Perioperative Management Of Infants Research Articles

The Relationship Between Perioperative Blood Product Use and the Incidence of Postoperative Renal Injury in Infants Undergoing Cardiac Surgery

Cardiac Surgery Associated Acute Kidney Injury (CS-AKI) is a serious complication that occurs in patients following cardiac surgery. It is characterized by the rapid decline in kidney function, leading to potential long-term kidney damage or even kidney failure. CS-AKI is a significant health concern, as it not only prolongs hospital stays and recovery time but also increases the risk of mortality. This study, conducted as a prospective observational study, aimed to investigate the relationship between perioperative blood product use and the incidence of postoperative acute kidney injury (AKI) in infants and young children undergoing cardiac surgery. It examined the perioperative use of these blood products and its association with the occurrence of AKI. The findings of this study revealed a significant association between the use of red blood cell suspension and platelets and the development of postoperative AKI. This suggests that the administration of these blood products during cardiac surgery may increase the risk of kidney injury in infants and young children. However, it is important to note that the study did not find a statistically significant association between plasma transfusion volume and the incidence of AKI. This suggests that while the use of certain blood products may contribute to the risk of AKI, the volume of plasma transfused does not seem to have a significant impact. The findings of this study provide valuable insights into the perioperative management of infants and young children undergoing cardiac surgery. It underscores the importance of carefully considering the use of blood products during surgery and taking necessary measures to minimize the risk of AKI.

Current perioperative care of infants with pyloric stenosis: comparison of survey results

BackgroundConsiderable variation in the perioperative management of infants with pyloric stenosis (PS) led the authors to undertake a survey of pediatric anesthesiologists to determine if consensus-based guidelines could be developed. Materials and methodsPhysicians who are members of the Society for Pediatric Anesthesia or the Association of Pediatric Anaesthetists of Great Britain and Ireland completed an online questionnaire through SurveyMonkey regarding current management of patients with PS. ResultsThere were significant differences in the use of anticholinergic premedication, the selection of induction technique, and the use of adjuvant regional analgesia between the members of both organizations. ConclusionsThe authors recommend creating an international multiinstitutional registry to prospectively record and track perioperative management of patients with PS to facilitate the development of clinical practice guidelines.

Resuscitation and Perioperative Management of the High-risk Single Ventricle Patient: First-stage Palliation

Infants born with hypoplastic left heart syndrome or other lesions resulting in a single right ventricle face the highest risk of mortality among all forms of congenital heart disease. Before the modern era of surgical palliation, these conditions were universally lethal; recent refinements in surgical technique and perioperative management have translated into dramatic improvements in survival. Nonetheless, these infants remain at a high risk of morbidity and mortality, and an appreciation of single ventricle physiology is fundamental to the care of these high-risk patients. Herein, resuscitation and perioperative management of infants with hypoplastic left heart syndrome are reviewed. Basic neonatal and pediatric life support recommendations are summarized, and perioperative first-stage clinical management strategies are reviewed.

Anesthetic management of a 6 month-old infant for near total pancreatectomy with persistent hyperinsulinemic hypoglycemia

Anesthetic management of a 6 month-old infant for near total pancreatectomy with persistent hyperinsulinemic hypoglycemia

Perioperative management of children undergoing craniofacial reconstruction surgery: a practice survey

To assess current practices in the management of children undergoing craniofacial surgery and identify areas of significant practice variability with the intent to direct future research. The perioperative management of infants and children undergoing craniofacial reconstruction surgery can be challenging because of the routine occurrence of significant blood loss with associated morbidity. A variety of techniques have been described to improve the care for these children. It is presently unknown to what extent these practices are currently employed. A web-based survey was sent to representatives from 102 institutions. One individual per institution was surveyed to prevent larger institutions from being over-represented in the results. Requests to complete the survey were sent to 102 institutions; 48 surveys were completed. The survey was composed of two parts: management of infants undergoing strip craniectomies, and management of children undergoing major craniofacial reconstruction. Significant variability exists in the management of children undergoing these procedures; further study is required to determine the optimal management strategies. Clinical trials assessing the utility of central venous pressure and other hemodynamic monitoring modalities would enable evidence-based decision-making for monitoring in these children. The development of institutional transfusion thresholds should be encouraged, as there exists a body of evidence supporting their efficacy and safety.

Anesthesia for epilepsy surgery in children

The perioperative management of infants and children for epilepsy surgery should focus on the specific problems unique to the state of the disease, age of the child, and operative conditions. A basic understanding of age-dependent variables and the interaction of anesthetic and surgical procedures are essential in minimizing perioperative morbidity and mortality. Specific medical conditions that impact the conduct of anesthesia include congenital anomalies, chronic anticonvulsant therapies, and evolving coagulopathies. The neurosurgical procedure and neurophysiological monitoring will determine the type of anesthetic technique to be utilized during surgery. This review will provide a systematic approach to pediatric patients undergoing epilepsy surgery.

Usefulness of continuous monitoring of airway resistance and flow-volume curve in the perioperative management of infants with central airway obstruction: A case of vascular ring

Usefulness of continuous monitoring of airway resistance and flow-volume curve in the perioperative management of infants with central airway obstruction: A case of vascular ring

Perioperative management of infants with the linear naevus sebaceous syndrome of Jadassohn: a report of two cases

Neurofibromatosis and tuberous sclerosis are the most well-recognized of the congential phakomatoses, a group of six hereditary neuro-oculo-cutaneous disorders. Although easily diagnosed at birth by a parasagittal line of facial sebaceous naevi, the linear naevus sebaceous syndrome (LNSS) of Jadassohn is the rarest phakomatosis, one often characterized by airway and anaesthetic considerations that do not apply to the other phakomatoses. In addition to its obvious cutaneous manifestations, LNSS is characterized by hemifacial asymmetry, an anatomic predictor of difficult trachael intubation, and intractable seizure activity, a condition that limits selection of anaesthetics. The perioperative management challenges of LNSS are depicted in the presentation of two cases of LNSS with different outcomes and contrasted with the major anaesthetic considerations in the perioperative management of other, more common phakomatoses.

PEDIATRIC ANESTHESIA AND POSTOPERATIVE ANALGESIA

Children are not "small adults," particularly when it comes to anesthesia and pain management. The psychological and physiologic uniqueness of children must not be forgotten. Cooperation and communication between the anesthesiologist, surgeon, and pediatrician are essential for successful anesthesia and pain management. Pediatric anesthesiologists involved in the perioperative management of infants and children are very much a part of the "continuity of care" concept.

Intraoperative transesophageal echocardiography for pediatric patients with congenital heart disease.

Intraoperative transesophageal echocardiography for pediatric patients with congenital heart disease.