scholarly journals Surgical Perspectives for Pediatric Theater Teams during the SARS-CoV-2 Pandemic and Beyond: Narrative Review and Mandatory Tasks Guidelines

2021 ◽  
Author(s):  
Roberta Iacona ◽  
Kiran Chima ◽  
Ami Kotecha ◽  
Amulya Saxena
Keyword(s):  
Pediatric Patient ◽  
Surgical Management ◽  
Endoscopic Surgery ◽  
Patient Management ◽  
Pediatric Patients ◽  
Narrative Review ◽  
Surgical Patients ◽  
Patient Anxiety ◽  
Local Hospital ◽  
Health Authorities

AbstractThis is a narrative review during the ongoing coronavirus disease 2019 (COVID-19) pandemic to streamline workflow of pediatric surgical patients in operating theaters and for theater teams involved in their management. Pediatric patient anxiety in theaters, aspects of communication, and optimizing vision during surgery during the pandemic have also been addressed. The COVID-19 pandemic has led to the creation of pathways in the surgical management of patients. As the pandemic progressed, hospitals developed pathways to offer increased protection to staff during procedures. This narrative review provides a clear perspective in the management of pediatric patients in operating theaters. Guidelines received from National Health Authorities and Societies affiliated with surgery, endoscopic surgery, anesthesiology, and endoscopy were carefully reviewed regarding their recommendations and data emerging from reports on COVID-19 were selected to compile the pathways specific for pediatric patients and staff. The workflow pathways have been successfully implemented during the pandemic and include a section on patients for endoscopy as well as approach to endoscopic surgery and open procedures. Theater room ergonomics that were successful during the pandemic have been outlined along with identification of areas specific to the pediatric patient anxiety, interteam communication/identification, and visor-related vision. The guidelines used successfully during the pandemic for pediatric theater teams can be used or adapted for formulating local hospital guidelines in other centers that could be valuable in patient management beyond the pandemic.

scholarly journals Anxiolysis in the Surgical Management of a Compound Odontoma in a Pediatric Patient

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Pier Paolo Poli ◽  
Luca Creminelli ◽  
Emma Grecchi ◽  
Silvia Pieriboni ◽  
Gregorio Menozzi ◽  
...  
Keyword(s):  
Pediatric Patient ◽  
Surgical Management ◽  
Pediatric Patients ◽  
Present Report ◽  
Outpatient Basis ◽  
Conservative Approach ◽  
The Common ◽  
Oral Premedication ◽  
Negative Feelings ◽  
Compound Odontoma

Among odontogenic tumors, odontoma is the most frequent. The common treatment contemplates a conservative approach. While this procedure is generally accepted and tolerated, some difficulties may be encountered in the case of pediatric patients. Indeed, negative feelings of tension, apprehension, nervousness, and fear are likely to occur. The present report is aimed at discussing the management of a compound odontoma in a pediatric patient under anxiolysis with diazepam on an outpatient basis. The surgery was carried out without complications, and the discharge was completed safely. Oral premedication with diazepam should be considered to avoid more invasive sedation procedures in anxious pediatric patients.

scholarly journals The diagnostic threshold of Cornell assessment of pediatric delirium in detection of postoperative delirium in pediatric surgical patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hong Hong ◽  
Chao Guo ◽  
Zhi-Hua Liu ◽  
Bo-Jie Wang ◽  
Shu-Zhe Zhou ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Assessment Instrument ◽  
Surgical Patients ◽  
Reference Standard ◽  
Diagnostic And Statistical Manual ◽  
Diagnostic Thresholds ◽  
Diagnostic Threshold ◽  
Effective Instrument ◽  
Sensitivity Specificity ◽  
Selective Surgery

