Pediatric Anesthesia最新文献

{"title":"Perspectives on Starting a Pediatric Spinal Anesthesia Program.","authors":"Alina Lazar, Alexander B Froyshteter, Ashlee E Holman, Emmett E Whitaker","doi":"10.1111/pan.15141","DOIUrl":"https://doi.org/10.1111/pan.15141","url":null,"abstract":"<p><p>The use of spinal anesthesia as an alternative to general anesthesia for infants has seen a significant resurgence in recent years, but achieving its successful implementation at an institutional level is not without challenges. This manuscript provides a structured approach to establishing a pediatric spinal anesthesia program, with emphasis on identifying implementation champions, careful preparation, stakeholder engagement, and quality control to ensure a successful and sustainable initiative. The key to success lies in creating an early blueprint for the process, with a focus on ensuring procedural success early on via thorough preparation and careful selection of patients within an initial pilot program. Successful expansion of the program depends on the implementation of robust staffing models and proactive efforts to educate staff and maintain adherence to established protocols.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258671","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":"Detection of Nociceptive Stimuli Using the Newborn Infant Parasympathetic Evaluation Index in Children Aged From 3 to 18 Years.","authors":"Frantisek Kolek, Jakub Jonas, Tomas Vymazal","doi":"10.1111/pan.15129","DOIUrl":"https://doi.org/10.1111/pan.15129","url":null,"abstract":"<p><strong>Background: </strong>One option to objectively monitor patient stress response is to measure parasympathetic nervous system tone using respiratory arrhythmia analysis. The Newborn Infant Parasympathetic Evaluation (NIPE) Index has been developed for children younger than 2 years of age, and reliability has been confirmed by several studies.</p><p><strong>Aims: </strong>The aim of this study is to determine whether this method is also applicable to older children.</p><p><strong>Methods: </strong>Patients aged 3-18 years, admitted to the Department of Anaesthesiology and Intensive Care Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, were included in this study. NIPE monitoring was provided on patients with airways secured by endotracheal intubation or tracheostomy. NIPE values were recorded before endotracheal suctioning, 1 min after the start, and 5 min after the end of suctioning. Subsequently, the averages of the values were analyzed using ANOVA and the Scheffé test. Along with the NIPE value, changes in hemodynamic parameters were monitored during the suction, and the results of both methods were compared.</p><p><strong>Results: </strong>The NIPE value during endotracheal suctioning was significantly lower, with an average reduction of 13.4 points on a 100-point scale, and returned to baseline 5 min after suctioning ended. No significant changes in hemodynamic parameters (heart rate and blood pressure) were observed, either in the whole group of patients or in the group not receiving catecholamine support.</p><p><strong>Conclusions: </strong>The NIPE index detects the stress response to endotracheal suctioning in children older than 3 years and is more sensitive than hemodynamic parameters, regardless of catecholamine therapy.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258670","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":"Virtual or In-Person Conferences? The Success of the Visiting Scholars in Pediatric Anesthesia Program (ViSiPAP) as a Hybrid Model for Perioperative Education.","authors":"Marla B Ferschl, Monica Hoagland, Viviane G Nasr, Steven J Staffa, Andrew Infosino","doi":"10.1111/pan.15128","DOIUrl":"https://doi.org/10.1111/pan.15128","url":null,"abstract":"<p><strong>Background: </strong>The Visiting Scholars in Pediatric Anesthesia Program (ViSiPAP) was founded in 2017 to promote professional and academic development and provide opportunities for extramural networking and collaboration in pediatric anesthesia. The COVID-19 pandemic necessitated the rapid pivot to a virtual format in 2020. With the lifting of COVID-19 travel restrictions, in-person exchanges were reinstituted.</p><p><strong>Aims: </strong>Our goal was to examine the advantages and disadvantages of both the virtual and in-person formats for ViSiPAP.