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Somri F, Somri M, Gaitini L, Kharouba J, Gómez-Ríos MÁ. Exploring a novel scavenger for inhalational induction in pediatric anesthesia. A promising approach. J Clin Anesth 2024; 94:111375. [PMID: 38211372 DOI: 10.1016/j.jclinane.2024.111375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/13/2023] [Accepted: 01/03/2024] [Indexed: 01/13/2024]
Affiliation(s)
- Feras Somri
- Faculty of Medicine, Universita degli Studi "Gabrielr d'Annunzio" Chieti, Pescara, Italy
| | - Mostafa Somri
- Department of Anesthesia, Bnai Zion Medical Center, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Luis Gaitini
- Department of Anesthesia, Bnai Zion Medical Center, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Johnny Kharouba
- Department of Pediatric Dentistry, the Maurice and Gabriela Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Manuel Á Gómez-Ríos
- Department of Anaesthesiology and Perioperative Medicine, Complejo Hospitalario Universitario de A Coruña, A Coruña, Galicia, Spain; Spanish Difficult Airway Group (GEVAD), Spain.
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2
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Rohmah I, Chen YC, Lin CJ, Tsao NH, Chiu HY. Diagnostic accuracy of the pediatric CAM-ICU, pre-school CAM-ICU, Pediatric Anesthesia Emergence Delirium and Cornell Assessment of Pediatric Delirium for detecting delirium in the pediatric intensive care unit: A systematic review and meta-analysis. Intensive Crit Care Nurs 2024; 82:103606. [PMID: 38158251 DOI: 10.1016/j.iccn.2023.103606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES Delirium is a frequent complication of critical illness, affecting 34% of children admitted to pediatric intensive care units. The commonly used tools for detecting delirium in the pediatric intensive care unit include the Pediatric Confusion Assessment Method for the intensive care unit (ICU, pCAM-ICU), Preschool Confusion Assessment Method for the ICU (psCAM-ICU), Pediatric Anesthesia Emergence Delirium and the Cornell Assessment of Pediatric Delirium. DATA SOURCES We searched four electronic databases for relevant articles from inception to March 1, 2023. STUDY SELECTION All full-text observational studies examining the sensitivity and specificity of the four tools for screening delirium in the pediatric intensive care units were included. DATA EXTRACTION Two researchers independently identified articles, extracted data, and retrieved the diagnostic accuracy parameters of the pediatric CAM-ICU, pre-school CAM-ICU, Pediatric Anesthesia Emergence Delirium, and Cornell Assessment of Pediatric Delirium relative to standard references. A bivariate diagnostic statistical analysis with a random-effects model was performed. DATA SYNTHESIS Four, five, three and seven studies on the pediatric CAM-ICU, pre-school CAM-ICU, Pediatric Anesthesia Emergence Delirium, and Cornell Assessment of Pediatric Delirium, respectively, were identified. Due to the limited number of Pediatric Anesthesia Emergence Delirium articles included, no pooled diagnostic accuracy was produced. The pooled sensitivity was 0.73, 0.84, and 0.95 for the pediatric CAM-ICU, pre-school CAM-ICU, and Cornell Assessment of Pediatric Delirium, respectively, whereas the pooled specificity was 0.98, 0.90, and 0.81, respectively. The Cornell Assessment of Pediatric Delirium had greater sensitivity compared to both the pediatric CAM-ICU and pre-school CAM-ICU (both p = 0.04) and lower specificity than the pediatric CAM-ICU did (p < 0.001). Age, sample size, and mechanical ventilation use were significant moderators of the specificity of the pediatric CAM-ICU (p < 0.001, <0.001, and = 0.001, respectively). CONCLUSIONS Our data indicate that the Cornell Assessment of Pediatric Delirium is a more dependable instrument than the pediatric CAM-ICU and pre-school CAM-ICU for detecting pediatric intensive care delirium occurrence. More studies on the Pediatric Anesthesia Emergence Delirium are warranted. IMPLICATIONS FOR CLINICAL PRACTICE Healthcare providers are suggested adopting the Cornell Assessment of Pediatric Delirium into daily routine for the early detection of delirium in pediatric intensive care units.
