Preoperative fasting is part of routine practice. Children subjected to prolonged preoperative fasting often suffer adverse effects. Consuming a preoperative lollipop may lessen their anxiety and have clinical benefits.
{"title":"Effect of a carbohydrate lollipop on the gastric volume of fasted pediatric patients","authors":"P. Odendaal, Annemie Burke, J. Coetzee","doi":"10.1111/pan.14479","DOIUrl":"https://doi.org/10.1111/pan.14479","url":null,"abstract":"Preoperative fasting is part of routine practice. Children subjected to prolonged preoperative fasting often suffer adverse effects. Consuming a preoperative lollipop may lessen their anxiety and have clinical benefits.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133493322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Susan R. Vishneski, Amit K Saha, Madeline R Fram, Leah B Templeton, Lisa K. Lee, D. Ririe, Eduardo J. Goenaga‐Díaz, L. D. Smith, T. Templeton
The prevalence and risk factors for residual neuromuscular blockade in children remain poorly characterized. We hypothesize that specific patient and anesthetic risk factors may be associated with the administration of additional reversal in children following initial reversal of rocuronium with neostigmine.
{"title":"Risk factors for administration of additional reversal following neuromuscular blockade with rocuronium in children: A retrospective case–control study","authors":"Susan R. Vishneski, Amit K Saha, Madeline R Fram, Leah B Templeton, Lisa K. Lee, D. Ririe, Eduardo J. Goenaga‐Díaz, L. D. Smith, T. Templeton","doi":"10.1111/pan.14463","DOIUrl":"https://doi.org/10.1111/pan.14463","url":null,"abstract":"The prevalence and risk factors for residual neuromuscular blockade in children remain poorly characterized. We hypothesize that specific patient and anesthetic risk factors may be associated with the administration of additional reversal in children following initial reversal of rocuronium with neostigmine.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"130 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122677223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Walker, T. Engelhardt, N. Ahmad, N. Dobby, Sridevi Nuria Peter Alison Michelle Sam De Prakash L Amaki Kuchi Masip Brooks Hare Casey Silva Krishnan Sogbo, Sridevi Kuchi, N. Masip, P. Brooks, A. Hare, M. Casey, Sam De Silva, P. Krishnan, L. A. Sogbodjor, Ellie Walker, Stephanie King, Katy Nicholson, Michelle Quinney, P. Stevens, A. Blevin, Mariangela Giombini, C. Goonasekera, Sadia Adil, S. Bew, Carole Bodlani, D. Gilpin, S. Jinks, N. Malarkkan, A. Miskovic, R. Pad, Juliet W Barry, Joy Abbott, J. Armstrong, Natalie A M Cooper, Lindsay Crate, J. Emery, K. James, H. King, Paul Martin, S. S. Catenacci, R. Bomont, Paul D Smith, S. Mele, A. Verzelloni, P. Dix, Graham Bell, Elena Gordeva, L. McKee, Esther Ngan, J. Scheffczik, Liyue Tan, M. Worrall, Carmel Cassar, K. Goddard, Victoria Barlow, V. Oshan, Khairi Shah, Sarah Bell, L. Daniels, M. Gandhi, David Pachter, C. Perry, Andrew Robertson, C. Scott, Lynne Waring, David Barnes, S. Childs, Joanne Norman, R. Sunderland, N. Disma, F. Veyckemans, K. Virág, T. Hans
The NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) prospective observational study reported critical events requiring intervention during 35.2% of 6542 anesthetic episodes in 5609 infants up to 60 weeks postmenstrual age. The United Kingdom (UK) was one of 31 participating countries.