Abstract Background Cornell assessment of pediatric delirium (CAPD) showed advantage in diagnosis of pediatric delirium in Chinese critically ill patients. But its performance in surgical patients is still unclear. The present study was designed to validate the diagnostic performance of CAPD in surgical pediatric patients. Methods This is a prospective validation study. Pediatric patients who underwent selective surgery and general anesthesia were enrolled. Primary outcome was the incidence of delirium within postoperative three days. CAPD Chinese version was used to evaluate if the patient had delirium one time per day. At the meantime, a psychiatrist employed Diagnostic and Statistical Manual of Mental Disorders fifth edition to diagnose delirium, which was the “gold standard”, and the result was considered as reference standard. Sensitivity, specificity and area under receiver operating characteristic (ROC) curve were calculated to investigate the performance of CAPD. Results A total of 170 patients were enrolled. Median age was 4 years old. As diagnosed by psychiatrist, 23 (13.5 %) patients experienced at least one episode of delirium during the follow-up period. When diagnostic threshold was set at 9, CAPD showed the optimal sensitivity (87.0 %, 95 %CI 65.3 %-96.6 %) and specificity (98.0 %, 95 %CI 93.7 %-99.5 %) in comparison with other diagnostic thresholds. ROC analysis showed that CAPD was a good delirium assessment instrument with area under curve of 0.911 (95 % CI 0.812 to 1.000, P < 0.001). Agreement between CAPD and reference standard was 0.849 (Kappa coefficient, P < 0.001). Conclusions This study found that Cornell assessment of pediatric delirium could be used as an effective instrument in diagnosis of delirium in pediatric surgical patients. Trial registration www.chictr.org.cn Identifier: ChiCTR-DDD-17,012,231, August 3, 2017.

scholarly journals Tracheostomy in Postoperative Pediatric Cardiac Surgical Patients—The Earlier, the Better

2021 ◽  
Author(s):  
Chalattil Bipin ◽  
Manoj K. Sahu ◽  
Sarvesh P. Singh ◽  
Velayoudam Devagourou ◽  
Palleti Rajashekar ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Hospital Stay ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Surgical Patients ◽  
Surgical Intensive Care Unit ◽  
Care Hospital ◽  
Surgical Intensive Care ◽  
Nutrition Supplementation

Abstract Objectives This study was aimed to assess the benefits of early tracheostomy (ET) compared with late tracheostomy (LT) on postoperative outcomes in pediatric cardiac surgical patients. Design Present one is a prospective, observational study. Setting The study was conducted at a cardiac surgical intensive care unit (ICU) of a tertiary care hospital. Participants All pediatric patients below 10 years of age, who underwent tracheostomy after cardiac surgery from January2019 to december2019, were subdivided into two groups according to the timing of tracheostomy: “early” if done before 7 days or “late” if done after 7 days postcardiac surgery. Interventions ET versus LT was measured in the study. Results Out of all 1,084 pediatric patients who underwent cardiac surgery over the study period, 41 (3.7%) received tracheostomy. Sixteen (39%) patients underwent ET and 25 (61%) underwent LT. ET had advantages by having reduced risk associations with the following variables: preoperative hospital stay (p = 0.0016), sepsis (p = 0.03), high risk surgery (p = 0.04), postoperative sepsis (p = 0.001), C-reactive protein (p = 0.04), ventilator-associated pneumonia (VAP; p = 0.006), antibiotic escalation (p = 0.006), and antifungal therapy (p = 0.01) requirement. Furthermore, ET was associated with lesser duration of mechanical ventilation (p = 0.0027), length of ICU stay (LOICUS; p = 0.01), length of hospital stay (LOHS; p = 0.001), lesser days of feed interruption (p = 0.0017), and tracheostomy tube change (p = 0.02). ET group of children, who had higher total ventilation-free days (p = 0.02), were decannulated earlier (p = 0.03) and discharged earlier (p = 0.0089). Conclusion ET had significant benefits in reduction of postoperative morbidities with overall shorter mechanical ventilation, LOICUS, and LOHS, better nutrition supplementation, lesser infection, etc. These benefits may promote faster patient convalescence and rehabilitation with reduced hospital costs.