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Affiliation(s)
| | - Yi-Chen Chen
- School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chia-Jou Lin
- School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Nan-Hsuan Tsao
- Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hsiao-Yean Chiu
- School of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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3
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Lyne TC, Everton HD, Barkley L, Blaise BJ. Limitations of the consent process in paediatric anaesthesia: the Death during Anaesthesia - Risk and Explanation (DARE) audit. Br J Anaesth 2024; 132:1001-1003. [PMID: 38514375 DOI: 10.1016/j.bja.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/05/2024] [Accepted: 02/10/2024] [Indexed: 03/23/2024] Open
Affiliation(s)
- Tom C Lyne
- Barnet Hospital, Royal Free London NHS Foundation Trust, Barnet, UK
| | - Harry D Everton
- Whittington Hospital, Whittington Foundation NHS Foundation Trust, London, UK
| | - Lisa Barkley
- Paediatric Psychology, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Benjamin J Blaise
- Department of Paediatric Anaesthetics, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK; Center for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas' Hospital, London, UK.
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4
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Erdoes G, Schindler E, Koster A, von Dossow V, Belciu IM, Meier S, El-Tahan MR, Nasr VG. European Pediatric Cardiac Anesthesia Fellowship Program: A First Proof of Concept. J Cardiothorac Vasc Anesth 2024; 38:1088-1091. [PMID: 38423885 DOI: 10.1053/j.jvca.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/22/2024] [Accepted: 02/03/2024] [Indexed: 03/02/2024]
Abstract
The Pediatric Cardiac Anesthesia (PCA) fellowship is a demanding training program in Europe and the United States. Successful completion of the program requires years of training in anesthesiology, a thorough understanding of cardiovascular anatomy and physiology, and extensive experience in the perioperative management of neonates and children with heart disease. In the context of the first candidate to successfully complete the PCA program in Europe, this article presents excerpts from the design and structure of the European PCA program. The PCA program is evaluated critically by both external and internal reviewers, and points are highlighted that could be included in the next version of the program.
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Affiliation(s)
- Gabor Erdoes
- Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Ehrenfried Schindler
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Andreas Koster
- Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center, North Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Vera von Dossow
- Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center, North Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Ioana Maria Belciu
- Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center, North Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Sascha Meier
- Department of Anesthesiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Mohammed R El-Tahan
- Cardiothoracic Anesthesia, Anesthesia, Surgical Intensive Care and Pain Medicine, College of Medicine, Mansoura University, Mansoura, Egypt; King Fahd Hospital of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Viviane G Nasr
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA
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Chao JY, Simpao AF, Yuan I. A Window into the Developing Brain: Toward a Deeper Understanding of Pediatric Anesthesia. Anesthesiology 2024; 140:863-864. [PMID: 38592355 PMCID: PMC11006386 DOI: 10.1097/aln.0000000000004937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Affiliation(s)
- Jerry Y Chao
- Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Allan F Simpao
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Ian Yuan
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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Takeshita J, Tachibana K, Takeuchi M, Shime N. Survey of pediatric cardiovascular anesthesia in Japan. J Anesth 2024; 38:279-281. [PMID: 37816941 DOI: 10.1007/s00540-023-03267-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/26/2023] [Indexed: 10/12/2023]
Affiliation(s)
- Jun Takeshita
- Department of Anesthesiology, Osaka Prefectural Hospital Organization, Osaka Women's and Children's Hospital, 840 Murodo-Cho, Izumi, Osaka, 594-1101, Japan.
| | - Kazuya Tachibana
- Department of Anesthesiology, Osaka Prefectural Hospital Organization, Osaka Women's and Children's Hospital, 840 Murodo-Cho, Izumi, Osaka, 594-1101, Japan
| | - Muneyuki Takeuchi
- Department of Critical Care Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-3-2 Kagamiyama, Higashihiroshima, Hiroshima, 739-8511, Japan
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Leahy C, McArdle J, Lewis H. Risk discussions in paediatric anaesthesia: a survey of current UK practice. Br J Anaesth 2024; 132:798-800. [PMID: 38242800 DOI: 10.1016/j.bja.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/24/2023] [Accepted: 12/21/2023] [Indexed: 01/21/2024] Open
Affiliation(s)
- Charlotte Leahy
- East Suffolk and North Essex NHS Foundation Trust, Essex, UK.