{"title":"Perioperative critical events and morbidity associated with anesthesia in early life: Subgroup analysis of United Kingdom participation in the NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) prospective multicenter observational study","authors":"S. Walker, T. Engelhardt, N. Ahmad, N. Dobby, Sridevi Nuria Peter Alison Michelle Sam De Prakash L Amaki Kuchi Masip Brooks Hare Casey Silva Krishnan Sogbo, Sridevi Kuchi, N. Masip, P. Brooks, A. Hare, M. Casey, Sam De Silva, P. Krishnan, L. A. Sogbodjor, Ellie Walker, Stephanie King, Katy Nicholson, Michelle Quinney, P. Stevens, A. Blevin, Mariangela Giombini, C. Goonasekera, Sadia Adil, S. Bew, Carole Bodlani, D. Gilpin, S. Jinks, N. Malarkkan, A. Miskovic, R. Pad, Juliet W Barry, Joy Abbott, J. Armstrong, Natalie A M Cooper, Lindsay Crate, J. Emery, K. James, H. King, Paul Martin, S. S. Catenacci, R. Bomont, Paul D Smith, S. Mele, A. Verzelloni, P. Dix, Graham Bell, Elena Gordeva, L. McKee, Esther Ngan, J. Scheffczik, Liyue Tan, M. Worrall, Carmel Cassar, K. Goddard, Victoria Barlow, V. Oshan, Khairi Shah, Sarah Bell, L. Daniels, M. Gandhi, David Pachter, C. Perry, Andrew Robertson, C. Scott, Lynne Waring, David Barnes, S. Childs, Joanne Norman, R. Sunderland, N. Disma, F. Veyckemans, K. Virág, T. Hans","doi":"10.1111/pan.14457","DOIUrl":"https://doi.org/10.1111/pan.14457","url":null,"abstract":"The NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE) prospective observational study reported critical events requiring intervention during 35.2% of 6542 anesthetic episodes in 5609 infants up to 60 weeks postmenstrual age. The United Kingdom (UK) was one of 31 participating countries.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132637323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. W. Madsen, M. K. Sørensen, P. Cromhout, C. Sølling, Marianne Berntsen, Kirsten Møller, S. Berg
An increasing number of children undergo magnetic resonance imaging requiring anesthesia or sedation to ensure their immobility; however, magnetic resonance imaging may increase body temperature whereas sedation or anesthesia may decrease it. We investigated changes in body temperature in children who underwent sedation or anesthesia for magnetic resonance imaging.
{"title":"Temperature change in children undergoing magnetic resonance imaging—An observational cohort study","authors":"T. W. Madsen, M. K. Sørensen, P. Cromhout, C. Sølling, Marianne Berntsen, Kirsten Møller, S. Berg","doi":"10.1111/pan.14450","DOIUrl":"https://doi.org/10.1111/pan.14450","url":null,"abstract":"An increasing number of children undergo magnetic resonance imaging requiring anesthesia or sedation to ensure their immobility; however, magnetic resonance imaging may increase body temperature whereas sedation or anesthesia may decrease it. We investigated changes in body temperature in children who underwent sedation or anesthesia for magnetic resonance imaging.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127475684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christine G Jette, Tammy Wang, E. Wang, Janice Y Man, Samuel Mireles, Birgit Maass, Roshni Mathew, B. Pinsky, R. Claure, G. D'souza
In order to prevent in‐hospital transmission and potential complications related to SARS‐CoV‐2 in the perioperative patient, most healthcare institutions require preoperative testing for SARS‐CoV‐2 prior to proceeding with elective surgery. The Centers for Disease Control and Prevention (CDC) recommends a time and symptom‐based duration of isolation for the presumed infectious period. The guidance to avoid retesting of asymptomatic patients in the 90 days following a positive reverse transcription polymerase chain reaction (RT‐PCR) test is because of the possibility of detection of non‐infectious viral shedding. When to reschedule asymptomatic patients who test RT‐PCR positive for SARS‐CoV‐2 preoperatively is of considerable debate, both from the perspective of ensuring a patient's full preoperative fitness, as well as reducing the risk of viral transmission within the hospital. We describe the novel perioperative use of a strand‐specific assay to detect minus strand ribonucleic acid (RNA) in a clinical decision‐making algorithm to determine optimal timing of elective surgery after a patient tests RT‐PCR positive for SARS‐CoV‐2. This is the first description in the literature of an attempt to further stratify patients who repeatedly test positive for SARS‐CoV‐2 into infectious versus non‐infectious for perioperative planning.
