Tight control of tidal volume using accurate monitoring may improve neonatal outcomes. However, respiratory function monitors incorporated in current anesthetic workstations are generally inaccurate at tidal volumes used for infants.
To determine if a specific respiratory function monitor for neonatal infants improved expired tidal volume delivery during anesthesia.
Childhood allergy is common, and increasing. Many children are incorrectly labeled as having allergy or adverse drug reactions. This can pose a dilemma for anesthetists and lead to a change in practice or drug selection. We review the pathophysiology of hypersensitivity reactions and the implications for anesthesia of food allergy, atopy, and family history of allergy in children. The epidemiology...
Diabetes mellitus is one of the most common endocrinopathies encountered in the perioperative period, and the pediatric population is increasingly using continuous subcutaneous insulin infusions for diabetes management. As these patients present for procedures or surgery requiring anesthesia, the anesthesia provider is charged with the task of managing these pumps perioperatively. Here, we review...
We report a complication from caudal epidural block for anesthesia in a 4‐year‐old child with Marfan syndrome who was undergoing lensectomy, orchidopexy, and circumcision resulting in apparent accidental dural puncture. Subsequent magnetic resonance imaging revealed a lumbosacral spinal meningeal cyst.
Studies of spinal anesthesia in children are limited to a reduced group of high‐risk patients and it remains relatively underused compared with general anesthesia in this age group in most institutions. In our experience, spinal anesthesia appears to be a good alternative to general anesthesia during pyloromyotomy in neonates and infants.
The purpose of this study was to retrospectively...
A living‐donor (adult) kidney transplantation in young children requires an increased cardiac output to maintain adequate perfusion of the relatively large kidney. To achieve this, protocols commonly advise liberal fluid administration guided by high target central venous pressure. Such therapy may lead to good renal outcomes, but the risk of tissue edema is substantial.
Manual propofol infusion regimens for neonates and infants have been determined from clinical observations in children under the age of 3 years undergoing anesthesia. We assessed the performance of these regimens using reported age‐specific pharmacokinetic parameters for propofol. Where performance was poor, we propose alternative dosing regimens.
Simulations using a reported general...
One‐lung ventilation is a challenging airway technique in the pediatric population. Multiple airway devices can be employed, but there is no consensus as to the most reliable and physiologically advantageous method. This report is a review of the methods of one‐lung ventilation in children in our practice, as well as an analysis of the impact of airway device type, patient age, and duration...
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