Use of Coagulation Point-of-Care Tests in the Management of Anticoagulation and Bleeding in Pediatric Cardiac Surgery: A Systematic Review.
The Summary Type of article: Systematic Review. The Aim: To summarise the literature on this topic specific to paediatric cardiac surgery. The Methodology: Appears sound and is clearly described. The Content: This is comprehensive and elements described from the review of the literature are given clinical context. The reader who wants an […]
Perioperative Preparations for COVID-19: The Pediatric Cardiac Team Perspective [published online ahead of print, 2020 Apr 28].
What’s the aim of this editorial? As described by the authors, this freestanding editorial aims “to review the literature and present current recommendations to inform the pediatric cardiac team preparing to take care of all children and adults during this COVID-19 pandemic”. Does it do this? No. The Breakdown It’s hard to see […]
Efficacy of Bilateral Transversus Thoracis Muscle Plane Block in Pediatric Patients Undergoing Open Cardiac Surgery [published online ahead of print, 2020 Feb 11].
What was the question? This group was exploring whether single shot ultrasound-guided bilateral transversus thoracic muscle plane blocks in children aged 6 months to 5 years produces effective analgesia. Why bother? Regional anaesthesia in these kids is interesting to lots of people in the hope that outcomes will be better with better analgesia […]
Neuromuscular-blocking agents for tracheal intubation in pediatric patients (0-12 years): A systematic review and meta-analysis.
The outcome of this study is unlikely to surprise any anaesthetists, however it is likely to confirm your existing practices. A systematic review and meta-analysis comparing intravenous neuromuscular blockade (NMBA) with no NMBA for tracheal intubation. Included RCTs of 0-12 year old children, ASA class I and II, requiring intubation for elective or […]
Top ten priorities for anesthesia and perioperative research: a report from the Canadian Anesthesia Research Priority Setting Partnership.
This Canadian group repeats the James Lind alliance priority setting project done previously in the UK. The methodology consumes several pages, but the final list is worth reading, and should be most people’s first target, after reading the title. Sourcing these questions from patients and caregivers (rather than medical researchers) is really valuable, and will […]
Towards integrative neuromonitoring of the surgical newborn: A systematic review.
This review looks at the current evidence behind neuromonitoring of different types, in surgical newborns having procedures under anaesthesia, and doesn’t find much to review. It advocates the idea of “integrated neuromonitoring” in its somewhat theoretical discussion. It’s a good read for those interested in the topic, but might put non enthusiasts off with its […]
Neuromonitoring Modalities in Pediatric Cardiac Anesthesia: A Review of the Literature [published online ahead of print, 2020 Mar 7].
This is an easily digested, high level review of neuromonitoring in the paediatric cardiac environment. Useful to read if you’re curious and just starting out in the area. It isn’t overly long or dense. Reviewed by Dr. Justin Skowno
Sugammadex and neuromuscular reversal: special focus on neonatal and infant populations;
Review of sugammadex pharmacology but only a small section specific to infants and neonates. FDA approval in 2015 but not approved for use in children. In Europe, sugammadex is approved for use in children aged 2-17 years old, for routine reversal only. Higher dosing for the reversal of vecuronium may be warranted as lower affinity […]
Palliative care, resuscitation status, and end-of-life considerations in pediatric anesthesia.
Introductory summary for those paediatric anaesthetists who may not conduct end-of-life conversations routinely but does not really provide a practical framework. WHO defines palliative care as an approach that “improves quality of life of patients and their families facing a life-threatening illness, through the prevention and relief of suffering”. It further states that for children, […]
The opioid epidemic in pediatrics: a 2020 update;
Provides a summary of current US perspectives on the opioid epidemic in children. For the first time in the last six decades, the life expectancy in all racial groups has declined primarily because of drug overdose, alcohol abuse, and suicide. There are little public health efforts to curtail or regulate opioid prescription in children. Importantly, […]