{"title":"Novel utilization of strand‐specific reverse transcription polymerase chain reaction in perioperative clinical decision making for SARS‐CoV‐2 polymerase chain reaction positive patients","authors":"Christine G Jette, Tammy Wang, E. Wang, Janice Y Man, Samuel Mireles, Birgit Maass, Roshni Mathew, B. Pinsky, R. Claure, G. D'souza","doi":"10.1111/pan.14448","DOIUrl":"https://doi.org/10.1111/pan.14448","url":null,"abstract":"In order to prevent in‐hospital transmission and potential complications related to SARS‐CoV‐2 in the perioperative patient, most healthcare institutions require preoperative testing for SARS‐CoV‐2 prior to proceeding with elective surgery. The Centers for Disease Control and Prevention (CDC) recommends a time and symptom‐based duration of isolation for the presumed infectious period. The guidance to avoid retesting of asymptomatic patients in the 90 days following a positive reverse transcription polymerase chain reaction (RT‐PCR) test is because of the possibility of detection of non‐infectious viral shedding. When to reschedule asymptomatic patients who test RT‐PCR positive for SARS‐CoV‐2 preoperatively is of considerable debate, both from the perspective of ensuring a patient's full preoperative fitness, as well as reducing the risk of viral transmission within the hospital. We describe the novel perioperative use of a strand‐specific assay to detect minus strand ribonucleic acid (RNA) in a clinical decision‐making algorithm to determine optimal timing of elective surgery after a patient tests RT‐PCR positive for SARS‐CoV‐2. This is the first description in the literature of an attempt to further stratify patients who repeatedly test positive for SARS‐CoV‐2 into infectious versus non‐infectious for perioperative planning.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130158227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Ballard, J. Hajduk, E. Cheon, M. King, J. Barsuk
Pediatric intravenous catheter insertion can be difficult in the operating room due to the technical challenges of small diameter vessels and the need to rapidly gain intravenous access in anesthetized children. Few studies have examined factors associated with difficult vascular access in the operating room, especially accounting for the increased possibility to use ultrasound guidance.
{"title":"Clinical and demographic factors associated with pediatric difficult intravenous access in the operating room","authors":"H. Ballard, J. Hajduk, E. Cheon, M. King, J. Barsuk","doi":"10.1111/pan.14438","DOIUrl":"https://doi.org/10.1111/pan.14438","url":null,"abstract":"Pediatric intravenous catheter insertion can be difficult in the operating room due to the technical challenges of small diameter vessels and the need to rapidly gain intravenous access in anesthetized children. Few studies have examined factors associated with difficult vascular access in the operating room, especially accounting for the increased possibility to use ultrasound guidance.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132462198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Keunen, N. S. Sperna Weiland, B. D. de Bakker, L. D. de Vries, M. Stevens
Neonatal surgery and concomitant anesthesia coincide with a timeframe of rapid brain development. The speed and complexity of early brain development superimposed on immature regulatory mechanisms that include incomplete cerebral autoregulation, insufficient free radical scavenging and an immature immune response puts the brain at risk. Brain injury may have long‐term consequences for multiple functional domains including cognition, learning skills, and behavior. Neurodevelopmental follow‐up studies have noted mild‐to‐moderate deficits in children who underwent major neonatal surgery and related anesthesia. The present review evaluates neonatal surgery against the background of neurobiological processes that unfold at a pace unparalleled by any other period of human brain development. First, a structured summary of early brain development is provided in order to establish theoretical groundwork. Next, literature on brain injury and neurodevelopmental outcome after neonatal surgery is discussed. Special attention is given to recent findings of structural brain damage reported after neonatal surgery. Notably, high‐quality imaging data acquired before surgery are currently lacking. Third, mechanisms of injury are interrogated taking the perspective of early brain development into account. We propose a novel disease model that constitutes a triad of inflammation, vascular immaturity, and neurotoxicity of prolonged exposure to anesthetic drugs. With each of these components exacerbating the other, this amalgam incites the perfect storm, resulting in brain injury. When examining the brain, it seems intuitive to distinguish between neonates (i.e., <60 postconceptional weeks) and more mature infants, multiple and/or prolonged anesthesia exposure and single, short surgery. This review culminates in an outline of anesthetic considerations and future directions that we believe will help move the field forward.