Surgical management and outcomes of pediatric open globe injuries requiring vitrectomy

2021 ◽  
pp. 112067212110006
Author(s):  
Xin Liu ◽  
Lufei Wang ◽  
Fengjuan Yang ◽  
Jia’nan Xie ◽  
Jinsong Zhao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Management ◽  
Pediatric Patients ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Poor Visual Outcome ◽  
Early Vitrectomy ◽  
Open Globe ◽  
Time From Injury ◽  
Ocular Sign

Purpose: To describe surgical management and establish visual outcomes of open globe injury (OGI) in pediatric patients requiring vitrectomy. Methods: Forty-eight eyes of 48 pediatric patients underwent vitrectomy for OGI with secondary vitreoretinal complications in the eye center of Jilin University were included. Characteristics of patients, details of ocular examination and operation, presenting and final visual acuity were recorded. Results: Presenting visual acuity less than 20/400 was found in 44 eyes (91.7%), which included no light perception (NLP) in four eyes. At last visit, there was no eyes with visual acuity of NLP, and 19 eyes (39.6%) had a vision recovery to 20/400 or better. Mechanisms of injury, intraocular contents prolapse, presence of hyphema, intraocular foreign body, vitreous hemorrhage, retinal detachment, and total time from injury to PPV > 2 weeks were significant predictors of visual prognosis. Logistic regression analysis showed that hyphema was a significant predictive factor for poor visual outcome. Conclusion: Visual acuity was improved in most of the patients with OGI in this study. Hyphema is an important presenting ocular sign in estimating the post-vitrectomy visual outcome for OGI in children. Proper timing of vitrectomy is suggested, and in this study patients may benefit more with early vitrectomy as less proliferative vitreoretinopathy (PVR) was found together with a better visual acuity.

IN MINIMAL ACCESS SURGERY

1996 ◽  
Vol 17 (12) ◽  
pp. 441-447
Author(s):  
Thom E Lobe
Keyword(s):  
Medical Care ◽  
Pediatric Patient ◽  
Endoscopic Surgery ◽  
State Of The Art ◽  
Outpatient Surgery ◽  
Cost Effective ◽  
Surgical Instruments ◽  
Short Stay ◽  
Minimal Access ◽  
Access Surgery

The pediatrician must be cognizant of the extensive applications of endoscopic surgery in the pediatric patient. The ability to provide either outpatient surgery or short-stay surgery appears to be cost-effective and appropriate state-of-the-art medical care. As the array of surgical instruments continues to evolve, new and innovative endoscopic procedures will become increasingly available.

Surgical Management of Ocular Cicatricial Pemphigoid in a Pediatric Patient

Cornea ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Rafael Ollero ◽  
Anna Soldevila ◽  
María Fideliz de la Paz ◽  
Ainhoa Martínez-Grau
Keyword(s):  
Pediatric Patient ◽  
Surgical Management ◽  
Cicatricial Pemphigoid ◽  
Ocular Cicatricial Pemphigoid

scholarly journals Bilateral Destructive Hip Disease from Untreated Juvenile Idiopathic Arthritis

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Arash Calafi ◽  
Alton W. Skaggs ◽  
Trevor J. Shelton ◽  
Brian M. Haus
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Femoral Head ◽  
Pediatric Patient ◽  
Acetabular Dysplasia ◽  
Pediatric Patients ◽  
Similar Case ◽  
Hip Pain ◽  
Complete Destruction ◽  
Hip Disease

We report a novel case of a pediatric patient with bilateral hip destruction from untreated Juvenile idiopathic arthritis (JIA). She was presented at the age of 9 with hip pain associated with bilateral acetabular dysplasia and a dislocated left femoral head. Only 1.5 years later, the patient developed complete destruction of the left femoral head and dislocated right femoral head. The authors have not identified literature describing a similar case report of bilateral femoral head destruction resulting from Persistent Oligoarticular JIA. Pediatric patients presenting with rapidly evolving destructive process should be evaluated for rheumatologic, infectious, and spinal etiologies.

Sign in / Sign up

Export Citation Format

Share Document