Bradycardic Arrest in a Child with Complex Congenital Heart Disease Due to Sugammadex Administration.

The neuromuscular blocking drugs rocuronium and vecuronium are often used during general anesthesia. These drugs temporarily paralyze the patient and thus both facilitate placement of an endotracheal tube and prevent any patient movement during surgery. Reversal of neuromuscular blockade is necessary at the end of surgery to avoid postoperative weakness and adverse respiratory events in the recovery room.

Management of difficult airway patients and the use of a difficult airway registry at a tertiary care pediatric hospital.

Background: Appropriate recognition and management of the pediatric difficult airway is essential. Two patient deaths in a 2-year period involving children with a known difficult airway led to the formation of the institution's multidisciplinary Difficult Airway Committee.

Methods: Patients with a suspected difficult airway or a known difficult airway are entered into a registry of difficult airway patients.

The use of extracorporeal life support in adolescent amlodipine overdose.

Calcium channel blocker (CCB) toxicity is associated with refractory hypotension and can be fatal. A 13 year old young woman presented to the emergency department(ED) six hours after an intentional overdose of amlodipine, barbiturates, and alcohol. She remained extremely hypotensive despite the administration of normal saline and calcium chloride and despite infusions of norepinephrine, epinephrine, insulin, and dextrose.

A trial of methadone tapering schedules in pediatric intensive care unit patients exposed to prolonged sedative infusions.

Objectives: To compare the efficacy of a low-dose methadone tapering schedule to a high-dose methadone tapering schedule in pediatric intensive care unit patients exposed to infusions of fentanyl, with or without infusions of midazolam, for ≥ 5 days.

Design: Prospective, double-blind, randomized trial.

Setting: Pediatric intensive care unit in a tertiary care children's hospital.

Chloral hydrate sedation for pediatric echocardiography: physiologic responses, adverse events, and risk factors.

Objective: The physiologic responses to chloral hydrate sedation in the setting of a pediatric echocardiography laboratory have not been well documented; neither has the population at risk been identified adequately. The purpose of this study was to describe the physiologic responses to chloral hydrate sedation, to report the occurrence of adverse events, and to identify any risk factors that predicted these adverse events in children who underwent sedation for echocardiography at our institution.

Methods: We analyzed retrospectively 1095 patients who were sedated for echocardiography.