2,366 results match your criteria Pediatrics Sedation


Dexmedetomidine use and mortality in mechanically ventilated patients with severe burns: A cohort study using a national inpatient database in Japan.

Burns 2021 May 12. Epub 2021 May 12.

Health Services Research & Development Centre, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, Japan; Department of Health Services Research, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, Japan.

Background: Dexmedetomidine is an alpha 2-adrenergic receptor agonist. Apart from its sedative effects, dexmedetomidine can potentially reduce mortality through its anti-inflammatory effect. However, the impact of dexmedetomidine on in-hospital outcomes of patients with severe burns remains unclear. Read More

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Comparison of Intranasal Dexmedetomidine and Midazolam as Premedication in Pediatric Surgical Patients: A Prospective, Randomized Double-Blind Study.

Anesth Essays Res 2020 Jul-Sep;14(3):384-389. Epub 2021 Mar 22.

Department of Anesthesiology and Critical Care, Institute of Medical Sciences, BHU, Varanasi, Uttar Pradesh, India.

Introduction: To relieve anxiety and fear is a major concern for pediatric anesthesiologist, and intranasal dexmedetomidine seems to be better alternative to midazolam to provide sedation and allay anxiety in children.

Aims And Objectives: We compare the sedative effects, anxiety level, successful child-parental separation, and hemodynamic parameters of either intranasal dexmedetomidine or midazolam as a premedication in children undergoing pediatric surgery.

Setting And Design: This is a prospective, randomized, double-blind study conducted on 60 patients belonging to the American Society of Anesthesiologists Physical Status Classes I and II, undergoing pediatric surgical procedures with the use of intranasal dexmedetomidine and midazolam as premedication. Read More

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Transcutaneous Mediastinal Ultrasonography for Lymphadenopathy in Children: A Pictorial Essay of Technique and Imaging Findings.

J Ultrasound Med 2021 Jun 3. Epub 2021 Jun 3.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, Ansari Nagar 110029, India.

Ultrasonography (US) forms the mainstay of imaging in children; however, in the chest, its use has traditionally been limited to evaluation of pleural pathology. US techniques such as endobronchial and endoscopic ultrasound, which are commonly used for detection of mediastinal lymphadenopathy are invasive, aerosol generating, and often require sedation. Transcutaneous mediastinal sonography (TMUS) offers a useful alternative, which is easier to perform and overcomes these limitations. Read More

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Sedation Rate Reduction in Paediatric Renal Nuclear Medicine Examinations: Consequences of a Targeted Audit.

Children (Basel) 2021 May 20;8(5). Epub 2021 May 20.

Department of Pediatric Urology, Hospital of the Sisters of Charity, Seilerstätte 4, 4020 Linz, Austria.

Background: Nuclear medicine investigations are essential diagnostic tools in paediatric urology. Child-orientated examination techniques and the avoidance of sedation or anaesthesia vary in different institutions. We aimed at evaluating child friendly measures in our department to identify the potential for improvement. Read More

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Neurological Complications Acquired During Pediatric Critical Illness: Exploratory "Mixed Graphical Modeling" Analysis Using Serum Biomarker Levels.

Pediatr Crit Care Med 2021 Jun 1. Epub 2021 Jun 1.

Department of Computer Science, University of Pittsburgh, Pittsburgh, PA. Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA. Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA. Safar Center for Resuscitation Research, University of Pittsburgh School of Medicine, Pittsburgh, PA Brain Care Institute, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA. Department of Computational and Systems Biology, University of Pittsburgh, Pittsburgh, PA.

Objectives: Neurologic complications, consisting of the acute development of a neurologic disorder, that is, not present at admission but develops during the course of illness, can be difficult to detect in the PICU due to sedation, neuromuscular blockade, and young age. We evaluated the direct relationships of serum biomarkers and clinical variables to the development of neurologic complications. Analysis was performed using mixed graphical models, a machine learning approach that allows inference of cause-effect associations from continuous and discrete data. Read More

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Development and Implementation of Pediatric ICU-based Mobility Guidelines: A Quality Improvement Initiative.

