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  • 1
    Electronic Resource
    Electronic Resource
    Single lung ventilation in children using a new paediatric bronchial blocker (2002)
    Oxford UK : Blackwell Science Ltd.
    Pediatric anesthesia 12 (2002), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: As video-assisted thoracoscopic surgery has become more common in paediatric patients, the use of single lung ventilation in children has also increased. Single lung ventilation in young children is performed by either advancing a tracheal tube into the mainstem bronchus opposite the side of surgery or by positioning a bronchial blocker into the mainstem bronchus on the operative side. Techniques for placing a variety of bronchial blockers outside the tracheal tube have been described. We describe a technique for placement of a new bronchial blocker through an indwelling tracheal tube using a multiport adaptor and a fibreoptic bronchoscope.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2002.00818.x
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  • 2
    Electronic Resource
    Electronic Resource
    Anaesthesia for liver transplantation in children (2001)
    Oxford UK : Blackwell Science Ltd
    Pediatric anesthesia 11 (2001), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2001.00541.x
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  • 3
    Electronic Resource
    Electronic Resource
    A comparison of three methods for estimating appropriate tracheal tube depth in children (2005)
    Oxford, UK : Blackwell Science Ltd
    Pediatric anesthesia 15 (2005), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Estimating appropriate tracheal tube (TT) depth following tracheal intubation in infants and children presents a challenge to anesthesia practitioners. We evaluated three methods commonly used by anesthesiologists to determine which one most reliably results in appropriate positioning.Methods:  After IRB approval, 60 infants and children scheduled for fluoroscopic procedures requiring general anesthesia were enrolled. Patients were randomly assigned to one of three groups: (1) deliberate mainstem intubation with subsequent withdrawal of the TT 2 cm above the carina (‘mainstem’ method); (2) alignment of the double black line marker near the TT tip at the vocal cords (‘marker’ method); or (3) placement of the TT at a depth determined by the formula: TT depth (cm) = 3 × TT size (mmID) (‘formula’ method). TT tip position was determined to be ‘appropriate’ if located between the sternoclavicular junction (SCJ) and 0.5 cm above the carina as determined by fluoroscopy. Risk ratios were calculated, and data were analysed by the chi-square test accepting statistical significance at P 〈 0.05.Results:  The mainstem method was associated with the highest rate of appropriate TT placement (73%) compared with both the marker method (53%, P = 0.03, RR = 1.56) and the formula method (42%, P = 0.006, RR = 2.016). There was no difference between the marker and formula methods overall (P = 0.2, RR = 1.27). Analysis of age-stratified data demonstrated higher success with the marker method compared with the formula method for patients 3–12 months (P = 0.0056, RR = 4.0).Conclusions:  Deliberate mainstem intubation most reliably results in appropriate TT depth in infants and children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1460-9592.2005.01577.x
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  • 4
    Electronic Resource
    Electronic Resource
    Single-lung ventilation in infants and children (2004)
    Oxford, UK : Blackwell Publishing Ltd
    Pediatric anesthesia 14 (2004), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: During the past decade, the use of video-assisted thoracoscopic surgery (VATS) has dramatically increased in children as well as adults. Although VATS can be performed while both lungs are being ventilated, single-lung ventilation (SLV) is desirable during VATS. In addition, anaesthesiologists are performing (and paediatric surgeons are requesting) SLV more frequently for open thoracotomies in infants and children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.01197.x
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  • 5
    Electronic Resource
    Electronic Resource
    Differential lung ventilation in infants and children with pulmonary hyperinflation (2003)
    Oxford, UK : Blackwell Science Ltd
    Pediatric anesthesia 13 (2003), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.01086.x
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  • 6
    Electronic Resource
    Electronic Resource
    Prolonged infusion of dexmedetomidine for sedation following tracheal resection (2005)
    Oxford, UK : Blackwell Science Ltd
    Pediatric anesthesia 15 (2005), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Dexmedetomidine is a centrally acting alpha-2 adrenergic agonist that is currently approved by the US Food and Drug Administration for short-term use (≤24 h) to provide sedation in adults in the ICU. This drug has been shown to be efficacious in adult medical and surgical patients in providing sedation, anxiolysis, and analgesia. Dexmedetomidine has been associated with rapid onset and offset, hemodynamic stability, and a natural, sleep-like state in mechanically ventilated adults. To date, there are few publications of the use of this drug in children, and prolonged infusion has not been described. We report our use of dexmedetomidine in a child during a 4-day period of mechanical ventilation following tracheal reconstruction for subglottic stenosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1460-9592.2005.01656.x