</p><p><strong>Methods: </strong>We surveyed ViSiPAP participants from 2021 to 2023 to compare in-person and virtual formats. Questions included Likert-scale ratings and free-text qualitative questions.</p><p><strong>Results: </strong>The survey response rate was 81.1% (n = 146). 46.3% of respondents preferred virtual exchanges, while 53.7% preferred an in-person format. Among those participating in person, 87% preferred the in-person format, while among those participating virtually, only 54% preferred the virtual format; 63% of men preferred in-person exchanges, and only 47% of women preferred in-person exchanges. Faculty rank or Under-Represented in Medicine (URiM) status did not significantly affect format preference. Most participants strongly agreed that they would recommend participating in ViSiPAP to their colleagues and that ViSiPAP should be continued in both the in-person and virtual formats.</p><p><strong>Conclusions: </strong>ViSiPAP is a valuable professional development program. Both in-person and virtual sessions are well received by participants. A mixed model incorporating both formats allows pediatric anesthesia divisions and speakers to optimize ViSiPAP for their individual institutions. These results could be extrapolated to other departmental conferences that have shifted to the virtual format.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258672","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":"Comparison of Spontaneous Breathing Versus Paralyzed Technique During Flexible Bronchoscopic Intubation in Anesthetized Children and Adolescents With Temporomandibular Joint Ankylosis: Randomized Parallel Group Trial.","authors":"Roopa, Devalina Goswami, Souvik Maitra, Ajoy Roychoudhury, Ongkilla Bhutia, Ramkumar Mukundarajan, Dalim Kumar Baidya","doi":"10.1111/pan.15130","DOIUrl":"https://doi.org/10.1111/pan.15130","url":null,"abstract":"<p><strong>Background: </strong>Literature is sparse on airway management in temporomandibular joint ankylosis patients, and it is not known whether spontaneous or paralyzed technique of intubation will be better for flexible bronchoscopic intubation.</p><p><strong>Aim: </strong>To compare the incidence of difficult flexible bronchoscopic intubation between the spontaneously breathing and paralyzed groups in anesthetized children and adolescents.</p><p><strong>Methods: </strong>In this Randomized parallel group study, after ethics committee approval and trial registration, we enrolled 70 children and adolescents up to 18 years with temporomandibular joint ankylosis and mouth opening < 1.5 cm scheduled for elective surgery after informed written consent from the parents. Patients were randomized into anesthetized spontaneous breathing (group S) and paralyzed (group P) groups. The primary objective was the incidence of difficult flexible bronchoscopic intubation. Secondary outcomes were time to glottis, carina, time required for intubation, desaturation, coughing/movement, and hemodynamics during intubation and postoperative sore throat. Data were analyzed in SPSS version 29.</p><p><strong>Results: </strong>Baseline and demographic data were comparable. The paralyzed group had a significantly lower incidence of difficult flexible bronchoscopic intubation [group P versus group S: 1 (2.86%) vs. 18 (51.42%), p < 0.001; RR (95% CI): 0.06 (0.01-0.39)], lower time to visualize the glottis [Median difference 30 (24, 36) sec, p < 0.001], lower time to the carina [Median difference 62 (29, 94) sec; p = 0.001], lower time to intubation [Median difference 97 (59, 135) sec, p = 0.003], lower incidence of vocal cord closure [-20% (-33.3% to -6.7%); p = 0.005], lower incidence of blood in the bronchoscopy field [-28.6% (-44.9% to -12.2%); p = 0.002], and lower incidence of desaturation [-14.3% (-27.9% to -0.63%); p = 0.04] compared to the spontaneous group. Coughing, hemodynamic response to intubation, and postoperative sore throat were comparable between the groups.</p><p><strong>Conclusion: </strong>Paralyzed technique is associated with lower incidence of difficult flexible bronchoscopic intubation compared to spontaneously breathing technique in children and adolescents with temporomandibular joint ankylosis.</p><p><strong>Trial registration: </strong>CTRI/2022/03/041362.