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Extracorporeal membrane oxygenation and mechanical support for the circulation 体外膜氧合和机械支持循环
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-10-01 Epub Date: 2026-09-19 DOI: 10.1016/j.mpaic.2026.08.005
Marie Horan
{"title":"Extracorporeal membrane oxygenation and mechanical support for the circulation","authors":"Marie Horan","doi":"10.1016/j.mpaic.2026.08.005","DOIUrl":"10.1016/j.mpaic.2026.08.005","url":null,"abstract":"<div><div>Extracorporeal membrane oxygenation (ECMO) is a modified form of cardiopulmonary bypass which can be used to support neonates, paediatric and adult patients with severe cardiac and/or respiratory failure for days, weeks and in some cases months. One of the key principles for a successful outcome from ECMO is careful patient selection. Candidates for ECMO must have a potentially reversible pathology and have no absolute contraindication to ECMO such as a severe brain haemorrhage, lethal chromosomal anomaly or an end-stage chronic condition. ECMO carries a high risk of complications both in the patient (e.g. cerebral thrombosis and infection) and with the extracorporeal circuit (air embolus, thrombus, circuit component problems such as an oxygenator failure). Given the risks of ECMO, it is vital that the ECMO patient (and circuit) is managed 24/7 by a fully trained specialist ECMO team. The outcome of ECMO depends largely on the indication for ECMO. Usually, ECMO is only considered for the most severely ill patients already on maximum conventional therapy who without ECMO, have a very high risk of mortality.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 10","pages":"Pages 654-662"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Paediatric cardiopulmonary arrest update: 2026 儿科心肺骤停更新：2026年
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-10-01 Epub Date: 2026-09-21 DOI: 10.1016/j.mpaic.2026.08.009
Robert J. Moynihan, Carrick AG. Allison
{"title":"Paediatric cardiopulmonary arrest update: 2026","authors":"Robert J. Moynihan,&nbsp;Carrick AG. Allison","doi":"10.1016/j.mpaic.2026.08.009","DOIUrl":"10.1016/j.mpaic.2026.08.009","url":null,"abstract":"<div><div>In this review article, we look at how cardiopulmonary arrest (CPA) in children differs in the out-of-hospital, in-hospital, and perioperative settings. We relay the latest evidence and recommendations, including those from the 2025 International Liaison Committee on Resuscitation (ILCOR) Consensus on Science with Treatment Recommendations. We discuss the management of CPA in trauma, which is a significant cause of CPA in older children. Extracorporeal cardiopulmonary resuscitation (ECPR) has potential benefits compared to conventional cardiopulmonary resuscitation (CPR). We explore the factors associated with good and poor outcomes, which can help to select appropriate patients for this treatment. Finally, we summarize the reliability of tests that can be used in neuroprognostication after CPA.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 10","pages":"Pages 591-595"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Paediatric perioperative blood management 儿科围手术期血液管理
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-10-01 Epub Date: 2026-10-15 DOI: 10.1016/j.mpaic.2026.08.008
Jessica McArdle, Nadia Ladak
{"title":"Paediatric perioperative blood management","authors":"Jessica McArdle,&nbsp;Nadia Ladak","doi":"10.1016/j.mpaic.2026.08.008","DOIUrl":"10.1016/j.mpaic.2026.08.008","url":null,"abstract":"<div><div>Paediatric blood management is underlined by the basic principles of maintaining haemoglobin concentration, optimizing haemostasis and minimizing blood loss. This article explores these principles and details further the management of iron deficiency in children. Transfusion of red cells is necessary in certain situations and this article explains calculations, practicalities of blood transfusion and consent, as well as the management of major haemorrhage.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 10","pages":"Pages 596-607"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intraosseous cannulation in children 儿童骨内插管
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-10-01 Epub Date: 2026-09-21 DOI: 10.1016/j.mpaic.2026.08.003
Victoria Bewick, Christopher WM. Horner
