[Acute hyponatremia can be a life-threatening condition. Recommendations for hydration of children in surgery and acute disease reduces the risk].

Hyponatremia is the most frequent electrolyte abnormality seen postoperatively in pediatric patients receiving maintenance fluid therapy. Hyponatremia is also common in acute pediatric illness. The main factors contributing to hyponatremia in these conditions are increased secretion of antidiuretic hormone (ADH) and routine use of sodium hypotonic fluids.

The development of pediatric anesthesia and intensive care in Scandinavia.

The initiation and development of pediatric anesthesia and intensive care have much in common in the Scandinavian countries. The five countries had to initiate close relations and cooperation in all medical disciplines. The pediatric anesthesia subspecialty took its first steps after the Second World War.

Recruitment and PEEP level influences long-time aeration in saline-lavaged piglets: an experimental model.

Objectives: To evaluate aeration/ventilation in saline-lavaged piglets during a 3-h follow-up after a recruitment maneuver (RM)/PEEP titration compared with PEEP 10 cmH2O without a RM.

Background: Lung recruitment and PEEP titration are used to find a PEEP preventing repetitive opening/collapsing of lung.

Methods: Twenty-one lung-lavaged piglets, mean age 7 weeks and mean weight 10 kg; a RM-group and a PEEP10-group, were ventilated at PEEP 5 cmH2O (baseline) followed by zero PEEP ventilation.

Lung aeration during ventilation after recruitment guided by tidal elimination of carbon dioxide and dynamic compliance was better than after end-tidal carbon dioxide targeted ventilation: a computed tomography study in surfactant-depleted piglets.

Objective: To test the hypothesis that tidal elimination of carbon dioxide and dynamic compliance guided lung recruitment and positive end-expiratory pressure titration in surfactant-depleted piglets result in improved aeration (repeated computed tomography scans) and reduced ventilation pressures compared to those of a control group with conventional end-tidal carbon dioxide targeted ventilation.

Design: Prospective animal investigation.

Setting: Clinical physiology research laboratory.

Intraoperative thromboelastometry is associated with reduced transfusion prevalence in pediatric cardiac surgery.

Background: The majority of pediatric cardiac surgery patients receive blood transfusions. We hypothesized that the routine use of intraoperative thromboelastometry to guide transfusion decisions would reduce the overall proportion of patients receiving transfusions in pediatric cardiac surgery.

Methods: One hundred pediatric cardiac surgery patients were included in the study.

A study of the physiological consequences of sympathetic denervation of the heart caused by the arterial switch procedure.

Background: The arterial switch operation is the corrective operation for transposition of the great arteries, defined as the combination of concordant atrioventricular and discordant ventriculo-arterial connections, but there have been concerns about silent subendocardial ischaemia on exercise and coronary artery growth. The arterial switch divides the majority of the sympathetic nerves entering the heart; we have studied the effects of coronary flow and sensitivity to catecholamine stimulation in an animal model.

Methods: A total of 10 piglets were operated on cardiopulmonary bypass with section and resuturing of aortic trunk, pulmonary artery and both coronary arteries, with 13 sham-operated controls.

VTCO2 and dynamic compliance-guided lung recruitment in surfactant-depleted piglets: a computed tomography study.

Objective: Using computed tomography (CT) as reference, our primary objectives were to test if maximal tidal elimination of carbon dioxide (VTCO2) could be used as a marker of "optimal recruitment," indicating maximal available lung tissue for gas exchange and if a decrease in dynamic compliance (Cdyn) indicated the beginning of lung collapse during a downward positive end-expiratory pressure (PEEP) titration.

Design: Prospective laboratory animal investigation.

Setting: Clinical physiology research laboratory.

Myocardial substrates in children with congenital heart disease: relationship to substrate supply, age, growth and desaturation.

Aim: The myocardial uptake of substrates in children has only been investigated on a small scale. The purpose of this study was to define myocardial substrate uptake in relation to the arterial supply of substrates, age, growth and oxygen saturation.

Methods: Thirty patients with congenital heart disease, aged 3 months to 16 years, were studied during cardiac catheterization.

Myocardial metabolism is better preserved after blood cardioplegia in infants.

Background: We have previously reported improved hemodynamic function after blood cardioplegia in comparison with crystalloid cardioplegia. Furthermore, lactate was released from the heart after crystalloid cardioplegia but not after blood cardioplegia. The purpose of this study was to determine whether the difference in substrate metabolism between the two cardioplegia methods was restricted to lactate, or whether the difference in metabolic derangement was more extensive.

Blood cardioplegia provides superior protection in infant cardiac surgery.

Background: We hypothesized that blood cardioplegia preserves myocardial metabolism and function more effectively than St Thomas' crystalloid cardioplegia in infant cardiac surgery.

Methods: Thirty infants with atrioventricular septal defects were randomly allocated to either blood or crystalloid intermittent cold (4 degrees C) cardioplegia. Arterial and coronary sinus blood was analyzed for lactate and oxygen.

The dynostatic algorithm accurately calculates alveolar pressure on-line during ventilator treatment in children.

Background: Monitoring of respiratory mechanics during ventilator treatment in paediatric intensive care is currently based on pressure and flow measurements in the ventilator or at the Y-piece. The characteristics of the tracheal tube will modify the pressures affecting the airways and alveoli in an unpredictable manner. The dynostatic algorithm (DSA), based on a one-compartment lung model, calculates the alveolar pressure during on-going ventilation.

Direct measurement of intratracheal pressure in pediatric respiratory monitoring.

We describe a method based on a Fabry-Perot interferometer at the tip of an optic fiber with a diameter of 0.25 mm for direct measurement of tracheal pressure in pediatric respiratory monitoring. The response time of the pressure transducer and its influence on the resistance of pediatric endotracheal tubes (internal diameter, 2.