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258669","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":"Oxygenation Practices During General Anesthesia in Pediatric Patients: An International Survey in Europe, USA, Australia, and New Zealand.","authors":"Jan J van Wijk, Sanne E Hoeks, Irwin K M Reiss, Robert Jan Stolker, Lonneke M Staals","doi":"10.1111/pan.15139","DOIUrl":"https://doi.org/10.1111/pan.15139","url":null,"abstract":"<p><strong>Aims: </strong>At present, there is a growing body of knowledge regarding the benefits and risks associated with oxygen use in medical practice. In the perioperative period, high fractions of inspiratory oxygen are used during airway management. However, oxygen can have direct toxic effects, as well as systemic effects. In different fields of medicine, protocols exist to limit the use of oxygen, for example, in the intensive care unit and emergency department. However, in pediatric perioperative care, such protocols do not exist. We conducted an international survey among pediatric anesthesiologists to assess their daily practices regarding oxygen use during non-cardiac surgery. The objective of this survey was to determine self-reported perioperative oxygen use across several key areas: the default oxygen settings on anesthesia machines, the prevalence of preoxygenation, the fraction of inspiratory oxygen used intraoperatively, and considerations regarding the intraoperative administration of oxygen.</p><p><strong>Methods: </strong>An online digital survey consisting of up to 21 questions in LimeSurvey was developed and sent to 5667 members of various international pediatric anesthesia societies (ESPA, APAGBI, SPA, SPANZA).</p><p><strong>Results: </strong>A total of 828 responses were received (response rate 15%). The median reported default inspiratory oxygen (FiO₂) value of anesthesia machines was 100% (IQR 30%-100%). Preoxygenation was used by 50% of the respondents, usually with 100% oxygen. 87% of respondents reported to titrate FiO₂ intraoperatively, mainly based on pulse oximetry values. Median standard percentage of oxygen intraoperatively was 35% (IQR 30%-40%).</p><p><strong>Conclusions: </strong>Oxygen administration practices during pediatric anesthesia are hardly regulated. There are opportunities to further limit the use of oxygen. For instance, default settings can be lowered, and intraoperative FiO₂ can be further titrated, mainly based on SpO₂.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249057","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":"The Effectiveness of Bubble-Blowing as a Distraction Technique During Pediatric Intravenous Cannulation: A Randomized Controlled Trial.","authors":"McKenna Postles, Nicholas West, Lindy Moxham, Jenna Ramji, Jade Palm, Christa Morrison, Matthias Görges, James Chen","doi":"10.1111/pan.15138","DOIUrl":"https://doi.org/10.1111/pan.15138","url":null,"abstract":"<p><strong>Background: </strong>Intravenous cannulation is a standard but potentially painful procedure. Distraction techniques can alleviate this discomfort by shifting attention from perceived pain. Bubble-blowing is an active distraction technique that combines breathing exercises and play therapy to alleviate pain and anxiety.</p><p><strong>Aims: </strong>To assess the effectiveness of bubble-blowing versus video-watching in reducing pain during and anxiety before pediatric intravenous cannulation.</p><p><strong>Methods: </strong>This ethically approved, randomized controlled trial assigned 2- to 5-year-old participants to bubble-blowing or video-watching groups during their intravenous cannulations in the medical imaging department. Patients who were non-verbal, did not have an awake intravenous cannulation, received premedication, or had topical anesthetic for < 30 min were excluded. The Face Legs Activity Cry Consolability scale rated pain before, during, and after intravenous cannulation. The modified Yale Preoperative Anxiety-Short Form rated anxiety immediately following parental consent (baseline) and before intravenous cannulation.</p><p><strong>Results: </strong>Data from 120 participants (60 females, median [interquartile range] age 3.8 [2.9-4.4] years) were available. Of these, 105 participants underwent intravenous cannulation and were included in the analysis. Pain scores during intravenous cannulation were 2.0 [0.0-7.0] in the video-watching and 2.0 [0.0-5.0] in the bubble-blowing group; median difference 0.0 (95% confidence interval (CI) -1.0 to 1.0), p = 0.888. Anxiety scores before intravenous cannulation were 36.5 [22.9-63.4] in the video-watching and 27.1 [22.9-52.1] in the bubble-blowing group; median difference 0.0 (95% CI -10.4 to 0.0), p = 0.178. Pain during intravenous cannulation increased in 29/52 (56%) children in the video-watching and 30/53 (57%) in the bubble-blowing group; odds ratio 0.97 (95% CI 0.42-2.24), p > 0.999. Anxiety increased in 27/52 (52%) children in the video-watching and 16/53 (30%) in the bubble-blowing group; odds ratio 2.48 (95% CI 1.04-6.02), p = 0.030.