{"title":"Intraosseous cannulation in children","authors":"Victoria Bewick,&nbsp;Christopher WM. Horner","doi":"10.1016/j.mpaic.2026.08.003","DOIUrl":"10.1016/j.mpaic.2026.08.003","url":null,"abstract":"<div><div>In an emergency situation when intravenous (IV) access cannot be rapidly achieved, the intraosseous (IO) route is recommended in order to infuse medications and fluids. Specifically designed needles make this technique quick, easy and safe. This article describes the anatomy and physiology relevant to IO cannula insertion, as well as indications and contraindications for IO use. The variety of devices available and the techniques for their use in the paediatric population are discussed.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 10","pages":"Pages 608-612"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trauma and burns in children 儿童创伤和烧伤
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-10-01 Epub Date: 2026-09-18 DOI: 10.1016/j.mpaic.2026.08.004
Laura Bubb
{"title":"Trauma and burns in children","authors":"Laura Bubb","doi":"10.1016/j.mpaic.2026.08.004","DOIUrl":"10.1016/j.mpaic.2026.08.004","url":null,"abstract":"<div><div>Trauma is the leading cause of death and disability in children over the age of 1 year. As a member of the paediatric trauma team, the anaesthetist performs a key role in the assessment, stabilization and urgent management of the injured child. This article describes the key principles of the primary and secondary survey as applied to paediatric trauma, including a discussion of the relevant paediatric anatomy and physiology that underpins the differences in injury pattern and management compared to adults. Paediatric traumatic cardiac arrest management focuses on the correction of hypoxia, haemorrhage, tension pneumothorax and cardiac tamponade as potential reversible causes. Traumatic brain injury is the most common severe injury in children and early correction of key physiological parameters can reduce the development of secondary injury. Intra-abdominal haemorrhage may necessitate damage control laparotomy. Burns are more common in children than adults and can pose significant challenges to the anaesthetist if a facial/airway burn or inhalational injury is present. Prompt fluid and analgesia management of these children can optimize their outcomes. Finally, we discuss pain management, suspected physical abuse and death in relation to paediatric trauma.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 10","pages":"Pages 613-622"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transporting critically ill children 运送危重儿童
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-10-01 Epub Date: 2026-09-18 DOI: 10.1016/j.mpaic.2026.08.007
Nalaayeni Kanesan, Matthew MacDonald, Matthew Harvey, Arun Ghose
{"title":"Transporting critically ill children","authors":"Nalaayeni Kanesan,&nbsp;Matthew MacDonald,&nbsp;Matthew Harvey,&nbsp;Arun Ghose","doi":"10.1016/j.mpaic.2026.08.007","DOIUrl":"10.1016/j.mpaic.2026.08.007","url":null,"abstract":"<div><div>The centralization of paediatric critical care services in most developed countries has seen an increase in the need for critically unwell and traumatically injured children to be transported for definitive care. This, in combination with the rising demand for paediatric critical care beds, has driven the development of stand-alone paediatric critical care retrieval teams, often sharing the skills and knowledge of medical and nursing staff from multiple paediatric intensive care units. Anaesthetists may be required to assist with, or lead the resuscitation, stabilization and occasionally the transfer of the critically unwell or injured child. This may have significant impact upon resource provision in the referring centre and potentially important cognitive impacts for the teams involved in the stabilization and resuscitation of the critically unwell child. Preparation for paediatric retrieval is performed by teams in referring hospitals where knowledge of retrieval processes, local organization and accessible shared protocols for the management of paediatric critical illness can ease the process. We consider the approach to the child who will require transfer to a paediatric critical care unit.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 10","pages":"Pages 623-632"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Self-assessment 自我评估
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-10-01 Epub Date: 2026-10-07 DOI: 10.1016/j.mpaic.2026.09.001
Vijayanand Nadella
