Pediatric Anesthesia

Extracorporeal Pediatric CPR

A small retrospective study of 56 Pediatric cardiac arrests (80% related to primary cardiac conditions), mean age 3.5 months (1-53).

Survival to hospital discharge was a very good c. 65%, best in younger age (3.5 months) and those with decreased extracorporeal CPR tones and those exposed to therapeutic hypothermia. Follow up showed a good quality of life and family functioning. Further studies are needed to establish whether the technique should be more widely available in Pediatric critical care.

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APRICOT Study – European Pediatric Anesthesia

A study of severe adverse pediatric anesthesia events across Europe, e.g. respiratory, cardiac, neurological, allergic. Intubation was a marker for increased adverse events, as was emergency surgery, and case volume / pediatric experience of the providers. Children younger than 3 years and those with prematurity, genetic/metabolic/neurological comorbitities, snoring, airway reactivity, with fever or taking medication are at increased risk of severe critical events and should be anesthetized in high-volume pediatric centres.

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Sedation and Pediatric NPO in ER

“In this study, there was no association between fasting duration and any type of adverse event. These findings do not support delaying sedation to meet established fasting guidelines”.

An observational study sparse on details on what sedation was used, depth of sedation and the procedures in ER. And the rate of vomiting was 5% but they evidently mostly got away with it. A study unlikely to convince anesthesiologists to abandon ASA and other fasting guidelines in this Pediatric population (or adults).

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Anesthesia and Pediatric Development

A story that just won’t go away, and there must  be reason for concern regarding the Pediatric brain and anesthesia. This time from Australia, with the conclusion:

”Children exposed to general anesthesia before 4 years have poorer development at school entry and school performance. While the association among children with 1 hospitalization with 1 general anesthesia and no other hospitalization was attenuated, poor numeracy outcome remained.”

Ped Anesth link