Modified fluid gelatin 4% for perioperative volume replacement in pediatric patients (GPS): Results of a European prospective noninterventional multicenter study.

Introduction: Modified fluid gelatin 4% is approved for use in children, but there is still a surprising lack of clinical studies including large numbers of pediatric patients. Therefore, we performed a European prospective noninterventional multicenter study to evaluate the use of a modified fluid gelatin 4% in saline (sal-GEL) or an acetate-containing balanced electrolyte solution (bal-GEL) in children undergoing major pediatric surgery.

Aims: The primary aim was to assess the indications and dosing of modified fluid gelatin, and the secondary aim was to assess the safety and efficacy, focusing, in particular, on routinely collected clinical parameters.

Morbidity and mortality after anaesthesia in early life: results of the European prospective multicentre observational study, neonate and children audit of anaesthesia practice in Europe (NECTARINE).

Background: Neonates and infants requiring anaesthesia are at risk of physiological instability and complications, but triggers for peri-anaesthetic interventions and associations with subsequent outcome are unknown.

Methods: This prospective, observational study recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. The primary aim was to identify thresholds of pre-determined physiological variables that triggered a medical intervention.

[Anaesthesia Induction in Non-fasting Patients - the Example of Pregnant Women and Children].

Aspiration during anesthesia induction is no triviality, but can lead to serious complications and mortality. The classic technique of rapid sequence induction (RSI) is a fundamental form of anesthesia induction in non-fasting patients to prevent pulmonary aspiration of gastric contents.Pregnant women and children pose a special challenge due to their hypoxia risk; the classical RSI concept "induction - apnea - (cricoid pressure -) intubation" can lead to hypoxia and therefore must be modified in favor of a controlled technique with preservation of oxygenation in this patient group.

Perioperative fluid management in children: can we sum it all up now?

Purpose Of Review: The composition and type of intravenous fluids during paediatric anaesthesia have been subjects of debates for decades. Errors in perioperative fluid management in children may lead to serious complications and a negative outcome. Therefore, in this review, historical and recent developments and recommendations for perioperative fluid management in children are presented, based on physiology and focused on safety and efficacy.