Performance of Shock Index as a predictor of severe postpartum hemorrhage following cesarean section under spinal anesthesia: a retrospective cohort study.

Background: An early diagnosis of a postpartum hemorrhage (PPH) can be challenging. The Shock Index (SI), the ratio of heart rate to systolic blood pressure, appears to be a useful indicator for the early diagnosis of severe PPH after vaginal delivery. Our primary aim was to evaluate if the SI has a predictive value for severe PPH following cesarean section (C-section) under spinal anesthesia (SA) and its best predictive threshold.

Lateral decubitus: its influence on hemodynamic and respiratory function during retroperitoneal robotic assisted laparoscopic pyeloplasty (R-RALP) in children.

Retroperitoneal robotic-assisted laparoscopic pyeloplasty (R-RALP) is the commonest urologic procedure performed in children, entailing retroperitoneal CO2 insufflation and lateral decubitus, whose effects on cardiopulmonary variables are poorly known. We, therefore, studied hemodynamic and respiratory changes due to CO2 insufflation and lateral decubitus in children undergoing R-RALP and their effects on regional tissue oxygenation. Between 1/2021 and 7/2024, children affected by ureteropelvic joint obstruction (UPJO) underwent a pyeloplasty by R-RALP at Necker Enfants Malades Hospital (Paris, France), using a standardized surgical technique and a lung-protecting anesthetic protocol aimed to prevent hypercarbia.

External lumbar drainage for the management of refractory intracranial hypertension in pediatric severe traumatic brain injury: a retrospective single-center case series.

Objective: Guidelines for the management of pediatric severe traumatic brain injury (TBI) recommend external ventricular drainage for CSF drainage as a first-tier treatment in the intracranial pressure (ICP) pathway. However, ventriculostomy in children can sometimes be challenging because of the small size of the lateral ventricles. External lumbar drainage (ELD) may be a useful alternative; therefore, the authors analyzed the outcome of a cohort of pediatric patients who underwent ELD to manage intracranial hypertension (ICH).

Behavioral training and mirroring techniques to prepare for elective anesthesia in children with autism spectrum disorder: a prospective evaluation of implemented program.

Background: Children with autism spectrum disorder (ASD) often require multiple interventions receiving general anesthesia during their lifetimes. However, a single negative experience may trigger and/or aggravate anxiety and subsequent development of unwanted behavior. This monocentric study assessed the compliance with mask induction of children with ASD who followed a preoperative preparation using behavioral training with positive reinforcement technique and use of mirroring technique.

Prognosis and assessment of the predictive value of severity scores in paediatric abdominal trauma: A French national cohort study.

Background: Paediatric closed abdominal trauma is common, however, its severity and influence on survival are difficult to determine. No prognostic score integrating abdominal involvement exists to date in paediatrics.

Objectives: To evaluate the severity and short-term and medium-term prognosis of closed abdominal trauma in children, and the performance of severity scores in predicting mortality.

Expanding safety boundaries in pediatric robotic-assisted laparoscopic surgery: are we protecting our children?

Little is known about the effects of CO insufflation (CDI) on cerebral oxygen saturation (CrSO) during laparoscopy in the pediatric population. In children undergoing robotic-assisted laparoscopic pyeloplasty (RALP), we prospectively assessed the effects of CDI using standard monitoring and cerebral near-infrared spectroscopy (NIRS). We also explored whether a correlation existed between CrSO and parameters known to affect cerebral blood flow.

Evaluation of quality of care in neonatal anesthesia using a bundle of intraoperative parameters.

Background: Maintenance of physiological homeostasis is key in the safe conduct of pediatric anesthesia. Achieving this goal is especially difficult in neonatal surgery.

Aims: The first aim was to document the absolute number of seven intraoperative parameters monitored during anesthesia in neonates undergoing gastroschisis surgery.

Effect of retropneumoperitoneum on cerebral and renal oxygen saturation during retroperitoneal robotic-assisted laparoscopic pyeloplasty (R-RALP) in a pediatric population: Preliminary results of a prospective observational study using a dedicated anesthetic protocol and Near-InfraRed Spectroscopy.

Background: Retroperitoneal robotic-assisted laparoscopic pyeloplasty (R-RALP) for ureteropelvic junction obstruction (UPJO) has gained growing acceptance among pediatric urologists, and is increasingly performed as day-case surgery, involving smaller children and infants. However, retroperitoneal CO insufflation may cause hemodynamic derangements, respiratory changes, and hypercapnia, whose consequences are poorly investigated. We, therefore, decided to prospectively study its effect on regional tissue perfusion and oxygenation in a cohort of pediatric patients undergoing R-RALP, using a dedicated anesthetic protocol and cerebral and renal Near InfraRed Spectroscopy (NIRS).

Post traumatic cerebral sinovenous thrombosis in children: A retrospective and multicenter study.

Context: Cerebral sinovenous thrombosis (CSVT) is a rare but life-threatening condition in the pediatric population and there is no pediatric guidelines regarding anticoagulation for post traumatic CSVT.

Objective: This study aims to describe a cohort of children with post traumatic CSVT and the use of anticoagulant therapy in this population.

Methods: A multicenter retrospective study.

Consequences of General Anesthesia in Infancy on Behavior and Brain Structure.

