A Presedation Fluid Bolus Does Not Decrease the Incidence of Propofol-Induced Hypotension in Pediatric Patients

Jager, Matthew D.; Aldag, Jean C.; Deshpande, Girish

doi:10.1542/hpeds.2014-0075

Cited by 18 publications

(10 citation statements)

References 36 publications

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“…In a randomized prospective study involving pediatric patients undergoing MRI, propofol had a significantly shorter time to onset of sedation, recovery time, and discharge time than dexmedetomidine [12]. However, the disadvantages of propofol include pain from injection, which is the most common adverse effect [31]; hypotension due to a reduction in systemic vascular resistance and reduced cardiac output [32]; and propofol infusion syndrome, which is a rare but critical complication with high mortality [33]. Propofol reduces FRC, which increases the risk of hypoxia and atelectasis in children [34,35].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Occurrence of Atelectasis during Sedation for Imaging in Pediatric Patients: A Retrospective Single Center Cohort Study

Kim

Park

Yoon

et al. 2021

JCM

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Sedation can induce atelectasis which may cause suboptimal image quality. This study aimed to identify factors associated with the occurrence of atelectasis during sedation for imaging in pediatric patients. Patients < 18 years who had undergone whole-body magnetic resonance imaging (MRI) under sedation with propofol or dexmedetomidine were included in this study. The development of atelectasis was visually and quantitatively assessed by coronal short tau inversion recovery images of the thoracic level. Multivariable logistic regression was performed to identify the independent factors associated with the development of atelectasis. Ninety-one patients were included in the analysis. In the multivariable analysis, administration of supplemental oxygen was the only factor significantly associated with the occurrence of atelectasis (adjusted odds ratio, 4.84; 95% confidence interval, 1.48–15.83; p = 0.009). Univariable analysis showed that the use of dexmedetomidine was associated with a lower incidence of atelectasis; however, this could not be verified in the multivariable analysis. Among the pediatric patients who had undergone imaging under sedation, additional oxygen supplementation was the only independent factor associated with atelectasis occurrence. A prospective clinical trial is required to identify the cause-effect relationship between oxygen administration and occurrence of atelectasis during sedation.

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Section: Discussionmentioning

confidence: 99%

Factors Associated with Occurrence of Atelectasis during Sedation for Imaging in Pediatric Patients: A Retrospective Single Center Cohort Study

Kim

Park

Yoon

et al. 2021

JCM

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“…Pretreatment with ketamine, ephedrine, dopamine, or naloxone may decrease risk [101][102][103][104][105], as does the use of the lowest effective dose [106]. Intravenous fluid administration does not appear to be an effective prevention [107,108].…”

Section: Propofolmentioning

confidence: 99%

Adverse Drug Reactions in the ICU

Moore¹,

Burkhart²

2016

Critical Care Toxicology

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“…Indeed, in CoA patients, the physiological blood flow is altered, resulting in high blood pressure in the upper part of the body. 15 The most common hemodynamic analysis involves measuring the pressure gradient ( P ) across the coarctation site via invasive catheterization. The guideline for CoA treatment recommends procedural treatment when at rest.…”

Section: Introductionmentioning

confidence: 99%

Effects of Uncertainty of Outlet Boundary Conditions in a Patient-Specific Case of Aortic Coarctation

et al. 2021

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Computational Fluid Dynamics (CFD) simulations of blood flow are widely used to compute a variety of hemodynamic indicators such as velocity, time-varying wall shear stress, pressure drop, and energy losses. One of the major advances of this approach is that it is non-invasive. The accuracy of the cardiovascular simulations depends directly on the level of certainty on input parameters due to the modelling assumptions or computational settings. Physiologically suitable boundary conditions at the inlet and outlet of the computational domain are needed to perform a patient-specific CFD analysis. These conditions are often affected by uncertainties, whose impact can be quantified through a stochastic approach. A methodology based on a full propagation of the uncertainty from clinical data to model results is proposed here. It was possible to estimate the confidence associated with model predictions, differently than by deterministic simulations. We evaluated the effect of using three-element Windkessel models as the outflow boundary conditions of a patient-specific aortic coarctation model. A parameter was introduced to calibrate the resistances of the Windkessel model at the outlets. The generalized Polynomial Chaos method was adopted to perform the stochastic analysis, starting from a few deterministic simulations. Our results show that the uncertainty of the input parameter gave a remarkable variability on the volume flow rate waveform at the systolic peak simulating the conditions before the treatment. The same uncertain parameter had a slighter effect on other quantities of interest, such as the pressure gradient. Furthermore, the results highlight that the fine-tuning of Windkessel resistances is not necessary to simulate the post-stenting scenario.

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A Presedation Fluid Bolus Does Not Decrease the Incidence of Propofol-Induced Hypotension in Pediatric Patients

Cited by 18 publications

References 36 publications

Factors Associated with Occurrence of Atelectasis during Sedation for Imaging in Pediatric Patients: A Retrospective Single Center Cohort Study

Factors Associated with Occurrence of Atelectasis during Sedation for Imaging in Pediatric Patients: A Retrospective Single Center Cohort Study

Adverse Drug Reactions in the ICU

Effects of Uncertainty of Outlet Boundary Conditions in a Patient-Specific Case of Aortic Coarctation

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