</p><p><strong>Conclusion: </strong>The use of bubble-blowing as a distraction did not significantly reduce pain during or anxiety before IV cannulation compared to video-watching. However, further research is needed to explore whether active distraction techniques could be beneficial for young, neurodiverse, anxious, or fearful children.</p><p><strong>Trials registration: </strong>This study was registered in ClinicalTrials.gov (NCT05899452; June 12, 2023).</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249059","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":"Pentazocine Pharmacodynamics in Children: Simulations to Assess Safety and Effectiveness.","authors":"Takayuki Omori, Takahiko Aoyama, Yasuhiro Tsuji","doi":"10.1111/pan.15135","DOIUrl":"https://doi.org/10.1111/pan.15135","url":null,"abstract":"<p><strong>Background: </strong>Pentazocine is used for postoperative pain but is known to cause respiratory depression. Although hepatic metabolic activity in children gradually reaches adult levels, the effect of multiple doses in children with decreased clearance has not been elucidated.</p><p><strong>Aims: </strong>The objective of this study is to evaluate respiratory depression caused by pentazocine using a pharmacokinetic-pharmacodynamic model and to optimize the dosing frequency to maintain target concentrations for analgesia.</p><p><strong>Methods: </strong>The pharmacokinetic model used the parameters of the three-compartment model reported by Hamunen et al. Pharmacodynamic parameters were estimated through sequential analysis, with the pharmacokinetic parameters fixed. Mean respiratory rate and oxygen saturation data were collected from Hamunen et al. after the administration of 0.5 mg/kg pentazocine. The pharmacodynamic model was a turnover model in which the plasma pentazocine concentration affected the respiratory rate and oxygen saturation. We used the pharmacokinetic-pharmacodynamic model to simulate changes in respiratory rate and oxygen saturation after 0.5 mg/kg pentazocine at 2-, 4-, and 6-h dosing intervals. We also simulated cases with 20% and 40% decreased clearance. Pain relief was assessed using our previous model.</p><p><strong>Results: </strong>After a single dose, respiratory rate dropped with a delayed response to the plasma concentration, reaching a minimum within 15 to 30 min and falling below the normal range. It returned to baseline after about 75 min. With multiple dosing, respiratory rate and oxygen saturation considerably decreased every 2 h, regardless of clearance changes. At a 4-h interval, respiratory depression occurred due to decreased clearance, whereas at a 6-h interval, it was minimal. Pain was well controlled at 2-, 4-, and 6-h dosing intervals.</p><p><strong>Conclusions: </strong>This pharmacokinetic-pharmacodynamic modeling study supports a 6-h dosing interval for pentazocine at 0.5 mg/kg in children. This interval strikes a balance between achieving effective analgesia and minimizing the risk of respiratory depression.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249058","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":"The Effect of Prophylactic Use of Antifibrinolytics During Pediatric Non-Cardiac Surgeries on Bleeding and Transfusions: A Systematic Review and Meta-Analysis.","authors":"Katherine Schertz Hickey, Morgan Smith, Oliver Karam, Michelle Demetres, David Faraoni, Vincent Duron, Yeu Sanz Wu, Marianne E Nellis","doi":"10.1111/pan.15137","DOIUrl":"https://doi.org/10.1111/pan.15137","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this meta-analysis is to determine the effect of intraoperative tranexamic acid, aminocaproic acid, and aprotinin on bleeding in pediatric surgery.</p><p><strong>Study design: </strong>A literature search was performed for the meta-analysis and systematic review in the following databases from inception until April 2023: Ovid MEDLINE, Ovid EMBASE, and The Cochrane Library. Studies included patients under 18 years of age, non-cardiac surgery, and administration of antifibrinolytics. Forest plots were used for statistical analysis. Primary outcomes were intraoperative blood loss and intraoperative blood transfusions.