Pediatric Anesthesia最新文献

{"title":"Availability and Practice Patterns of Videolaryngoscopy and Adaptation of Apneic Oxygenation in Pediatric Anesthesia: A Cross-Sectional Survey of Pediatric Anesthesiologists.","authors":"Wenyu Bai, Prabhat Koppera, Yuan Yuan, Graciela Mentz, Bridget Pearce, Megan Therrian, Paul Reynolds, Sydney E S Brown","doi":"10.1111/pan.15079","DOIUrl":"https://doi.org/10.1111/pan.15079","url":null,"abstract":"<p><strong>Background: </strong>Videolaryngoscopy (VL) and apneic oxygenation are highly recommended and increasingly used in pediatric anesthesia practice; yet, availability, use in recommended clinical settings (e.g., neonates, airway emergencies, and out-of-operating-room tracheal intubation), and the association of VL availability with how pediatric anesthesiologists define difficult intubation have not been explored.</p><p><strong>Method: </strong>An electronic survey was distributed to the members of several international pediatric anesthesia societies to examine the availability and practice patterns of VL and to explore the criteria used to define a difficult tracheal intubation in children in the context of VL.</p><p><strong>Results: </strong>The response rate was 12.9%. VL was reported to be \"most likely available\" in main pediatric operating rooms and offsite locations 93% and 80.1% of the time, respectively. Fifty-seven percent of participants would select VL first when anticipating a difficult tracheal intubation; nearly 30% of respondents would choose direct laryngoscopy first and VL as a backup in this scenario. One-third of subjects would select VL as their first choice for nonoperating room (non-OR) emergency tracheal intubation and for premature or newborn infants, regardless of anticipated difficulty with intubation. Thirty percent of subjects reported using apneic oxygenation during difficult laryngoscopy. Institutional VL availability was not associated with how providers defined difficult tracheal intubation.</p><p><strong>Conclusion: </strong>VL is highly available, but the adoption of VL and apneic oxygenation for managing difficult tracheal intubation was lower than expected, given recent recommendations by pediatric anesthesia societies. There was heterogeneity in how difficult intubation was defined, resulting in a possible patient safety risk.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Dose Naltrexone for Pediatric Chronic Pain and Inflammatory States: Perioperative Considerations.","authors":"Henry Huang, D Chiamaka Ijebuonwu, Rodney Whitney, Karla Wyatt-Thompson","doi":"10.1111/pan.15070","DOIUrl":"https://doi.org/10.1111/pan.15070","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NARS1-Related Disorder-An Orphan Disease.","authors":"Neha Hasija, Jessica Lees","doi":"10.1111/pan.15071","DOIUrl":"https://doi.org/10.1111/pan.15071","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthetic-Sparing Effects of Dexmedetomidine in Children Receiving Total Intravenous Anaesthesia.","authors":"Robert J Starr, Le Roux Jacobs, Craig Lyons","doi":"10.1111/pan.15076","DOIUrl":"https://doi.org/10.1111/pan.15076","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authorship: The Editors' Perspective.","authors":"Andrew Davidson","doi":"10.1111/pan.15072","DOIUrl":"https://doi.org/10.1111/pan.15072","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetic and Physiological Concepts Relevant for Determining Sevoflurane Dose.","authors":"James D Morse, Brian J Anderson","doi":"10.1111/pan.15077","DOIUrl":"https://doi.org/10.1111/pan.15077","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of infusion line connection and infusion line characteristics on start-up fluid delivery from syringe infusion pumps used for microinfusion.","authors":"Markus Weiss, Pedro David Wendel-Garcia, Vincenzo Cannizzaro, Maren Kleine-Brueggeney","doi":"10.1111/pan.15031","DOIUrl":"10.1111/pan.15031","url":null,"abstract":"<p><strong>Background: </strong>Connecting an infusion line to a closed stopcock results in pressurization of fluid within the syringe infusion pump assembly leading to flow irregularities when opening the stopcock and activating the pump.</p><p><strong>Aims: </strong>It was the purpose of this study to assess the extent of pressurization under different conditions and its impact on start-up fluid delivery.</p><p><strong>Methods: </strong>Intraluminal pressures and start-up fluid delivery at 1 mL/h flow rate were assessed with connection of the infusion line 1 min (delayed connection) or immediately after purging (immediate connection) using two different infusion lines made from polyvinylchloride (PVC) or polyethylene (PE).</p><p><strong>Results: </strong>Delayed connection resulted in an increase of intraluminal pressures from zero to 5.1 [4.5 to 5.7] mmHg with the PVC line and from zero to 47.1 [44.8 to 49.3] mmHg with the PE line (mean difference 42.0 [95% CI 39.3-44.7] mmHg; p < .0001). Immediate connection resulted in an increase of intraluminal pressures from zero to 44.3 [41.8-46.8] mmHg with the PVC line and from zero to 61.3 [57.2-65.4] mmHg with the PE line (mean difference 17.0 [95% CI 11.8-22.2] mmHg; p < .0001). The increase in intraluminal pressures was significantly higher with PE lines for both delayed and immediate connection when compared to the PVC lines (mean difference 29.5 [95% CI 19.3-39.7] mmHg; p < .0001). Related fluid volumes delivered at 10 s and 360 s after starting the pump ranged from -252% to 1321% (10 s) of expected infusion volumes and from 59% to 129% (360 s), respectively.</p><p><strong>Conclusions: </strong>Both, timing of infusion line connection after purging and infusion line characteristics considerably affect intraluminal pressures and start-up fluid delivery when connecting a new syringe infusion pump assembly to a closed stopcock. Consecutive alterations in drug administration can have considerable hemodynamic consequences when dealing with catecholamine infusions in critically ill patients.