anesthetic technique, perioperative monitoring and complications were analyzed.
General anesthesia was used in 94% of children. Regional anesthesia was used in 1.7% of children at CNHU and 17% of children at Hopital de la Mere et de l’Enfant Lagune. Inhalational induction was the commonest technique used. Halothane PF-00299804 Protein Tyrosine Kinase inhibitor was the only inhalational agent available for induction. Seventy-two percent of children having general anesthesia were intubated. Muscle relaxation was used in 48% of cases, only with pancuronium. The available perioperative monitoring equipment was not used regularly. All children having general anesthesia breathed spontaneously with manual assistance. There were eight cardiac arrests recorded, giving an incidence of 156 cardiac arrests per 10 000 anesthetics. Hypoxia was the commonest cause of cardiac arrest. The mortality associated with cardiac arrest was very high (62%).
There were three prognostic factors that predicted a poor outcome: age < 1 year, emergency surgery and an ASA score of three or more.
Pediatric anesthesia in the two University Hospitals is far from satisfactory. Morbidity and mortality are unacceptably high. Suggestions are made to improve the safety of children undergoing anesthesia.”
“Background: Volume management remains a challenging component of caring for the critically ill. Renal failure complicates fluid management. We sought to identify relationships between delta blood volume and physiology-based JPH203 ic50 targets for both Autophagy Compound Library purchase the adequacy of left ventricular filling (stroke volume index [SVI]) and preload
dependency (stroke volume variability [SVV]) in patients undergoing dialysis in the intensive care unit.
Methods: Patients undergoing dialysis with an arterial line in place were eligible. Delta blood volume was measured during dialysis along with simultaneous SVI and SW via an arterial pressure cardiac output monitor. Patients were dichotomized as “”negative”" fluid strategy if fluid was removed, or “”positive”" fluid strategy if fluid was added during renal replacement therapy. Delta blood volume’s association with SVI and SVV was examined separately by fluid strategy group.
Results: A total of 26 patients (11 continuous and 15 intermittent dialysis) were investigated. Compared with that in patients with negative fluid strategy, SVV was significantly higher at baseline in patients with positive fluid strategy, while baseline SVI was significantly lower. Fluid removal was associated with significant increases to SVV in both strategy groups. Fluid removal was associated with significant decreases to SVI, and this effect was similar regardless of fluid strategy.