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  • 7
    Electronic Resource
    Electronic Resource
    Anaesthetic management for the child with a mediastinal mass (2004)
    Oxford, UK : Blackwell Publishing Ltd
    Pediatric anesthesia 14 (2004), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Administering anaesthesia to a child with an anterior mediastinal mass may lead to respiratory or circulatory collapse, even in those without symptoms. Institutions should have algorithms to manage children with mediastinal masses. Preoperative evaluations should include computed tomography, echocardiography and flow-volume studies. Anaesthesia may be induced with inhalation agents and maintained with spontaneous respiration via facemask or laryngeal mask airway. Alternatively, positive-pressure ventilation may be used, including tracheal intubation without muscle relaxants. Rigid bronchoscopy may be life-saving in the event of tracheal or bronchial collapse under anaesthesia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.01196.x
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  • 8
    Electronic Resource
    Electronic Resource
    A technique for maintenance of airway access in infants with a difficult airway following tracheal extubation (2001)
    Oxford UK : Blackwell Science Ltd
    Pediatric anesthesia 11 (2001), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Tracheal extubation of patients with a difficult airway represents a challenge to anaesthesiologists and intensive care physicians. While a variety of techniques designed to maintain access to the airway in case of the need for tracheal reintubation have been described in adults, no reports have been published in infants and young children. We describe an approach to this issue in a young child with severe micrognathia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2001.00729.x
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  • 9
    Electronic Resource
    Electronic Resource
    Determination of the median effective concentration (EC50) of propofol during oesophagogastroduodenoscopy in children (2001)
    Oxford UK : Blackwell Science Ltd
    Pediatric anesthesia 11 (2001), S. 0 
    Details
    ISSN: 1460-9592
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Propofol is commonly used to provide anaesthesia for children undergoing oesophagogastroduodenoscopy (OGD). Despite this, the plasma concentration–response relationships for propofol used in this setting have not been established. Methods: In order to determine the EC50 of propofol during OGD, we studied 12 children aged 3–10 years. No premedication was given. Propofol was administered via a target-controlled infusion system using the STANPUMP software based on a paediatric pharmacokinetic model. The ‘up-and-down’ method described by Dixon was used to determine the EC50. Accordingly, the target plasma propofol concentration for each patient, beginning with the second subject, was determined by the response of the previous patient. A patient was considered a ‘responder’ if there was minimal movement and the heart rate (HR) and blood pressure (BP) remained ≤ 120% of baseline during the procedure. Patients who moved excessively, i.e. requiring more than gentle restraint, or who manifest HR and BP 〉120% of baseline, were considered ‘nonresponders’. Results: The EC50 of propofol during OGD was 3.55 μg·ml–1 in this study. Conclusions: The plasma propofol concentration associated with adequate anaesthesia for OGD in 50% of unpremedicated children is 3.55 μg·ml–1. This concentration is higher than that required for OGD in adult patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2001.00731.x
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  • 10
    Electronic Resource
    Electronic Resource
    Bladder augmentation can be problematic with renal failure and transplantation (1997)
    Springer
    Pediatric nephrology 11 (1997), S. 672-675 
    Details
    ISSN: 1432-198X
    Keywords: Key words: Bladder augmentation ; Renal failure ; Transplantation ; End-stage renal disease ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Ten consecutive patients with failure of urinary bladder augmentation (UBA) performed either prior to or after reaching end-stage renal disease (ESRD) were studied. Seven patients developed increased hydroureteronephrosis, infectious complications, and advanced to ESRD after UBA. The mean time to development of ESRD in patients who had UBA performed with moderate chronic renal failure (CRF) was 1.8 years. The UBAs in all seven patients were taken down prior to transplantation. Subsequently, five of these UBA-takedown patients have received kidney grafts and all have stable, good renal function. Three patients had their UBA performed after they reached ESRD, in preparation for renal transplantation. All three of these patients experienced recurrent urosepsis following transplantation, resulting in death in one patient and loss of graft in another. The third patient will undergo takedown of the UBA. This study suggests that UBA may possibly not be the best option for patients with moderate CRF and those awaiting transplantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004670050362
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