The relationship among thromboelastography, hemostatic variables, and bleeding after cardiopulmonary bypass surgery in children.

Background: Mediastinal bleeding is common after pediatric cardiopulmonary bypass (CPB) surgery. Thromboelastography (TEG) may predict bleeding and provide insight into likely mechanisms. We aimed to (a) compare perioperative temporal profiles of TEG and laboratory hemostatic variables between patients with significant hemorrhage (BLEED) and those without (CONTROL), (b) investigate the relationship between TEG variables and routine hemostatic variables, and (c) develop a model for prediction of bleeding.

A randomised trial to evaluate prescribing accuracy when using the Paediatric Analgesia Wheel.

Objective: To compare the accuracy of prescribing analgesic and anti-emetic drugs to children when using either the 2006 BNF for children (BNFC) or a new device, the Paediatric Analgesia Wheel.

Study Design: A simulated prescription chart was created requiring doctors to prescribe seven drugs to each of two children (14 prescriptions in total). 52 doctors from anaesthesia, paediatrics and emergency medicine were recruited and randomly assigned to complete the chart using either the BNFC or a new device, the Paediatric Analgesia Wheel.

The influence of hyperchloraemia on acid base interpretation in diabetic ketoacidosis.

Objectives: During the acute treatment of diabetic ketoacidosis we (a) determined the temporal incidence of hyperchloraemia, and (b) quantified the influence of hyperchloraemia on interpretation of common blood gas derived acid base parameters, namely base deficit and bicarbonate.

Design And Setting: Retrospective chart review in two regional paediatric intensive care units.

Measurements And Results: Stewart's physicochemical theory was used to develop regression equations quantifying the acidifying effect of hyperchloraemia on both base deficit and bicarbonate.