</p><p><strong>Results: </strong>One hundred thirty articles met inclusion. Tranexamic acid compared to control resulted in an estimated blood loss of -410.0 mL p-value = < 0.001 for scoliosis surgery, -14.0 mL/kg p-value = < 0.001 for craniofacial surgery, and -21.0 mL p-value < 0.001 for tonsillectomy/adenoidectomy surgery. Aminocaproic acid compared to control resulted in an estimated blood loss of -464.0 mL p-value < 0.001 for scoliosis surgery. Tranexamic acid compared to aminocaproic acid resulted in an estimated blood loss of -391.0 mL p-value < 0.001 for scoliosis surgery. For blood transfusion during craniosynostosis surgery, tranexamic acid compared to control resulted in a mean decrease of -7 mL/kg p-value = 0.010 and aprotinin compared to control resulted in a mean decrease of -20.0 mL/kg p-value < 0.001. The analysis for VRO/VDRO and hip reconstruction did not reach statistical significance.</p><p><strong>Conclusions: </strong>In craniofacial, scoliosis, and tonsillectomy/adenoidectomy surgery, prophylactic administration of tranexamic acid results in lower estimated blood loss. Tranexamic acid and aprotinin are effective for reducing transfusion in craniofacial surgery. For scoliosis surgery, tranexamic acid is more efficacious than aminocaproic acid. More literature is needed to assess the efficacy of tranexamic acid in VRDO/VRO and hip reconstruction surgery and the efficacy of different dosing regimens.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234719","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":"Clear Liquid Fasting Guidelines for Pediatric Patients: A Survey of the Society for Pediatric Anesthesia.","authors":"Todd A Glenski, Michelle Wu, Christian Taylor, Emily Weisberg, Nichole Doyle","doi":"10.1111/pan.15140","DOIUrl":"https://doi.org/10.1111/pan.15140","url":null,"abstract":"<p><strong>Introduction: </strong>Recently, several international anesthesia societies have updated their guidelines by shortening the NPO clear liquid time from 2 to 1 h in children. When the American Society of Anesthesiologists (ASA) released their interim update to the preoperative fasting guidelines, they maintained the 2-h clear liquid fasting recommendation, while advising the use of clinical judgment for cases involving PO intake within 2 h. Given international support for decreased NPO times, we aimed to evaluate the current practice and opinions of the Society for Pediatric Anesthesia (SPA) members regarding clear liquid NPO times.</p><p><strong>Methods: </strong>A 17-question survey was developed by members of Children's Mercy Kansas City Department of Anesthesiology and submitted to the SPA Research Committee for review. After approval, a survey link and QR code were distributed to all SPA members.</p><p><strong>Results: </strong>A total of 430 surveys (9.85%) were completed. Seventy-three percent indicated that their department follows a 2-h NPO policy for clear liquids, while 24% reported a 1-h policy. Overall, 71% of respondents felt that 1-h is the ideal NPO time for clear liquids. Of the respondents whose department follows a 2-h policy, 86% believe their NPO policy would be shortened if ASA guidelines were updated to 1-h. Forty-nine percent of respondents reported that NPO instructions to patients are congruent with departmental policies, while 33% reported that NPO instructions differ from departmental NPO policies.</p><p><strong>Discussion: </strong>The results demonstrate that although only a small number of respondents practice a 1-h policy, most respondents believe that a 1-h policy is ideal. This discrepancy is potentially due to adherence to ASA practice guidelines/recommendations, as 86% of respondents who have an NPO policy of 2 or more hours indicated that their departments would switch to 1-h if the ASA were to revise their guideline.</p>","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234718","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":"Carotid Flow Time Analysis as a Method to Predict Fluid Responsiveness in Mechanically Ventilated Children.","authors":"Humberto M Silva, Raisa S Uzun, Victoria C Lintz, Roberto J N Nogueira, Tiago H De Souza","doi":"10.1111/pan.15136","DOIUrl":"https://doi.org/10.1111/pan.15136","url":null,"abstract":"","PeriodicalId":19745,"journal":{"name":"Pediatric Anesthesia","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199801","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}