Blood Volume In Children Research Articles

The Effect of ringer Lactate as the Priming Solution of the Cardiopulmonary by Pass Circuit on Plasma Potassium Levels after Open Heart Surgery in Children

Background: Conduct of cardiopulmonary bypass (CPB) due to the higher volume of priming solution in comparison to the total blood volume in children requires careful consideration. Recently attention has been focused on the potential risk of hyperkalemia in these patients. Given its significant effects on cardiac rhythm, hyperkalemia is considered a medical emergency. In this cross-sectional study we aimed to determine the changes in K+ and other electrolytes following CPB in a pediatric cardiac surgery setting. Method: Sixty children scheduled for pediatric cardiac surgery weighing more than 5 kilograms with Hct level above 30% were enrolled. The prime solution used was Ringer-lactate. Venous blood were collected at defined time points: before, during and after CPB and at discharge. A p-value of less than 0.05 was considered statistically significant. Results: Mean age of the studied patients was 3.69±2.77 years. A rise in potassium levels during surgery was recorded. Also a significant difference in the potassium levels before surgery and at discharge were observed (p=0.007). A significant drop and a subsequent rise in the Hct level was seen overtime whereas a significant decrease in the PH and bicarbonate levels were detected. 31 experienced cardiac arrhythmia after undergoing CPB. Conclusion: A K+-free crystalloid that will offset the K+ load of stored blood is highly anticipated in these patients

Measurement of Blood Loss during Adenotonsillectomy in Children and Factors Affecting It

This prospective study was done at the Southern Railway Headquarters Hospital, Ayanavaram, Chennai to measure the intraoperative blood loss during adenotonsillectomy and to assess the factors affecting it. Since blood volume in children is low, even a small loss will result in dreaded complications, so blood loss measurement in paediatric surgery is important. Adenotonsillectomy is the most common surgery performed in the field of otolaryngology, so blood loss measurement is essential in this surgery. In the study, 50 children who underwent adenotonsillectomy, by conventional dissection and snare method for tonsillectomy and curette method for adenoidectomy, were evaluated for operative blood loss. This study was conducted over a 1 year period, from June 2013 to June 2014. Both gravimetric method and blood volume studies were used to measure the operative blood loss. The estimated blood loss by gravimetric method was 94.35 ml, whereas the actual blood loss by blood volume studies was 90.57 ml and the average blood loss was 92.46 ml. The youngest child who was operated was 4 years old and the oldest child was 15 years old. The minimum blood loss was 40.30 ml and the maximum was 278.46 ml. In our series, operative blood loss was dependent on fibrosis of tonsil and the grade of the tonsil. There was no significant correlation between age and sex of the patient and the surgical skills.

Hemodialysis for infants, children, and adolescents.

Children with chronic kidney disease stage 5 requiring dialysis can be treated by peritoneal or hemodialysis. In the United Kingdom nearly twice as many children receive peritoneal dialysis compared with hemodialysis. Technical aspects of pediatric hemodialysis are challenging and include the relative size of extracorporeal circuit and child's blood volume, assessment of adequacy,technical and complications of vascular access. Alternatives to standard hospital-based hemodialysis are also increasingly available. Optimizing nutritional status with the support of specialist pediatric dietitians is key to the management of children receiving hemodialysis. The effects of chronic illness on growth and school achievement, as well as the psychological, emotional, and social development of the child should not be underestimated. This review focuses on the above elements and highlights common pediatric practice in the United Kingdom.

Airways obstruction and pulmonary capillary blood volume in children with sickle cell disease

Airways obstruction and pulmonary capillary blood volume in children with sickle cell disease

Airways obstruction and pulmonary capillary blood volume in children with sickle cell disease

SummaryObjectives and Working Hypothesis Airways obstruction occurs in young children with sickle cell disease (SCD). Our aim was to test the hypothesis that increased pulmonary capillary blood volume at least in part explained the increased airways obstruction as this would inform which therapy might be most appropriate to treat the airway obstruction. Study design Observational study. Patient-subject selection Twenty-five SCD children and 25 ethnic origin matched controls were recruited. Methodology Respiratory system resistance, using impulse oscillometry at 5 Hz (R5 %pred), pulmonary capillary blood volume (Vc), alveolar volume (VA), and spirometry were assessed before and after bronchodilator (ipratropium bromide). Lung volume measurements were also made. Results The SCD children compared to the controls had a higher R5 %pred before (median 133 (range 88–181)% vs. 102 (83–184)%, P = 0.0046) and after (105 (79–150)% vs. 91 (64–147)%, P = 0.0489) bronchodilator and their median Vc/VA (ml/L) was higher before (26 (18–38) vs. 18 (14–28) P < 0.0001) and after (26 (19–41) vs. 18 (13–27) P < 0.0001) bronchodilator. There were similar decreases in R5 %pred post-bronchodilator in the two groups, but no significant changes in Vc/VA in either group. Vc/VA correlated significantly with R5 %pred in the SCD children only. Conclusions Increased pulmonary capillary blood volume contributes to the increased airways obstruction in children with SCD, hence, bronchodilators may be of limited benefit in reducing their airways obstruction. Pediatr Pulmonol. 2014; 49:716–722. © 2013 Wiley Periodicals, Inc.