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Dagher K, Benvenuti C, Virag K, Habre W. The Incidence of Postoperative Complications Following Lumbar and Bone Marrow Punctures in Pediatric Anesthesia: Insights From APRICOT. J Pediatr Hematol Oncol 2024; 46:165-171. [PMID: 38447107 PMCID: PMC10956654 DOI: 10.1097/mph.0000000000002849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/05/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Bone marrow aspiration and lumbar puncture are procedures frequently performed in pediatric oncology. We aimed at assessing the incidence and risk factors of perioperative complications in children undergoing these procedures under sedation or general anesthesia. METHODS Based on the APRICOT study, we performed a secondary analysis, including 893 children undergoing bone marrow aspiration and lumbar puncture. The primary outcome was the incidence of perioperative complications. Secondary outcomes were their risk factors. RESULTS We analyzed data of 893 children who underwent 915 procedures. The incidence of severe adverse events was 1.7% and of respiratory complications was 1.1%. Prematurity (RR 4.976; 95% CI 1.097-22.568; P = 0.038), intubation (RR: 6.80, 95% CI 1.66-27.7; P =0.008), and emergency situations (RR 3.99; 95% CI 1.14-13.96; P = 0.030) increased the risk for respiratory complications. The incidence of cardiovascular instability was 0.4%, with premedication as risk factor (RR 6.678; 95% CI 1.325-33.644; P =0.021). CONCLUSION A low incidence of perioperative adverse events was observed in children undergoing bone marrow aspiration or lumbar puncture under sedation and/or general anesthesia, with respiratory complications being the most frequent. Careful preoperative assessment should be undertaken to identify risk factors associated with an increased risk, allowing for appropriate adjustment of anesthesia management.
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Affiliation(s)
| | - Claudia Benvenuti
- Department of Anesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Kathy Virag
- Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - Walid Habre
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Iliff HA, Baxter A, Chakladar A, Endlich Y, McGuire B, Peyton J. Airway topicalization in pediatric anesthesia: An international cross-sectional study. Paediatr Anaesth 2024; 34:145-152. [PMID: 37818989 DOI: 10.1111/pan.14783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND There is no national or international consensus or guideline on recommended dosing of lidocaine for airway topicalization in children. Doses quoted in the literature vary substantially. AIMS The primary aim of the study was to ascertain current international dosing practices (mg.kg-1 and concentration of solution) for lidocaine airway topicalization in children. The secondary aims included examining aftercare instructions for those receiving lidocaine airway topicalization and instances of local anesthetic systemic toxicity secondary to the use of lidocaine for airway topicalization in pediatric patients. METHODS This cross-sectional study consisted of 11-20 questions across three domains-population demographics, clinical practice, and local anesthetic systemic toxicity. It adhered to the consensus-based checklist for reporting of survey studies. Responses were collected over 14 weeks using a combination of probability (cluster and simple random) and nonprobability (purposive, convenience and snowball) sampling. Data were analyzed based on the response rate per question with proportions expressed as percentages and nonparametric data expressed as median (interquartile range [range]) in an effort to minimize nonresponse error. No weighting of items or propensity scoring was applied. RESULTS After initial exclusions, 1501 participants from 69 countries, across six continents, were included. Consultant anesthetists or those with an equivalent level of experience accounted for 1262/1501 (84.1%) of responses. Results showed heterogeneity in dosing and timing regimens and evidence that dosing may contribute to adverse outcomes. The maximum dose reported by participants who use lidocaine for airway topicalization as part of their normal practice was 5 mg.kg-1 (4-6 mg.kg-1 [0.5-50]) median (interquartile range [range]) over 2 h (1-4 h [0-30]). CONCLUSION The results support the need for further research and consensus in this area, in order to provide safe provision of lidocaine airway topicalization in children. It is hoped the results of this study can support future collaborative work in this area.