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"118-124"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procedural sedation and analgesia in pediatric diagnostic and interventional radiology: Comment.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1111/pan.15026","DOIUrl":"10.1111/pan.15026","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"180"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Language and parental satisfaction during inpatient stay: A pilot survey study in a quaternary pediatric hospital.","authors":"Benjamin P Telicki, Karina Lukovits, Rachel Bernier, Amanda W Baier, Steven J Staffa, Viviane G Nasr","doi":"10.1111/pan.15035","DOIUrl":"10.1111/pan.15035","url":null,"abstract":"<p><strong>Background: </strong>Considering the significant volume of non-English speakers seeking medical care in the United States and the challenges they may encounter within the hospital environment, it is necessary to assess the satisfaction of non-English-speaking families during their hospital stays and to determine potential areas of improvement in order to optimize care.</p><p><strong>Aims: </strong>We aimed to evaluate and describe the satisfaction of Arabic-, Spanish-, and English-speaking families at a quaternary pediatric hospital. From the measures assessed, we sought to identify perceived strengths and weaknesses of the inpatient experience for families who spoke different languages. In doing so, we aimed to identify ways to improve the hospital experience for patients and their families.</p><p><strong>Methods: </strong>We created a 23-item satisfaction questionnaire that was vetted by the hospital's Global Services Department, professionally translated into Arabic and Spanish, and tested by native speakers. The survey contained questions pertaining to parent/guardian demographics, their experience with the hospital environment, and their care team or services. Using the questionnaire, we surveyed Arabic-, Spanish-, and English-speaking parents/guardians of post-procedural patients under 18 years of age in intensive care units (ICUs) and on inpatient floors.</p><p><strong>Results: </strong>A total of 162 surveys were collected with roughly equal distribution across the three language groups (52 Arabic, 53 Spanish, 57 English). We found no statistically significant difference in satisfaction scores across the three language groups, nor across self-reported English-proficient and non-English-proficient Arabic and Spanish respondents. In addition, there was no statistically significant difference in satisfaction between parents/guardians in ICUs and those on inpatient floors.</p><p><strong>Conclusions: </strong>This pilot survey suggests that inclusivity and availability of interpretation resources play a role in successfully creating an environment where both English and non-English speakers are satisfied. Further development and validation of the survey instrument should be performed, along with testing at other institutions.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"140-146"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol development and feasibility of the PEACH in Asia study: A pilot study on PEri-anesthetic morbidity in CHildren in Asia.","authors":"Soichiro Obara, Choon Looi Bong, Zehra Serpil Ustalar Ozgen, Shemila Abbasi, Ekta Rai, Evangeline K Villa, Andi Ade W Ramlan, Raihanita Zahra, Christopher Kapuangan, Komang Ayu Ferdiana, Ina Ismiarti Shariffuddin, Vivian Yuen, Elsa Varghese, Josephine S K Tan, Norifumi Kuratani","doi":"10.1111/pan.15034","DOIUrl":"10.1111/pan.15034","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive data on pediatric anesthesia outcomes, particularly severe critical events (SCEs), are scarce in Asia. This highlights the need for standardized research to assess anesthesia safety and quality in the diverse settings.</p><p><strong>Aims: </strong>The PEACH in Asia pilot study aimed to test the feasibility of a standardized protocol for investigating SCEs in anesthesia practices across Asia, evaluate the data acquisition processes, and determine the sample size for a main study.</p><p><strong>Methods: </strong>This multicenter pilot study involved ten institutions across nine Asian countries, including children from birth to 15 years undergoing diagnostic or surgical procedures. Data on SCEs were collected using standardized definitions. The study assessed the feasibility and estimated the sample size needed for the main study.</p><p><strong>Results: </strong>The pilot study enrolled 330 patients, with a SCE incidence of 12.4% (95% CI: 9.2-16.4%). Respiratory events were observed in 7.0% of cases, cardiovascular instability in 4.9%, and drug errors in 0.6%. Based on the SCE incidence observed in the pilot study, the estimated sample size required for the main study is at least 10 958 patients. The pilot study demonstrated the feasibility of the study protocol but identified several challenges, particularly in resource-limited settings. These challenges included a significant burden associated with data collection, technical issues with electronic case report forms (e-CRFs), variability in patient enrollment across institutions (ranging from 4 to 86 patients per site), and incomplete data acquisition (24.8% of height data and 9.7% of disposition data were missing).</p><p><strong>Conclusions: </strong>The PEACH in Asia pilot study successfully validated a protocol for investigating SCEs in pediatric anesthesia across Asia. Addressing the challenges identified in the pilot study will be crucial for generating robust data to improve pediatric anesthesia safety in the region. Key issues to address include improving data collection methods, resolving e-CRF technical difficulties, and ensuring consistent institutional support.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":"125-139"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}