{"title":"Impact of surgery and anesthesia during early brain development: A perfect storm","authors":"K. Keunen, N. S. Sperna Weiland, B. D. de Bakker, L. D. de Vries, M. Stevens","doi":"10.1111/pan.14433","DOIUrl":"https://doi.org/10.1111/pan.14433","url":null,"abstract":"Neonatal surgery and concomitant anesthesia coincide with a timeframe of rapid brain development. The speed and complexity of early brain development superimposed on immature regulatory mechanisms that include incomplete cerebral autoregulation, insufficient free radical scavenging and an immature immune response puts the brain at risk. Brain injury may have long‐term consequences for multiple functional domains including cognition, learning skills, and behavior. Neurodevelopmental follow‐up studies have noted mild‐to‐moderate deficits in children who underwent major neonatal surgery and related anesthesia. The present review evaluates neonatal surgery against the background of neurobiological processes that unfold at a pace unparalleled by any other period of human brain development. First, a structured summary of early brain development is provided in order to establish theoretical groundwork. Next, literature on brain injury and neurodevelopmental outcome after neonatal surgery is discussed. Special attention is given to recent findings of structural brain damage reported after neonatal surgery. Notably, high‐quality imaging data acquired before surgery are currently lacking. Third, mechanisms of injury are interrogated taking the perspective of early brain development into account. We propose a novel disease model that constitutes a triad of inflammation, vascular immaturity, and neurotoxicity of prolonged exposure to anesthetic drugs. With each of these components exacerbating the other, this amalgam incites the perfect storm, resulting in brain injury. When examining the brain, it seems intuitive to distinguish between neonates (i.e., <60 postconceptional weeks) and more mature infants, multiple and/or prolonged anesthesia exposure and single, short surgery. This review culminates in an outline of anesthetic considerations and future directions that we believe will help move the field forward.","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132528231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mitchell Phillips, H. Ballard, N. Volpe, C. Lemoine, R. Superina, E. Cheon
There is substantial evidence that prolonged mechanical ventilation after surgery leads to longer intensive care unit (ICU) and hospital length of stay (LOS). 1 However, there is a paucity of data regard ing interstage extubation in pediatric patients undergoing staged procedures. Congenital portosystemic (CPSS) are a condition in which venous splanchnic the and drains directly into the systemic circulation. At our institution, a two- stage procedure is performed for cases which are not amenable to embolization in the interventional radiology suite. The venous malformation is par tially occluded, and the patient is then transferred to the ICU with a temporary abdominal closure. Over approximately 5 days, the por tal system is given to expand to accommodate the extra blood If the portal pressure is deemed to be acceptable on venogram, the patient returns to the operating for permanent 2
{"title":"A retrospective cohort study of pediatric patients undergoing staged laparotomy with interstage extubation","authors":"Mitchell Phillips, H. Ballard, N. Volpe, C. Lemoine, R. Superina, E. Cheon","doi":"10.1111/pan.14432","DOIUrl":"https://doi.org/10.1111/pan.14432","url":null,"abstract":"There is substantial evidence that prolonged mechanical ventilation after surgery leads to longer intensive care unit (ICU) and hospital length of stay (LOS). 1 However, there is a paucity of data regard ing interstage extubation in pediatric patients undergoing staged procedures. Congenital portosystemic (CPSS) are a condition in which venous splanchnic the and drains directly into the systemic circulation. At our institution, a two- stage procedure is performed for cases which are not amenable to embolization in the interventional radiology suite. The venous malformation is par tially occluded, and the patient is then transferred to the ICU with a temporary abdominal closure. Over approximately 5 days, the por tal system is given to expand to accommodate the extra blood If the portal pressure is deemed to be acceptable on venogram, the patient returns to the operating for permanent 2","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124598673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Kurth, S. Nicolson, D. Cohen, J. Steven, A. Costarino
{"title":"In memory of Dr. John J. \"Jack\" Downes.","authors":"C. Kurth, S. Nicolson, D. Cohen, J. Steven, A. Costarino","doi":"10.1111/pan.14397","DOIUrl":"https://doi.org/10.1111/pan.14397","url":null,"abstract":"","PeriodicalId":281130,"journal":{"name":"Paediatric anaesthesia","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114172398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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