Background: One in 7 children will need general anesthesia (GA) before the age of 3. Brain toxicity of anesthetics is controversial. Our objective was to clarify whether exposure of GA to the developing brain could lead to lasting behavioral and structural brain changes.

Incidence of iatrogenic withdrawal syndrome and associated factors in surgical pediatric intensive care.

Background: Iatrogenic withdrawal syndrome (IWS) is a complication of prolonged sedation/analgesia in pediatric intensive care unit (PICU) patients. The epidemiology of IWS is poorly understood, as validated diagnostic tools are rarely used. The main objective of our study was to use the WAT-1 score to assess the incidence of IWS in our unit.

Use of combined cerebral and somatic renal near infrared spectroscopy during noncardiac surgery in children: a proposed algorithm.

Cerebral near infrared spectroscopy (NIRS) monitoring has been extensively applied in neonatology and in cardiac surgery, becoming a standard in many pediatric cardiac centers. However, compensatory physiological mechanisms favor cerebral perfusion to the detriment of peripheral tissue oxygenation. Therefore, simultaneous measurement of cerebral and somatic oxygen saturation has been advocated to ease the differential diagnosis between central and peripheral sources of hypoperfusion, which may go undetected by standard monitoring and not mirrored by cerebral NIRS alone.

Abusive Head Trauma in Infants During the COVID-19 Pandemic in the Paris Metropolitan Area.

Importance: The COVID-19 pandemic and the containment and mitigation measures taken were feared to be associated with increased child abuse.

Objective: To investigate the trend of abusive head trauma (AHT) incidence and severity in infants during the COVID-19 pandemic.

Design, Setting, And Participants: In a time-series analysis of a longitudinal, population-based, cohort study, all consecutive cases of AHT in infants younger than 12 months old referred between January 2017 and December 2021 to Necker Hospital for Sick Children, the single regional pediatric neurosurgery center for the Paris metropolitan area, were included.

Injuries and child abuse increase during the pandemic over 12942 emergency admissions.

Introduction: A strict lockdown was decided from 17/03/2020 to 11/05/2020 in France in order to tackle the first wave of the COVID19 pandemic. In the Great Paris region, several areas are severely affected by overcrowding, creating difficult conditions for children and their families during a period of nearly two months. The objective was to assess the effects of the 2020 spring lockdown on injuries, child abuse and neglect.

Severe Traumatic Brain Injury in French-Speaking Pediatric Intensive Care Units: Study of Practices.

Best strategies for managing severe pediatric traumatic brain injury (TBI) are not established, with wide variations among professional practices. The main objective of this study was to assess compliance with updated pediatric TBI management guidelines (2019). A survey was distributed among French-speaking pediatric intensive care physicians from April 1 to June 30, 2019.

A follow-up of pain reported by children undergoing outpatient surgery using a smartphone application: AlgoDARPEF multicenter descriptive prospective study.

In pediatric patients, pain remains the most common complaint after surgery. This French multicenter epidemiological study (AlgoDARPEF) aimed to evaluate the use of a smartphone application (App) to assess the duration and severity of pain experienced by children undergoing outpatient surgery. Children younger than 18 years scheduled for an elective outpatient procedure in one of the participating centers were eligible.

Epidemiology and complications of anaesthesia in the French centres that participated to NECTARINE: A secondary analysis.

Introduction: Neonatal and infant anaesthesia are associated with a high risk of perioperative complications. The aim of the current study was to describe those risks in France using the French data from the NECTARINE study.

Material And Methods: Data from the French centres that participated to the NECTARINE study were analysed.

Prior infection by seasonal coronaviruses, as assessed by serology, does not prevent SARS-CoV-2 infection and disease in children, France, April to June 2020.

BackgroundChildren have a low rate of COVID-19 and secondary severe multisystem inflammatory syndrome (MIS) but present a high prevalence of symptomatic seasonal coronavirus infections.AimWe tested if prior infections by seasonal coronaviruses (HCoV) NL63, HKU1, 229E or OC43 as assessed by serology, provide cross-protective immunity against SARS-CoV-2 infection.MethodsWe set a cross-sectional observational multicentric study in pauci- or asymptomatic children hospitalised in Paris during the first wave for reasons other than COVID (hospitalised children (HOS), n = 739) plus children presenting with MIS (n = 36).

Anaesthesia management during paediatric robotic surgery: preliminary results from a single centre multidisciplinary experience.

Introduction: Paediatric robotic surgery is gaining popularity across multiple disciplines and offers technical advantages in complex procedures requiring delicate dissection. To date, limited publications describe its perioperative management in children.

Material & Methods: We retrospectively analysed the prospectively collected anaesthetic data of the first 200 robotic-assisted surgery procedures in our paediatric university hospital as part of a multidisciplinary program from October of 2016 to February of 2019.

Anesthetic management for percutaneous reverse Potts shunt creation in children with refractory idiopathic pulmonary arterial hypertension: A case series.

Percutaneous reverse Potts shunt improves right ventricular function in patients with suprasystemic idiopathic pulmonary arterial hypertension. There are no data regarding the anesthesia in this high-risk procedure. We report our experience of the anesthetic management for the creation of percutaneous reverse Potts shunt in children with suprasystemic idiopathic pulmonary arterial hypertension.