ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00163.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00164.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00165.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00166.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryThe characteristics of all the paediatric admissions made to a district general hospital over a three‐year period were analysed in this study. Paediatric admissions averaged 23 per year (10% of the total admissions to the unit over that time). The mean age was six years, median age was four years. Sixty‐two per cent were medical admissions and 38% surgical. Forty‐seven per cent of the surgical admissions involved head injuries. Seventy‐four per cent of medical admissions were directly related to upper and lower airway problems. Mean total admission time was six days, with a median of two days. Fifty‐nine per cent (40) of all cases required intubation for a mean period of five days (median = three days). All cases were PRISM scored (Pollack, Ruttimann&Getson 1988). The mean score was 8. Ninety‐four percent of admissions surviving to go home. There were a total of four deaths over the three‐year period. The PRISM scores of those who died had a mean of 30, which was significantly different (P<0.05) from the survivors who had a mean PRISM score of six and a median of four. The organs of one of the nonsurvivors were transplanted. Currently there is considerable interest in the feasibility of transferring all paediatric intensive care patients to a regional centre, the consequences of such a policy must be carefully assessed if its implementation is to

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00167.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryWe describe combined subarachanoid‐epidural anaesthesia for inguinal herniotomy in eight ex‐premature babies less than 47 weeks postconception and one full‐term baby aged 21 weeks who had Pierre‐Robin syndrome. No additional anaesthetic supplements were needed during surgery. Motor block was profound and operating conditions were excellent. One baby had brief self‐limiting bradycardias shortly after lumbar puncture. A second baby with severe bronchopulmonary dysplasia had recurrent oxygen desaturations associated with apnoea during surgery. There were no other intra‐ or postoperative complications. All babies were fed immediately on return to the ward. We conclude that combined subarachnoid‐epidural anaesthesia is a satisfactory technique for anaesthesia for inguinal herniotomy in babies at risk of apnoea

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00168.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryHigh flows of halothane and N2O are commonly used in children during induction of anaesthesia. We prospectively evaluated the efficiency of a double mask system in children, during inhalational induction with photoacoustic infrared spectroscopy. Thirty‐two children 5 days to 8.5 years of age were studied. Anaesthesia was induced with inspired halothane concentrations of 2–3% and N2O 50–70% in 6–8 litres of freshgas flow via a Jackson‐Rees breathing system. Children were randomly assigned into two groups. Anaesthesia was induced in group 1 using a Rendell‐Baker mask with a regular scavenging device (25 1·min−1). In group II a double‐mask system was connected to an active scavenging system (580 1 min−1). Halothane and N2O were measured at 10 cm below the chin of the anaesthesiologist. We could demonstrate that the use of double‐mask system with a regular scavenging device substantially reduced the exposure of the anaesthesiologist to halothane by 89% and to N2O 80% respectively during in

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00169.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryIn order to evaluate the efficiency of glucose homeostatic mechanisms in otherwise healthy infants and children during and after anaesthesia and surgery four different fluid regimes were studied in 40 patients, 6–24 months old. The four regimes all resulted in a total fluid volume of 10 ml·kg−1·h−1intraoperatively and 3 ml·kg−1h−1postoperatively. One group received a combination of glucose 300 mg·kg−1h−1and Ringer acetate intraoperatively and glucose postoperatively, a second group was given the same intraoperative fluid followed by glucose free Ringer acetate postoperatively. A third group received Ringer acetate both intra‐ and postoperatively and a fourth group was given Ringer acetate intraoperatively and glucose postoperatively. Blood glucose concentrations were measured after induction (Preop.), immediately after surgery (Postop.) and after 30, 60 and 120 min. Increased blood glucose concentrations were found in all children immediately after surgery. The concentrations were highest among children given glucose. Postoperatively blood glucose remained elevated in children receiving glucose after surgery. In patients without postoperative glucose supply blood glucose concentrations declined. Hypoglycaemia was not seen on any occasion. The differences in blood glucose concentrations with different regimes were significant but small. We conclude that the studied group of healthy children appeared to be capable of regulating blood glucose levels within normal limits with or without intraoperative glucose and also if the intraoperative glucose supply was interrup

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00170.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

SummaryThe purpose of this study was to compare the effects of two methods of providing sedation for young children undergoing magnetic resonance imaging (MRI) studies on efficiency of scanner utilization. Thirty‐nine patients were randomized to receive either propofol or chloral hydrate. Age and gender distributions were not significantly different between the groups. Induction time was significantly less for propofol than for chloral hydrate (6 ± 3 minvs41 ± 9 min;P<0.0001); and recovery time for propofol was significantly shorter than for chloral hydrate (18 ± 7 minvs47 ± 28 min;P<0.0001). Procedure times were not significantly different. Three of 19 patients who received chloral hydrate moved and their scans were interrupted; two of these received propofol. None of the patients in the propofol group moved. Utilization efficiency of the MRI scanner, defined as 100 ± (Procedure Time)/(Induction Time + Procedure Time), was 87 ± 6% for propofol and 45 ± 13% for chloral hydrate. These data demonstrate that propofol sedation allows the MRI scanner to be utilized more efficiently than chloral hydrate

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00171.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:1155-5645    

DOI:10.1111/j.1460-9592.1994.tb00172.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY