Perioperative use of glucose containing solutions in infants less than 6 months of age: A clinical practice survey among US academic centers.

Background: Although there is a wide breadth of literature on glucose homeostasis in infants, standardization of perioperative hypoglycemia diagnosis and management is lacking.

Aims: Survey of academic pediatric anesthesiology departments across the USA to evaluate institutional policies regarding the perioperative use of glucose containing solutions in infants less than 6 months of age.

Methods: A questionnaire was sent to 20 United States university affiliated academic pediatric anesthesiology departments.

Myasthenic crisis in the setting of Coronavirus Disease 2019 (COVID-19).

• A patient with Myasthenia Gravis (MG) on immunosuppressive therapy with underlying respiratory compromise may be more susceptible to infection with COVID-19 or severe manifestations of the virus. • It is theorized that patients with MG may be more vulnerable to bacterial and viral infections, due to respiratory muscle weakness and use of immunosuppressive medications. • It is critical for practitioners to be prepared for severe respiratory compromise in patients with MG and concomitant COVID-19 superinfection.

Peters anomaly: A 5-year experience.

Background: Peters anomaly is a rare, congenital eye malformation characterized by an opaque cornea and blurred vision. Central corneal opacification can lead to delayed progression of visual development caused by defects in Descemet membrane and the posterior stroma. These children require several anesthetics for multiple eye examinations under anesthesia and corneal transplantation.

Anesthetic Implications of a Patient With Kniest Dysplasia and Mitochondrial Disease: A Case Report.

Kniest dysplasia, or metatropic dysplasia type II, is a rare chondrodysplasia caused by abnormal type II collagen. Clinically, it is characterized by dwarfism, deafness, skeletal derangements, and ocular abnormalities. Mitochondrial diseases produce a spectrum of abnormalities in affected individuals and predominantly impact organs of high energy utilization, including the brain, skeletal muscles, kidneys, and liver.

Postoperative Harlequin Syndrome: Case Report of a Rare but Clinically Striking Condition.

We present a case of a 2-year-old boy who underwent thoracoscopic resection of a left paraspinal mediastinal mass and developed Harlequin syndrome postoperatively. Harlequin syndrome is a rare neurological condition characterized by unilateral hyperhidrosis and erythema of the head and neck. Our discussion highlights this condition and other differential diagnoses that may present similarly in the postoperative period.

Anesthesia for Pygopagus Conjoined Twins During Single-Twin and Simultaneous Pneumoperitoneum: A Case Report.

We present the case of the first stage of separation of 9-month-old pygopagus conjoined twins who demonstrated minimal shared vasculature on preoperative imaging and no cross-sedation or cross-neuromuscular blockade during separate inductions of anesthesia. Laparoscopy was implemented in 1 twin at a time, then in both twins simultaneously. Despite insufflation of a single-twin's abdomen, both twins demonstrated hypercapnia and signs of a concomitant respiratory acidosis because of carbon dioxide diffusion through a shared peritoneal membrane.

International teleconsultation on conjoined twins leading to a successful separation: a case report.

Conjoined twins are identical twins that have incompletely separated in utero. The prognosis for conjoined twins is poor and management in a skilled tertiary care centre is paramount for definitive care. We describe our experience with a telemedical consultation on conjoined twins in The Dominican Republic from our eHealth centre in Valhalla, NY.

Ondansetron with propofol reduces the incidence of emesis in children following tonsillectomy.

Purpose: This study tested the hypothesis that the antiemetic effects of a combination of ondansetron and propofol were superior to propofol alone in children undergoing tonsillectomy surgery.

Methods: A prospective, randomized, double-blind, placebo-controlled study design was employed. Young children underwent mask induction with halothane, nitrous oxide and oxygen and then had i.

Venovenous modified ultrafiltration after cardiopulmonary bypass in children: a prospective randomized study.

Background: Cardiopulmonary bypass is associated with the production of both proinflammatory and anti-inflammatory cytokines, the balance of which leads to varying degrees of postoperative systemic inflammation. Arteriovenous modified ultrafiltration effectively reduces total body water and improves postoperative hemodynamic and homeostatic functions. Venovenous modified ultrafiltration is a modification of this technique, which has the potentially added advantage of eliminating the obligatory left-to-right shunt associated with arteriovenous modified ultrafiltration.

Total intravenous anesthesia for children undergoing brief diagnostic or therapeutic procedures.

Study Objective: To compare the quality of anesthesia with propofol, ketamine, or etomidate in children undergoing brief diagnostic or therapeutic procedures.

Design: Retrospective study.

Setting: University hospital.

An audit of adverse events in children sedated with chloral hydrate or propofol during imaging studies.

We examined records of sedations provided by the paediatric anaesthesiology staff for 455 children (ages 1 mo-17 yr) undergoing MRI or CT scans at our institution over a twelve-month period with regard to the monitoring of adverse events: excessive sedation, agitation, vomiting, hypoxaemia, and major airway compromise. One hundred-and-thirty-one patients (29%) received chloral hydrate; 324 patients (71%) received propofol. All patients were monitored with continuous noninvasive pulse oximetry and received supplemental oxygen via nasal cannulae.

Propofol reduces the incidence of vomiting after tonsillectomy in children.

We compared the effect of a propofol-based anaesthetic to an isoflurane-based anaesthetic on the incidence of postoperative vomiting in children following tonsillectomy. Thirty-nine children were enrolled in the study and randomized to receive one of the proposed anaesthetics. All patients underwent a mask induction with halothane, nitrous oxide, and oxygen.

Delayed awakening from general anaesthesia in a patient with Hunter syndrome.

Hunter syndrome is one of a heterogeneous group of recessively inherited mucopolysaccharide storage diseases (MPS) with similar biochemical defects manifested by impairments in mucopolysaccharide catabolism with variable but progressive clinical courses. Abnormal accumulation and deposition of mucopolysaccharides in the tissue of several organs to numerous anatomical, musculoskeletal and neurological abnormalities which are known to complicate anaesthetic and airway management. Hunter syndrome has a wide variance of clinical phenotypes ranging from mild to severe.

Use of propofol for the prevention of chemotherapy-induced nausea and emesis in oncology patients.

Nausea and vomiting associated with antineoplastic chemotherapy are distressing and may keep patients from complying with chemotherapy protocols. No drug has emerged among many as an effective antiemetic. It has been speculated that propofol may have intrinsic antiemetic properties.

Anesthesia for diagnostic and therapeutic procedures in pediatric outpatients.

Appropriate sedation of pediatric oncology patients during painful diagnostic and therapeutic procedures is a recognized problem. At the Memorial Sloan-Kettering Cancer Center the pediatric oncologists and anesthesiologists have developed a cooperative program that has provided safe and effective sedation of outpatients. The experience with 100 consecutive outpatients is reported.

The release of a leukotriene D4-like substance following myocardial infarction in rabbits.

Myocardial infarction was induced in rabbits and 24-48 h later the hearts were removed and perfused in vitro with the coronary effluent superfusing a guinea-pig ileum. The formyl tripeptide (FMLP: 10-100 ng) induced the dose-related release of a substance which contracted the ileum, an effect mimicked by exogenous LTD4 (2-200 ng), blocked by FPL 55712 (2 micrograms/ml) and inhibited with BW755C (2 micrograms/ml) but not indomethacin (1 micrograms/ml). The delayed release of this LTD4-like material may suggest a role in the complications accompanying myocardial infarction.