Pediatr Qual Saf 2021 May-Jun;6(3):e414. Epub 2021 May 19.

Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pa.

Critical illness results in physical impairments which may be mitigated by intensive care unit (ICU)-based early mobility. This initiative aimed to develop and implement ICU-based mobility guidelines for critically ill children.

Methods: A multidisciplinary team developed and implemented ICU-based mobility guidelines. Read More

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Analgesia, Sedation, and Neuromuscular Blockade in Infants with Congenital Diaphragmatic Hernia.

Am J Perinatol 2021 May 27. Epub 2021 May 27.

Department of Pediatrics, Ann & Robert H Lurie Children's Hospital of Chicago, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Objective:  The aim of this study was to describe the use, duration, and intercenter variation of analgesia and sedation in infants with congenital diaphragmatic hernia (CDH).

Study Design:  This is a retrospective analysis of analgesia, sedation, and neuromuscular blockade use in neonates with CDH. Patient data from 2010 to 2016 were abstracted from the Children's Hospitals Neonatal Database and linked to the Pediatric Health Information System. Read More

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Procedural Sedation for Pediatric Upper Gastrointestinal Endoscopy in Korea.

J Korean Med Sci 2021 May 24;36(20):e136. Epub 2021 May 24.

Department of Pediatrics, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea.

Background: Sedative upper endoscopy is similar in pediatrics and adults, but it is characteristically more likely to lead to respiratory failure. Although recommended guidelines for pediatric procedural sedation are available within South Korea and internationally, Korean pediatric endoscopists use different drugs, either alone or in combination, in practice. Efforts are being made to minimize the risk of sedation while avoiding procedural challenges. Read More

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Ethical Challenges in Pediatric Oncology Care and Clinical Trials.

Recent Results Cancer Res 2021 ;218:149-173

Division of Pediatric Hematology/Oncology, Harvard Medical School, Center for Bioethics, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, 02215, USA.

The care of pediatric cancer patients is a vast departure from cancer care of adults. While the available treatment modalities-chemotherapy, radiation, and surgery-are the same, the diseases, care-delivery, and outcomes differ greatly. And just as 'children are not just little adults,' pediatric bioethics occupies a distinct place within the broader field of bioethics. Read More

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MR spectroscopy in pediatric neuroradiology.

Transl Pediatr 2021 Apr;10(4):1169-1200

Neuroradiology Unit, Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.

Magnetic resonance spectroscopy (MRS), being able to identify and measure some brain components (metabolites) in pathologic lesions and in normal-appearing tissue, offers a valuable additional diagnostic tool to assess several pediatric neurological diseases. In this review we will illustrate the basic principles and clinical applications of brain proton (H; hydrogen) MRS (HMRS), by now the only MRS method widely available in clinical practice. Performing HMRS in the brain is inherently less complicated than in other tissues (e. Read More

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Factors affecting successful use of intranasal dexmedetomidine: a cohort study from a national paediatrics tertiary centre.

Transl Pediatr 2021 Apr;10(4):765-772

Department of Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore, Singapore.

Background: Use of intranasal (IN) dexmedetomidine for procedural sedation has been reported in recent years. Good patient selection is important to ensure high success rates. We aimed to identify factors that influence the successful use of IN dexmedetomidine in non-invasive investigations. Read More

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Point-of-Care Ultrasound-Guided Hematoma Block for Forearm Fracture Reduction.

Pediatr Emerg Care 2021 Apr 8. Epub 2021 Apr 8.

From the Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY.

Abstract: Fractures of the radius and ulna are very common in pediatric patients. Procedural sedation or general anesthesia is typically required to perform orthopedic reductions. There are several studies in the adult literature that conclude that point-of-care ultrasound-guided hematoma blocks are faster and just as efficacious as procedural sedation for reducing fractures in the emergency department. Read More

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Nonpharmacological interventions to reduce sedation/general anaesthesia in paediatric patients undergoing magnetic resonance imaging: A systematic review and meta-analysis protocol.

Acta Anaesthesiol Scand 2021 May 15. Epub 2021 May 15.

Children's Hospital Copenhagen and Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Background: Magnetic resonance imaging is frequently used in paediatrics and requires the child/adolescent to remain still for 45 min or more. The long and narrow scanner gantry makes loud noises and may cause anxiety. To complete the procedure, children and adolescents are often sedated or receive general anaesthesia. Read More

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How Can Dentists Effectively Manage Behavior, Sedation, and General Anesthesia in Pediatric Patients?

Compend Contin Educ Dent 2021 May;42(5):210-211

Professor, Pediatric Dentistry and Pediatrics, Chair, Program Director, Pediatric Dentistry, CWRU School of Dental Medicine; Anne Hunter Jenkins Endowed Master Clinician in Pediatric Dentistry and Orthodontics, Chief of Dentistry, Rainbow Babies and Children's Hospital.

The problem of treating and healing such patients is complex. Considerations encompass the safety and comfort of the child, the amount and difficulty of treatment needed, the level of the patient's anxiety and whether or not the patient is cooperative, the parent or guardian's attitude and level of trust, and whether or not the patient is physically resistant and, if so, the level of resistance. Other considerations are medicolegal implications, financial implications of treatment, insurance considerations, the dentist's and staff's training and experience, and the availability of sedation or general anesthesia. Read More

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D-Cystine di(m)ethyl ester reverses the deleterious effects of morphine on ventilation and arterial blood gas chemistry while promoting antinociception.

Sci Rep 2021 May 11;11(1):10038. Epub 2021 May 11.

Department of Pharmacology, Case Western Reserve University, Cleveland, OH, 44106, USA.

We have identified thiolesters that reverse the negative effects of opioids on breathing without compromising antinociception. Here we report the effects of D-cystine diethyl ester (D-cystine diEE) or D-cystine dimethyl ester (D-cystine diME) on morphine-induced changes in ventilation, arterial-blood gas chemistry, A-a gradient (index of gas-exchange in the lungs) and antinociception in freely moving rats. Injection of morphine (10 mg/kg, IV) elicited negative effects on breathing (e. Read More

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Surfactant therapy via thin catheter in preterm infants with or at risk of respiratory distress syndrome.

Cochrane Database Syst Rev 2021 05 10;5:CD011672. Epub 2021 May 10.

Department of Paediatrics, Royal Hobart Hospital, Hobart, Australia.

Background: Non-invasive respiratory support is increasingly used for the management of respiratory dysfunction in preterm infants. This approach runs the risk of under-treating those with respiratory distress syndrome (RDS), for whom surfactant administration is of paramount importance. Several techniques of minimally invasive surfactant therapy have been described. Read More

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End-of-life care in children and adolescents with cancer: perspectives from a French pediatric oncology care network.

Tumori 2021 May 4:3008916211013384. Epub 2021 May 4.

RIFHOP, Île-de-France Regional Network of Pediatric Hematology-Oncology, Paris, France.

Background: In developed countries, cancer remains the leading cause of pediatric death from illness after the neonatal period.

Objective: To describe the end-of-life care characteristics of children and adolescents with solid tumors (ST) or hematologic malignancies (HM) who died from tumor progression in the Île-de-France area.

Methods: This is a regional, multicentric, retrospective review of medical files of all children and adolescents with cancer who died over a 1-year period. Read More

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A Prospective Randomized Controlled Trial Using Propofol or Dexmedetomidine for Conscious Sedation in Pediatric Patients Undergoing Sclerotherapy.

J Pediatr Neurosci 2020 Oct-Dec;15(4):379-385. Epub 2021 Jan 19.

Department of Anaesthesia, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.

Aim: Sodium tetradecyl sulfate (STS) sclerotherapy in pediatric patients is usually undertaken under sedation inside digital subtraction angiography (DSA) suite. These patients are day-care patients and need adequate sedation for small duration. We performed this study to compare propofol and dexmedetomidine as sedative agents in these patients. Read More

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January 2021

An unusual case of epistaxis in a four month old.

Am J Emerg Med 2021 Apr 17;47:228-230. Epub 2021 Apr 17.

Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, 55404, United States of America.

Epistaxis is a routine complaint in Emergency Medicine and presents most commonly in adults and children and its incidence increases with age. It is rare in infants and neonates. We discuss a case of epistaxis in a four-month-old male who presented to a critical access hospital. Read More

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"Difficult to Sedate": Successful Implementation of a Benzodiazepine-Sparing Analgosedation-Protocol in Mechanically Ventilated Children.

Children (Basel) 2021 Apr 28;8(5). Epub 2021 Apr 28.

Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA.

We sought to evaluate the success rate of a benzodiazepine-sparing analgosedation protocol (ASP) in mechanically ventilated children and determine the effect of compliance with ASP on in-hospital outcome measures. In this single center study from a quaternary pediatric intensive care unit, our objective was to evaluate the ASP protocol, which included opiate and dexmedetomidine infusions and was used as first-line sedation for all intubated patients. In this study we included 424 patients. Read More

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Hexosylceramides and Glycerophosphatidylcholine GPC(36:1) Increase in Multi-Organ Dysfunction Syndrome Patients with Pediatric Intensive Care Unit Admission over 8-Day Hospitalization.

J Pers Med 2021 Apr 24;11(5). Epub 2021 Apr 24.

Pediatric Critical Care Unit, Helen DeVos Children's Hospital, Grand Rapids, MI 49503, USA.

Glycero- and sphingo-lipids are important in plasma membrane structure, caloric storage and signaling. An un-targeted lipidomics approach for a cohort of critically ill pediatric intensive care unit (PICU) patients undergoing multi-organ dysfunction syndrome (MODS) was compared to sedation controls. After IRB approval, patients meeting the criteria for MODS were screened, consented ( = 24), and blood samples were collected from the PICU at HDVCH, Michigan; eight patients needed veno-arterial extracorporeal membrane oxygenation (VA ECMO). Read More

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The effect of alpha-2A adrenergic receptor (ADRA2A) genetic polymorphisms on the depth of sedation of dexmedetomidine: a genetic observational pilot study.

Braz J Anesthesiol 2021 Apr 26. Epub 2021 Apr 26.

Korea University Ansan Hospital, College of Medicine, Department of Anesthesiology and Pain Medicine, Ansan, Republic of Korea.

Background: The genetic polymorphisms of the alpha-2A adrenergic receptor (ADRA2A), which plays a significant role in sedation, anxiety relief, and antinociception, particularly in dexmedetomidine, may differ in the degree of sedation. This study aimed to investigate the effect of the genetic polymorphisms of ADRA2A (rs11195418, rs1800544, rs2484516, rs1800545, rs553668, rs3750625) on the sedative effects of dexmedetomidine.

Methods: A total of 131 patients aged 50 years or more from May 2018 to August 2019 were included in this study. Read More

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Implementing capnography to help improve patient safety during procedural sedation: quality improvement in a high-volume gastroenterology department.

Eur J Gastroenterol Hepatol 2021 Apr 19. Epub 2021 Apr 19.

aDepartment of Gastroenterology and Hepatology, UZ Leuven, Belgium bCoreva Scientific, Königswinter, Germany cDepartment of Pneumology dDepartment of Pediatrics, UZ Leuven, Belgium eMedasense Biometrics, Raman Gat fAt the time of writing at Medtronic, Jerusalem, Israel.

Objective: Respiratory compromise is a major cause of adverse events during procedural sedation; continuous monitoring is vital for identifying and halting decompensation. We performed a quality improvement investigation to assess patient safety during procedural sedation in gastroenterology and the impact of implementing capnography monitoring.

Patients And Methods: Sedation-related adverse events and interventions were prospectively recorded during the endoscopic procedure and in recovery. Read More

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The use of a noninvasive positive pressure system to facilitate tracheal intubation in a difficult pediatric airway: a case report.

Braz J Anesthesiol 2021 Apr 19. Epub 2021 Apr 19.

North Florida/Southern Georgia Veterans Health System and the University of Florida, Department of Anesthesiology, Gainesville, Florida.

