Pediatric trauma transfusion and cognitive aids.

Adult current practice and emerging trends around transfusion relating to trauma and, by inference, massive blood loss from surgical practice are reviewed with reference to paediatric practice. This review promises much from the title but delivers little new information. This is no fault of the author, rather a reflection of the paucity of paediatric-specific research […]

Changes in tissue and cerebral oxygenation following spinal anesthesia in infants: a prospective study

This study is a prospective, non-randomized, non-blinded study looking at the effect of awake spinal anaesthesia on cerebral and regional Near Infra Red Spectroscopy (NIRS) in infants. This study seeks to add further information to the debate about possible toxicity of anaesthesia in infants. It uses a recent article describing a reduction in cerebral blood […]

Clinical Evidence of Any Effect of Anesthesia on the Developing Brain

There has been a steady stream of articles on the potential neurotoxicity issue since the FDA set the cat amongst the pigeons a year or so back. Some articles are just expert bias, others are well considered and balanced. This review of the human evidence by two of the leaders in the field is an […]

SmartTots Update Regarding Anesthetic Neurotoxicity in the Developing Brain

This special article is a relevant update and summary of the current issues in the field of anaesthetic neurotoxicity. This group of authors highlight well the issues facing paediatric anaesthetists since the FDA released their statement in 2016. The warning states that ‘repeated or lengthy use of general anaesthetic and sedation drugs during surgeries in […]

Transnasal humidified rapid insufflation ventilatory exchange for oxygenation of children during apnoea: a prospective randomised controlled trial

This is a prospective, single-centre randomised controlled trial of using high-flow nasal canulae to safely prolong apnoea in children aged 1-6 years (10-20kg) scheduled for elective surgery using neuromuscular blockade. Patients were randomly allocated to three groups: Low-flow 100% oxygen 0.2mL/kg/min High-flow 100% oxygen at 2L/kg/min High-flow 30% oxygen at 2L/kg/min All patients were subjected […]

Preoperative fasting in children: review of existing guidelines and recent developments

This paper provides a concise review of current literature on preoperative fasting in children, including the physiological rationale. The key points presented are: Pulmonary aspiration in adults is rare, but can be associated with devastating consequences Pulmonary aspiration in children is rare, morbidity or mortality have NOT been reported Rate of gastric emptying in children […]

Incidence, characteristics, and predictive factors for medication errors in paediatric anaesthesia: a prospective incident monitoring study

This prospective observational study was conducted with the aim of describing anaesthetic medication errors in a single paediatric centre in Lyon, France that does not perform cardiac surgery. Anonymous and “voluntary” incident forms were provided for all patients over a three-month period. High response rates are facilitated by the presence of nurse anaesthetists involved in […]

Deep or awake removal of laryngeal mask airway in children at risk of respiratory adverse events undergoing tonsillectomy – a randomised controlled trial

This was a single centre open-label parallel-arm randomised trial performed at Princess Margaret Hospital in Perth. Children undergoing tonsillectomy with a Laryngeal Mask Airway (LMA) and who had at least one risk factor for perioperative respiratory adverse events (PRAE), were randomised to have the LMA removed deep or awake. Their list of risk factors is […]

Chest Computed Tomography Image for Accurately Predicting the Optimal Insertion Depth of Left-Sided Double-Lumen Tube

This study is a single-centre, prospective, randomized study in adult patients. Preoperative CT guided tracheal measurements (vocal chords to carina) were used to help guide insertion of a left sided Double lumen Tube (DLT) compared to traditional clinically guided insertion.  Ease, speed and success rate together with incidence of complications was compared between the two […]