Airways obstruction and pulmonary capillary blood volume in children with sickle cell disease

Airways obstruction occurs in young children with sickle cell disease (SCD). Our aim was to test the hypothesis that increased pulmonary capillary blood volume at least in part explained the increased airways obstruction as this would inform which therapy might be most appropriate to treat the airway obstruction. Observational study. Twenty-five SCD children and 25 ethnic origin matched controls were recruited. Respiratory system resistance, using impulse oscillometry at 5 Hz (R5 %pred), pulmonary capillary blood volume (Vc), alveolar volume (VA), and spirometry were assessed before and after bronchodilator (ipratropium bromide). Lung volume measurements were also made. The SCD children compared to the controls had a higher R5 %pred before (median 133 (range 88-181)% vs. 102 (83-184)%, P = 0.0046) and after (105 (79-150)% vs. 91 (64-147)%, P = 0.0489) bronchodilator and their median Vc/VA (ml/L) was higher before (26 (18-38) vs. 18 (14-28) P < 0.0001) and after (26 (19-41) vs. 18 (13-27) P < 0.0001) bronchodilator. There were similar decreases in R5 %pred post-bronchodilator in the two groups, but no significant changes in Vc/VA in either group. Vc/VA correlated significantly with R5 %pred in the SCD children only. Increased pulmonary capillary blood volume contributes to the increased airways obstruction in children with SCD, hence, bronchodilators may be of limited benefit in reducing their airways obstruction.

A reference frame for blood volume in children and adolescents

BackgroundOur primary purpose was to determine the normal range and variability of blood volume (BV) in healthy children, in order to provide reference values during childhood and adolescence. Our secondary aim was to correlate these vascular volumes to body size parameters and pubertal stages, in order to determine the best normalisation parameter.MethodsPlasma volume (PV) and red cell volume (RCV) were measured and F-cell ratio was calculated in 77 children with idiopathic nephrotic syndrome in drug-free remission (mean age, 9.8 ± 4.6 y). BV was calculated as the sum of PV and RCV. Due to the dependence of these values on age, size and sex, all data were normalised for body size parameters.ResultsBV normalised for lean body mass (LBM) did not differ significantly by sex (p < 0.376) or pubertal stage (p < 0.180), in contrast to normalisation for the other anthropometric parameters. There was no significant difference between reference values for children and adults.ConclusionLBM was the anthropometric index most closely correlated to vascular fluid volumes, independent of age, gender and pubertal stage.

Major hepatic tumor resection using profound hypothermia and circulation arrest

In spite of recent reports of more aggressive investigation and treatment of malignant liver tumors in infants and children, there is still an alarming morbidity and mortality in the operative aspect of this tumor. Our operative approach to partial hepatectomy follows that laid down by many authors, but we seem to have the same intraoperative problems in removing the huge tumor confined to one liver lobe. The blood loss in such operations may equal or exceed the child's blood volume while intraoperative cardiac arrest is not unknown. The bleeding can be most acute in the course of the retrohepatic caval and hepatic veins dissection. Once bleeding becomes excessive, the dissection must continue in a hurried fashion leading to the above problems. Since 1977, six children have been admitted to our hospital with huge malignant liver tumors involving almost all of one liver lobe and part of the other. Each was explored through a long midline abdominal incision finding what was felt to be a resectable liver tumor. The incision was then carried upwards via a sternal split or a right thoracoabdominal incision and the liver mobilized. The patient was then put on cardiopulmonary bypass and cooled to a rectal temperature below 20 degrees C. Circulation arrest at this low temperature provided 1 hr or less of bloodless dissection, and an extended hepatic lobectomy was easily carried out. The patients were rewarmed on bypass and normal hemodynamics restored. Bleeding from the liver edge was controlled and the remainder of the operation completed. What was previously the most difficult aspect of a liver tumor operation has become the easiest part of the entire procedure. This operative approach is recommended in highly selected large tumor cases.

Circulating blood volume in children

Circulating blood volume in children

Pulmonary diffusing capacity, membrane diffusing capacity, and capillary blood volume in children with intractable asthma with and without chronic overinflation of the lungs

Regression equations for pulmonary diffusing capacity (D LCO) were computed from data obtained on sixty-nine normal boys and fifty-seven normal girls, between the ages of 6 and 15. Similarly, equations were computed for pulmonary membrane diffusing capacity (D MCO) and capillary blood volume (Vc) from data obtained on forty-five normal boys and thirty-one normal girls. Ten children with intractable asthma with chronic overinflation had an increased pulmonary diffusing capacity and a markedly increased membrane diffusing capacity. These changes from the normal are statistically significant. The capillary blood volume is less than predicted but the difference is not statistically significant. Increased pulmonary diffusing capacity is a summation of a moderate increase in pulmonary surface area due to overinflation and a greater decrease in membrane thickness. Six children with intermittent overinflation had higher than predicted values for diffusing capacity and membrane diffusing capacity which were not significantly different, while the values for capillary blood volume were the same as the predicted. Ten children without overinflation had values the same as the predicted for diffusing capacity, membrane diffusing capacity, and capillary blood volume. Overinflation with increased surface area and thinner membranes does not appear to be affected by treatment with steroid drugs.

Studies of the total amount of hemoglobin and the blood volume in children. I. Determination of total hemoglobin and blood volume in normal children.

Studies of the total amount of hemoglobin and the blood volume in children. I. Determination of total hemoglobin and blood volume in normal children.