Babies and Children at Last

Trieu, Christine T.; Williams, Todd A.; Marijic, Jure

doi:10.1097/aln.0000000000002673

Cited by 9 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the hemodynamic point of view, the most common perioperative pediatric cardiac output monitoring uses surrogates such as mixed venous oxygen saturation, lactate levels, regional venous oxygen saturation, toe–core temperature difference, and serial echocardiographic exams. Non-invasive technology is becoming more popular: non-invasive monitors of perfusion (SpO2 probes with sophisticated features) can give information on the Perfusion Index, which combines information from both the hemodynamic as well the nociceptive side; regional oximeters [ 63 ], bioreactance, and impedance cardiography are currently being evaluated [ 64 ] but are still not available for extensive use [ 65 ]. Transcranial Doppler (TCD) has become a basic skill for the anesthesiologist/intensivist, allowing the detection of cerebral flow variations at the bedside with no employment of radiation.…”

Section: Pediatric Anesthesia During Masmentioning

confidence: 99%

Minimal Access in Pediatric Surgery: An Overview on Progress towards Dedicated Instrument Developments and Anesthesiologic Advances to Enhance Safe Completion of Procedures

Pelizzo,

Destro,

Pierucci

et al. 2024

Children

View full text Add to dashboard Cite

Surgical techniques are evolving in Pediatric Surgery, especially in the area of minimal access surgery (MAS) where indications for applications are expanding. Miniaturization of instruments, using natural orifices, single incisions, or remotely controlled robot-assisted procedures, promises to increase the benefits of MAS procedures in pediatrics. Many pediatric pathologies are rare, and specialized surgical and anesthesiologic instruments are necessary to manage them, defined as “orphan devices”, for which development and dissemination on the market are slowed down or sometimes hindered by regulatory standards and limiting financial conflicts of interest. In pediatric surgery, it is of utmost importance to work in a multidisciplinary way to offer a surgical path that is safe and supported by technological advances. For this reason, optimizing pediatric anesthesia is also a crucial factor where technological advances have made monitoring more precise, thereby enhancing safety in the operative room. The development of customized instruments and technologies should be supported by pediatric research and should be adapted to the individualities of the small patient. This overview outlines the importance of dedicated instruments developed for the safe completion of MAS procedures in pediatrics.

show abstract

Section: Pediatric Anesthesia During Masmentioning

confidence: 99%

Minimal Access in Pediatric Surgery: An Overview on Progress towards Dedicated Instrument Developments and Anesthesiologic Advances to Enhance Safe Completion of Procedures

Pelizzo,

Destro,

Pierucci

et al. 2024

Children

View full text Add to dashboard Cite

show abstract

“…1,[6][7][8] However, choosing the optimal method to measure CO in pediatric patients remains challenging, and so far, no reliable continuous less-invasive or noninvasive method is available. 5,[9][10][11][12] Indicator dilution methods-such as pulmonary artery or transpulmonary thermodilution-are invasive and not routinely used, especially in infants. Bedside echocardiography is frequently used for perioperative CO assessment but requires experienced operators and provides CO discontinuously.…”

mentioning

confidence: 99%

“…5 In contrast, pulse wave analysis (PWA) allows real-time continuous CO estimation, 13,14 but robust method comparison studies for the validation of the various commercially available PWA devices in pediatric patients are rare and results are conflicting. [9][10][11][12] The pressure recording analytical method (PRAM), implemented in the MostCareUp system (Vygon), is an uncalibrated PWA method that samples and analyzes the arterial waveform with high frequencies (1000 Hz) to estimate CO. 13,14 In adults, PRAM was validated against reference methods. [15][16][17] However, in pediatric patients, studies comparing PRAM to established reference methods are scarce.…”

mentioning

confidence: 99%

Pulse Wave Analysis Using the Pressure Recording Analytical Method to Measure Cardiac Output in Pediatric Cardiac Surgery Patients: A Method Comparison Study Using Transesophageal Doppler Echocardiography as Reference Method

Greiwe

Hapfelmeier

Zajonz

et al. 2022

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

BACKGROUND: Cardiac output (CO) is a key determinant of oxygen delivery, but choosing the optimal method to obtain CO in pediatric patients remains challenging. The pressure recording analytical method (PRAM), implemented in the MostCareUp system (Vygon), is an invasive uncalibrated pulse wave analysis (PWA) method to measure CO. The objective of this study is to compare CO measured by PRAM (PRAM-CO; test method) with CO simultaneously measured by transesophageal Doppler echocardiography (TEE-CO; reference method) in pediatric patients. METHODS: In this prospective observational method comparison study, PRAM-CO and TEE-CO were assessed in pediatric elective cardiac surgery patients at 2 time points: after anesthesia induction and after surgery. The study was performed in a German university medical center from March 2019 to March 2020. We included pediatric patients scheduled for elective cardiac surgery with arterial catheter and TEE monitoring. PRAM-CO and TEE-CO were compared using Bland-Altman analysis accounting for repeated measurements per subject, and the percentage error (PE). RESULTS: We included 52 PRAM-CO and TEE-CO measurement pairs of 30 patients in the final analysis. Mean ± SD TEE-CO was 2.15 ± 1.31 L/min (range 0.55–6.07 L/min), and mean PRAM-CO was 2.21 ± 1.38 L/min (range 0.55–5.90 L/min). The mean of the differences between TEE-CO and PRAM-CO was −0.06 ±0.38 L/min with 95% limits of agreement (LOA) of 0.69 (95% confidence interval [CI], 0.53–0.82 L/min) to −0.80 L/min (95% CI, −1.00 to −0.57 L/min). The resulting PE was 34% (95% CI, 27%–41%). CONCLUSIONS: With a PE of <45%, PRAM-CO shows clinically acceptable agreement with TEE-CO in hemodynamically stable pediatric patients before and after cardiac surgery.

show abstract

Continuous cardiac output measured with a Swan‐Ganz catheter reacts too slowly in animal experiments with sudden circulatory failure

Magnúsdóttir

Simonsen

Rasmussen

et al. 2022

Anim Models and Exp Med

View full text Add to dashboard Cite

show abstract

Babies and Children at Last

Abstract: This editorial accompanies the article on p. 712 and has a related Infographic on p. 19A.

Cited by 9 publications

References 10 publications

Minimal Access in Pediatric Surgery: An Overview on Progress towards Dedicated Instrument Developments and Anesthesiologic Advances to Enhance Safe Completion of Procedures

Minimal Access in Pediatric Surgery: An Overview on Progress towards Dedicated Instrument Developments and Anesthesiologic Advances to Enhance Safe Completion of Procedures

Pulse Wave Analysis Using the Pressure Recording Analytical Method to Measure Cardiac Output in Pediatric Cardiac Surgery Patients: A Method Comparison Study Using Transesophageal Doppler Echocardiography as Reference Method

Continuous cardiac output measured with a Swan‐Ganz catheter reacts too slowly in animal experiments with sudden circulatory failure

Contact Info

Product

Resources

About