Objective In recent years, low-dose, short-acting anesthetic agents, which replaced the former high-dose opioid regimens, offer a faster postoperative recovery and decrease the need for mechanical ventilatory support. In this study, the aim was to determine the success rate of fast-track approach in surgical procedures for congenital heart disease. Methods There is some evidence, mostly from retrospective analyses, that fast tracking can be beneficial. Ninety-one cases with moderate complex cardiac malformations were operated with fast-track protocol during cardiothoracic charitable missions. The essential aspects of early extubation in our cohort included selected patients with good preoperative status, good surgical result with hemodynamic stability in low dose of inotropic drugs at the end of bypass, and no active bleeding. In this setting, a careful choice and dosing of anesthetic agents, alongside a good postoperative analgesia are mandatory. Results The authors found that an early extubation (< 4 hours) can be both effective and safe as it reduces intubation and ventilator times without increasing postoperative complications in pediatric congenital heart disease. Conclusion This study supports a wider use of fast-track extubation protocols in pediatric patients submitted for congenital cardiac surgery in developing countries.

In recent years, low-dose, short-acting anesthetic agents, which replaced the former high-dose opioid regimens, offer a faster postoperative recovery and decrease the need for mechanical ventilatory support. In this study, the aim was to determine the success rate of fast-track approach in surgical procedures for congenital heart disease. There is some evidence, mostly from retrospective analyses, that fast tracking can be beneficial. Ninety-one cases with moderate complex cardiac malformations were operated with fast-track protocol during cardiothoracic charitable missions. The essential aspects of early extubation in our cohort included: selected patients with good preoperative status, good surgical result with hemodynamic stability in low dose of inotropic drugs at the end of bypass, no active bleeding. In this setting a carefull choice and dosing of anesthetic agents, alongside a good postoperative analgesia are mandatory. The authors found that an early extubation (< 4 hours) can be both effective and safe as it reduces intubation and ventilator times without increasing post-operative complications in pediatric congenital heart disease. This study supports a wider use of fast-track extubation protocols in paediatric patients submitted for congenital cardiac surgery in developing countries.

The adsorption behavior of selected metal ions on water hyacinth powder was investigated by Fourier Transform Infrared (FTIR) spectroscopy. Water hyacinth powder was used as an adsorbent due to its popularity, low cost and ease of availability. Water hyacinth stems were dried and ground to a powder. Batch adsorption experiments were conducted at room temperature by adding known concentrations of Pb2+, Cd2+, Cr3+, Zn2+ and Ni2+ to 5 g of water hyacinth powder in different test tubes and allowed to stand for the same time respectively. Adsorption is one of the methods used to remove heavy metals from aqueous solutions and wastewaters. FTIR analysis was performed to identify the functional groups in the water hyacinth powder using the KBr disc method. The study showed a strong broad absorption band in the region of 3300-3200cm-1 which is characteristic of O-H stretching vibrations of the adsorbed water molecules at the surface of raw water hyacinth powder particles. Other peaks appeared at 1732cm-1 which corresponded to C=O stretching vibrations while the band at 1396cm-1 could be attributed to C-H bonds. The functional groups identified were: C-H; O-H; C=O or C-O. After adsorption there was a disappearance, reduction or a shift in the adsorption bands depending on the type of metal ion. Lead for example showed a strong absorption band in the region of 1732cm-1 which is characteristic of C=O stretching bond structure which is found in esters and carboxylic acids. The disappearance of the peaks indicated that the H atom present in the functional groups of the raw water hyacinth powder could have been substituted with lead ion. The intensity of the adsorption bands reduced for all the metals confirming that functional groups were responsible for adsorption of the heavy metal ions on to the material.