Patients with burns to the head and neck may be difficult to intubate or ventilate via facemask. Furthermore, post-burn scarring and microstomia may reduce the success of rescue supraglottic airway placement. While awake tracheal intubation using a flexible intubation scope is considered the optimal technique for these patients, it may not always be feasible in the pediatric population. Read More

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Eutectic Mixture of Lidocaine and Prilocaine Decreases Movement and Propofol Requirements for Pediatric Lumbar Puncture During Deep Sedation: A Randomized, Placebo-Controlled, Double Blind Trial.

J Pediatr Hematol Oncol 2021 Apr 21. Epub 2021 Apr 21.

Departments of Anesthesiology Pediatrics Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC.

Deep sedation/general anesthesia is commonly used in pediatric oncology patients undergoing lumbar puncture (LP). Propofol is often used for sedation, with or without a narcotic. We hypothesized that eutectic mixture of lidocaine and prilocaine (EMLA) would allow for lower cumulative doses of propofol and less movement. Read More

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Factors Predisposing to Post Dural Puncture Headache in Children.

J Child Neurol 2021 Apr 21:8830738211007699. Epub 2021 Apr 21.

2969Children's Hospital of MI, Detroit, MI, USA.

Background: Knowledge of the factors that predispose to postdural puncture headache in children may help reduce the occurrence of this complication.

Materials And Methods: A retrospective cohort study of children who presented to the study institution between 2010 and 2018 was conducted. Children were divided into 2 groups: those who experienced postdural puncture headache and those who did not. Read More

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Effect of music on pediatric endoscopic examinations: a randomized controlled trial.

Endosc Int Open 2021 Apr 13;9(4):E599-E605. Epub 2021 Apr 13.

Department of Gastroenterology and Nutrition, Division of Pediatrics, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile.

 The primary objective was to measure the effect of music as an adjunct to sedation in patient anxiety levels during pediatric endoscopic examinations.  We performed a single-blind randomized controlled trial comparing music with no music in children aged 2 to 18 years. Anxiety was measured using the Modified Yale Preoperative Anxiety Scale (m-YPAS) and the Visual Analog Anxiety Scale (VAS-anxiety). Read More

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Targeted metabolomics revealed changes in phospholipids during the development of neuroinflammation in Abcd1 mice and X-linked adrenoleukodystrophy patients.

J Inherit Metab Dis 2021 Apr 14. Epub 2021 Apr 14.

Department of Pediatrics and Adolescent Medicine, Division of Pediatric Neurology, University Medical Center Göttingen, Georg August University, Göttingen, Germany.

X-linked adrenoleukodystrophy (X-ALD) is the most common leukodystrophy. Despite intensive research in recent years, it remains unclear, what drives the different clinical disease courses. Due to this missing pathophysiological link, therapy for the childhood cerebral disease course of X-ALD (CCALD) remains symptomatic; the allogenic hematopoietic stem cell transplantation or hematopoietic stem-cell gene therapy is an option for early disease stages. Read More

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The Multidimensional Assessment for Pediatric Patients in Radiotherapy (M.A.P.-RT) Tool for Customized Treatment Preparation: RADAR Project.

Front Oncol 2021 29;11:621690. Epub 2021 Mar 29.

UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Pediatric patients may experience considerable distress during radiotherapy. Combining psychological interventions with standard therapies can reduce the need for sedation. The RADAR Project aims to use a systematic method of recording data that can reveal patients' difficulties and fragility during treatment. Read More

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Implementation of an Analgesia-Sedation Protocol Is Associated With Reduction in Midazolam Usage in the PICU.

Pediatr Crit Care Med 2021 Apr 12. Epub 2021 Apr 12.

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Department of Anaesthesia, Harvard Medical School, Boston, MA. Computational Health Informatics Program, Boston Children's Hospital, Boston, MA. Division of Medical Critical Care, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA.

Objectives: Examine the association of a revised analgesia-sedation protocol with midazolam usage in the PICU.

Design: A single-center nonrandomized before-after study.

Setting: PICU at a quaternary pediatric hospital (Boston Children's Hospital, Boston, MA). Read More

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