{"title":"Self-assessment","authors":"Vijayanand Nadella","doi":"10.1016/j.mpaic.2026.09.001","DOIUrl":"10.1016/j.mpaic.2026.09.001","url":null,"abstract":"","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 10","pages":"Pages 663-664"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Special considerations in paediatric intensive care 儿科重症监护的特殊注意事项
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-10-01 Epub Date: 2026-09-18 DOI: 10.1016/j.mpaic.2026.08.010
Rebecca Pearce, Arun Ghose, Matthew Harvey
{"title":"Special considerations in paediatric intensive care","authors":"Rebecca Pearce,&nbsp;Arun Ghose,&nbsp;Matthew Harvey","doi":"10.1016/j.mpaic.2026.08.010","DOIUrl":"10.1016/j.mpaic.2026.08.010","url":null,"abstract":"<div><div>Paediatric critical care units (PCCU) provide care to the most critically ill or injured children. Children are admitted to PCCU with a wide variety of illnesses, injuries and following a range of surgical procedures. High staff-to-patient ratios are required both because of the potentially rapid evolution of critical illness in children, as well as the complexity of the supportive therapies offered. Definitive evidence for specific paediatric therapies is often limited with extrapolation taken from adult experience, but there are increasing international collaborative efforts that have produced consensus treatment guidelines that serve to promote the use of best practice therapies. This article reviews therapies and techniques that define care in the PCCU and principles of management of acute respiratory distress syndrome (ARDS), septic shock and traumatic brain injury (TBI). Neonatal and cardiac intensive care medicine topics are outside the scope of this article.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 10","pages":"Pages 643-653"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fluid and electrolyte balance in children 儿童的体液和电解质平衡
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-10-01 Epub Date: 2026-09-18 DOI: 10.1016/j.mpaic.2026.08.006
Nalaayeni Kanesan, Arun Ghose, Matthew Harvey
{"title":"Fluid and electrolyte balance in children","authors":"Nalaayeni Kanesan,&nbsp;Arun Ghose,&nbsp;Matthew Harvey","doi":"10.1016/j.mpaic.2026.08.006","DOIUrl":"10.1016/j.mpaic.2026.08.006","url":null,"abstract":"<div><div>Intravenous fluid and electrolyte management in paediatrics requires an understanding of the indication for intravenous fluid therapy and the underlying pathophysiology to meet requirements and avoid adverse events. Careful consideration needs to be given to the rate as well as the composition of intravenous therapy, and children's ongoing needs should be reviewed regularly. Fluid therapy can be separated into maintenance fluids, replacement fluids that address electrolyte deficits and ongoing losses, and resuscitation fluids. We review the critical considerations when prescribing intravenous fluid for children and consider the challenges of non-osmotic secretion of anti-diuretic hormone (ADH), hyponatraemic encephalopathy and other electrolyte abnormalities. Fluid management in children with diabetic ketoacidosis is also reviewed.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 10","pages":"Pages 633-642"},"PeriodicalIF":0.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149175597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethics of clinical trials 临床试验伦理
IF 0.6
Anaesthesia and Intensive Care Medicine Pub Date : 2026-09-01 Epub Date: 2026-08-22 DOI: 10.1016/j.mpaic.2026.07.005
James Paul Durkan, Mark A Henderson
{"title":"Ethics of clinical trials","authors":"James Paul Durkan,&nbsp;Mark A Henderson","doi":"10.1016/j.mpaic.2026.07.005","DOIUrl":"10.1016/j.mpaic.2026.07.005","url":null,"abstract":"<div><div>Clinical research is essential to modern evidence-based medicine. The potential for human harm must be minimized and balanced against the greater utility to society. With a multitude of clinical, governmental, and regulatory actors now working to ensure clinical research is ethically robust, it is important that we reflect on the current paradigm of clinical research in the UK, to safeguard participant safety. We also discuss ethical principles of clinical trials, according to different bioethical models.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"27 9","pages":"Pages 572-575"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148934456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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