The purpose of this report is to describe the international growth, outcomes, complications, and technology used in pediatric extracorporeal life support (ECLS) from 2009 2015 as reported by participating centers Extracorporeal Life Support Organization (ELSO). To date, there are 59,969 children who have received ECLS ELSO Registry; among those, 21,907 since with an overall survival hospital discharge rate 61%. In 2009, 2,409 cases were performed at 157 centers. By 2015, that number grew...

Background Emergence agitation in children after sevoflurane is common. Different drugs have been used to decrease its occurrence with variable efficacy. The authors compared the incidence and severity of emergence who received a single dose propofol at end strabismus surgery versus saline. Methods In this prospective, randomized, double-blind study, enrolled 80 healthy aged 2-6 yr. were randomly allocated group (n = 41), which 1 mg/kg surgery, or saline 39), Results mean scores on Pediatric...

In Brief BACKGROUND: Emergence from general anesthesia can be associated with coughing, agitation, and hemodynamic disturbances. Remifentanil may attenuate these responses. METHODS: a prospective, double-blind, randomized trial, we enrolled 60 adult patients undergoing nasal surgery using remifentanil-based anesthesia. During the emergence phase, remifentanil group had reduced to one tenth of maintenance rate, whereas control discontinued. RESULTS: Times awakening tracheal extubation were...

Although there have been numerous attempts to predict perioperative mortality in adults, an objective model children has not developed. In this study, we aimed develop a Pediatric Risk Assessment (PRAm) score undergoing noncardiac surgery.We included all recorded the 2012 and 2013 American College of Surgeons National Surgical Quality Improvement Program databases derivation cohort those from 2014 database validation cohort. The primary outcome was incidence in-hospital mortality. A total...

In this review, the most recent and relevant developments in field of emergence agitation children, as related to its assessment, etiology, management, are discussed.Studies have shown that a more specific assessment tool is needed decrease measurement errors. Such scales been developed recently incorporate cognitive-related items addition behaviors. Young, emotional, impulsive less social children with anxious parents undergoing head neck surgery identified be at risk for development...

In Brief BACKGROUND: Hypotension after spinal anesthesia for cesarean delivery is common. Previous studies have demonstrated that a crystalloid fluid "coload" (rapid administration of bolus starting at the time intrathecal injection) superior to conventional preload (fluid administered before preventing hypotension. Colloid provides sustained increase in central blood volume. We hypothesized that, contrast crystalloid, colloid may be more effective than coload reducing incidence...

Children with major and severe congenital heart disease (CHD) undergoing noncardiac surgery are at increased risk of mortality. The objective this study was to identify the predictors for in-hospital mortality, develop a stratification score that could be used help decision making development perioperative management guidelines.We included all children (eg, tetralogy Fallot wide open pulmonary insufficiency, hypoplastic left syndrome including stage 1 repair) or CHD uncorrected CHD,...

Risk stratification models to predict perioperative mortality in pediatric surgical populations are based on patient comorbidities, but do not take into consideration the intrinsic risk of procedures.Surgical procedures identified by specialty independent factors for patients. However, multivariable predictive algorithms, interaction comorbidities with procedure strongly predicts 30-day mortality.Recently developed incorporate as predictors fail consider procedures. In this study, authors...

BACKGROUND: With advances in surgical and catheter-based interventions technologies patients with congenital heart disease (CHD), the practice of pediatric cardiac anesthesiology has evolved parallel surgery cardiology as a distinct subspecialty over past 80 years. To date, there not been an analysis distribution anesthesiologists relative to noncardiac procedures population. The primary aim is report results survey its subsequent describe that include interventions, catheterization...

From the Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts. Conflicts Interest, Funding: Please see DISCLOSURES at end this article. Address correspondence to Viviane G. Nasr, MD, MPH, FASA, 300 Longwood Ave, MA 02115. e-mail [email protected].

BACKGROUND: The population of patients with congenital heart disease has grown, but the supply pediatric cardiac anesthesiologists not kept pace. Pediatric Anesthesia Leadership Council (PALC) and Congenital Cardiac Society (CCAS) formed a task force to evaluate current state specialty anesthesia, including staffing, work environment, education, compensation, career development. METHODS: Five working groups developed survey questions that explored 5 different aspects anesthesiologist’s...

To determine whether mortality differs between roller and centrifugal pumps used during extracorporeal membrane oxygenation in infants weighing less than 10 kg.Retrospective propensity-matched cohort study.All centers reporting to the Extracorporeal Life Support Organization.All patients kg supported on 2011-2016 within Organization Registry.Centrifugal pump recipients were propensity matched (1:1) based predicted probability of receiving a using demographic variables, indication for...

Early identification of children at high risk for perioperative mortality could lead to improved outcomes; however, there is a lack well-validated prediction tools. The Pediatric Risk Assessment (PRAm) score new model prognosticate in pediatric patients undergoing noncardiac surgery. It was derived from the American College Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. In this study, we aimed externally validate PRAm 1 large institution.A prospectively...

Abstract Advances made in pediatric cardiology, cardiac surgery and critical care have significantly improved the survival rate of patients with congenital heart disease (CHD) leading to an increase children CHD presenting for noncardiac surgical procedures. This study aims (1) describe trend perioperative mortality rates undergoing procedures at children’s hospitals over past 5 years (2) patient characteristics most common type The Pediatric Health Information System (PHIS) is...