage may perturb EEG activity in children to an extent where age-related differences are not discernible.
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Meta Analysis
The association between parent mental health and pediatric chronic pain: a systematic review and meta-analysis.
Mental health problems are common among parents of children with chronic pain and associated with worse outcomes for the child with chronic pain. However, the effect sizes of these associations between parent mental health and pediatric chronic pain vary widely across studies. The aim of this systematic review and meta-analysis was to generate pooled estimates of the (1) prevalence of mental health problems among parents of children with chronic pain and (2) associations between parent mental health and the (2a) presence of child chronic pain and (2b) functioning of children with chronic pain. ⋯ Poorer parent mental health was significantly associated with the presence of chronic pain (anxiety: OR = 1.91 [1.51-2.41]; depression: OR = 1.90 [1.51-2.38]; general distress: OR = 1.74 [1.47-2.05]) and worse related functioning (ie, pain intensity, physical functioning, anxiety and depression symptoms; r s = 0.10-0.25, all P s < 0.05) in children. Moderator analyses were generally nonsignificant or could not be conducted because of insufficient data. Findings support the importance of addressing parent mental health in the prevention and treatment of pediatric chronic pain.
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Suicide is among the leading causes of death in U.S. youth. Rural residency is a risk factor, but suicide variability by race/ethnicity is more nuanced. Early detection of suicidal ideation and intent are key components of prevention, but to the authors' knowledge, few prior studies have examined how rurality and race interact on youth suicidality. This study examined suicidality between White non-Hispanic versus non-White or Hispanic youth, as well as those who lived in rural versus non-rural areas. ⋯ Racial/ethnic minority youth who lived in rural areas were more likely to experience suicidality as compared to their non-rural counterparts. Larger prospective studies are needed to identify causal elements of the rural environment that may hasten racial disparities in youth suicidality.