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Affiliation(s)
- H A Iliff
- Department of Anaesthesia, Cardiff and Vale University Health Board, Cardiff, UK
- Health Education and Improvement Wales, Cardiff, UK
| | - A Baxter
- Department of Anaesthesia, Royal Hospital for Children and Young People, Edinburgh, UK
| | - A Chakladar
- Department of Anaesthesia, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Y Endlich
- Department of Anaesthesia, Royal Adelaide Women's and Children's Hospital, South Australia, Adelaide, Australia
| | - B McGuire
- Department of Anaesthesia, Ninewells Hospital, Dundee, UK
| | - J Peyton
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
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Fernandez PG, Dexter F, Brown J, Whitney G, Koff MD, Cao S, Loftus RW. Epidemiology of Enterococcus , Staphylococcus aureus , Klebsiella , Acinetobacter , Pseudomonas , and Enterobacter Species Transmission in the Pediatric Anesthesia Work Area Environment With and Without Practitioner Use of a Personalized Body-Worn Alcohol Dispenser. Anesth Analg 2024; 138:152-160. [PMID: 36623234 PMCID: PMC10918764 DOI: 10.1213/ane.0000000000006326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Personalized body-worn alcohol dispensers may serve as an important tool for perioperative infection control, but the impact of these devices on the epidemiology of transmission of high-risk Enterococcus , Staphylococcus aureus , Klebsiella, Acinetobacter , Pseudomonas , and Enterobacter (ESKAPE) pathogens is unknown. We aimed to characterize the epidemiology of ESKAPE transmission in the pediatric anesthesia work area environment with and without a personalized body-worn alcohol dispenser. METHODS This controlled before and after study included 40 pediatric patients enrolled over a 1-year study period. Two groups of operating room cases were compared: (1) operating room cases caring for patients with usual care (December 17, 2019, to August 25, 2020), and (2) operating room cases caring for patients with usual care plus the addition of a personalized, body-worn alcohol hand rub dispenser (September 30, 2020, to December 16, 2020). Operating rooms were randomly selected for observation of ESKAPE transmission in both groups. Device use was tracked via wireless technology and recorded in hourly hand decontamination events. RESULTS Anesthesia providers used the alcohol dispenser 3.3 ± 2.1 times per hour. A total of 57 ESKAPE transmission events (29 treatment and 28 control) were identified. The personalized body-worn alcohol dispenser impacted ESKAPE transmission by increasing the contribution of provider hand contamination at case start (21/29 device versus 10/28 usual care; relative risk, [RR] 2.03; 99.17% confidence interval [CI], 1.025-5.27; P = .0066) and decreasing the contribution of environmental contamination at case end (3/29 device versus 12/28 usual care; RR, 0.24; 99.17% CI, 0.022-0.947; P = .0059). ESKAPE pathogen contamination involved 20% (8/40) of patient intravascular devices. There were 85% (34/40) of preoperative patient skin surfaces contaminated with ≥1 (1.78 ± 0.19 [standard deviation {SD}]) ESKAPE pathogens. CONCLUSIONS A personalized body-worn alcohol dispenser can impact the epidemiology of ESKAPE transmission in the pediatric anesthesia work area environment. Improved preoperative patient decolonization and vascular care are indicated to address ESKAPE pathogens among pediatric anesthesia work area reservoirs.
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Affiliation(s)
- Patrick G Fernandez
- From the Division of Pediatric Anesthesiology, Department of Anesthesiology, University of Colorado, Aurora, Colorado
| | - Franklin Dexter
- Department of Anesthesia, University of Iowa, Iowa City, Iowa
| | - Jeremiah Brown
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Gina Whitney
- From the Division of Pediatric Anesthesiology, Department of Anesthesiology, University of Colorado, Aurora, Colorado
| | - Matthew D Koff
- Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Scott Cao
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Randy W Loftus
- Department of Anesthesia, University of Iowa, Iowa City, Iowa
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Dutton RP, Bryskin RB, Starks M'R, Shukla AS, Lounsbury O. Pediatric Anesthesia in the Community. Adv Anesth 2023; 41:127-142. [PMID: 38251614 DOI: 10.1016/j.aan.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Pediatric anesthesia is a diverse subspecialty practiced at thousands of hospitals and ambulatory surgery centers across the country. Most unusual and high-risk cases are performed in dedicated children's hospitals. However, the majority of cases and practitioners are based in the community. We present a review of demographics in pediatric anesthesia in the United States across 7 years of data from US Anesthesia Partners, a national anesthesia practice, which covers the full range of hospitals and outpatient facilities.
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Affiliation(s)
- Richard P Dutton
- Department of Anesthesiology, Texas A&M College of Medicine, Baylor University Medical Center, Dallas, TX, USA.
| | | | | | - Aesha S Shukla
- Quality, Analytics & Patient Experience, US Anesthesia Partners
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Zhang BS, Zhang XJ, Wang CA. The efficacy and safety of esketamine in pediatric anesthesia: A systematic review and meta-analysis. Asian J Surg 2023; 46:5661-5663. [PMID: 37684126 DOI: 10.1016/j.asjsur.2023.08.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/15/2023] [Indexed: 09/10/2023] Open
Affiliation(s)
- Bin-Sen Zhang
- The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, Gansu, 730030, China
| | - Xiao-Jia Zhang
- The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, Gansu, 730030, China
| | - Chun-Ai Wang
- Anesthesia and Pain Medical Center, Gansu Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, 730050, China.
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