Optimum End Tidal Sevoflurane Concentration Required for Intravenous Cannulation in Children

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Bassel Mohamed Essam Noureldin ◽  
Eman Mohamed Kamal Abo Seif ◽  
Omar Mohamed Mohamed Eltawansy ◽  
Mohamed Mohamed Abdel Fattah Ghoneim
Keyword(s):  
Clinical Trial ◽  
Pediatric Patients ◽  
Pediatric Anesthesia ◽  
Healthy Children ◽  
Intravenous Access ◽  
Inhalational Induction ◽  
Sevoflurane Concentration ◽  
Untoward Event ◽  
Inhalation Agent ◽  
End Tidal

Abstract Background Inhalation mask induction is a cornerstone of pediatric anesthesia. Because of their natural aversion to needles, healthy children are usually anesthetized by mask prior to intravenous insertion. The early insertion of an intravenous access provides a means for administering fluids and drugs if an untoward event occurs during inhalational induction. Sevoflurane is the inhalation agent most commonly used for mask inductions in pediatric anesthesia, having largely replaced halothane for this purpose. Objectives The aim of the study was to evaluate the optimum end tidal concentration of Sevoflurane at which an intravenous cannulation can be successfully attempted without movement in pediatric patients. Patients and Methods In this clinical trial, pediatric subjects of either sex aged 2-5 years, weighing 10-20 kg were included. Results Showed that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation without movement in children. Conclusion We conclude that an end tidal sevoflurane of 1.46% has 50% probability for successful intravenous cannulation in un- premedicated children aged between 2 and 5 years.

scholarly journals End-tidal Sevoflurane and Halothane Concentrations during Simulated Airway Occlusion in Healthy Humans

2009 ◽  
Vol 111 (2) ◽  
pp. 287-292 ◽  
Author(s):  
Nick P. Talbot ◽  
Andrew D. Farmery ◽  
Keith L. Dorrington
Keyword(s):  
Minimal Alveolar Concentration ◽  
Healthy Human ◽  
Inhalational Induction ◽  
Sevoflurane Concentration ◽  
Airway Occlusion ◽  
Healthy Humans ◽  
Monoexponential Model ◽  
Body Compartments ◽  
S Period ◽  
End Tidal

Background In a patient whose airway is likely to become obstructed upon loss of consciousness, anesthesia may be induced using an inhaled vapor. If the airway occludes during such an inhalational induction, the speed of patient awakening is related to the rate at which anesthetic gas redistributes away from lung and brain to other body compartments. To determine whether redistribution occurs more rapidly with a more blood-soluble or a less blood-soluble agent, the authors used subanesthetic concentrations of halothane and sevoflurane to simulate inhalational induction and airway obstruction in eight healthy human volunteers. Methods Inhalational induction was simulated using stepwise increases in inspired halothane or sevoflurane concentration, sufficient to reach an end-tidal concentration of approximately 0.1 minimal alveolar concentration. Airway occlusion was then simulated by initiating a 90-s period of rebreathing from a 1-l bag. During rebreathing, end-tidal halothane or sevoflurane concentration was measured continuously by mass spectrometry, and a time constant for the decline in concentration was calculated using a monoexponential model. Results At the onset of rebreathing, end-tidal concentrations of halothane and sevoflurane were 0.10 +/- 0.03 and 0.11 +/- 0.03 minimal alveolar concentration, respectively (mean +/- SD; P > 0.1, Student t test). During rebreathing, the time constants for the decline in end-tidal halothane and sevoflurane concentration were 22 +/- 9 and 62 +/- 16 s, respectively (P < 0.0001). Conclusions During simulated airway occlusion in healthy volunteers, the end-tidal concentration of halothane falls more rapidly than that of sevoflurane. Halothane may therefore lead to more rapid awakening, compared with sevoflurane, should the airway obstruct during an inhalational induction of anesthesia.

Nutritional Status of Pediatric Patients in Ramathibodi Hospital Using the WHO Child Growth Standard and the Thai Growth Reference

2020 ◽  
Vol 103 (10) ◽  
pp. 1099-1106
Keyword(s):  
Nutritional Status ◽  
Pediatric Patients ◽  
Chronically Ill ◽  
Child Growth ◽  
World Health ◽  
Healthy Children ◽  
Growth Standard ◽  
Growth Reference ◽  
Child Growth Standard

Background: The appropriate assessment of nutritional status in children is an essential aspect of health supervision. Currently, there are two references used for growth assessment in Thailand. The WHO child growth standard, which has been widely used since 2007, and the Thai growth reference developed by the Ministry of Public Health, which has been used since 1998. However, there were very few studies that made a direct comparison between both tools. Objective: To compare the nutritional status of healthy pediatric patients in Ramathibodi Hospital assessed by the World Health Organization (WHO) child growth standard and the Thai growth reference. Materials and Methods: The present study was a cross-sectional study. The data were collected from all pediatric patients registered in the outpatient department (OPD) of Faculty of Medicine, Ramathibodi Hospital between January 2013 and December 2018. All healthy children (aged 0 to 15 years) were included. Exclusion criteria of possibly chronically ill children were defined by those who were 1) visiting subspecialty clinics, 2) OPD and emergency room (ER) visits more than ten times per year, 3) having ICD-10 of chronic conditions, or 4) had been admitted in the hospital during the study. The weight and height or length data were extracted from the Electronic Medical Record system. All data were analyzed by the Stata Statistical Software focusing on age and sex-specific Z-scores, which references the WHO child growth standard and the Thai growth reference. Results: Sixty-two thousand one hundred four OPD visits were divided into 31,662 OPD visits for boys and 30,442 OPD visits for girls. Percent of weight for age and height or length for age more than +2 Z-score of both boys and girls when using the Thai growth reference was greater than that using the WHO child growth standard, especially for children aged 0 to 12 months. The Thai growth reference classified as overweight were approximately 10.26% to 31.12% more than using the WHO child growth standard. There was no difference in classification of height by both standards. Conclusion: There was a difference in classification of nutritional status between the Thai growth reference and the WHO child growth standard. Keywords: Nutritional status, Pediatric growth reference, Assessment tool, Overweight

scholarly journals Investigation of TAGAP gene polymorphism (rs1738074) in Turkish pediatric celiac patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Melek Pehlivan ◽  
Tülay K. Ayna ◽  
Maşallah Baran ◽  
Mustafa Soyöz ◽  
Aslı Ö. Koçyiğit ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Disease Risk ◽  
Polymerase Chain Reaction Method ◽  
Control Group ◽  
Healthy Children ◽  
Single Nucleotide ◽  
Significant Difference ◽  
Allele Specific ◽  
And Control

Abstract Objectives There are several hypotheses on the effects of the rs1738074 T/C single nucleotide polymorphism in the TAGAP gene; however, there has been no study on Turkish pediatric patients. We aimed to investigate the association of celiac disease (CD) and type 1 diabetes mellitus (T1DM) comorbidity with the polymorphism in the TAGAP gene of Turkish pediatric patients. Methods Totally, 127 pediatric CD patients and 100 healthy children were included. We determined the polymorphism by the allele-specific polymerase chain reaction method. We used IBM SPSS Statistics version 25.0 and Arlequin 3.5.2 for the statistical analyses. The authors have no conflict of interest. Results It was determined that 72% (n=154) of only CD patients had C allele, whereas 28% (n=60) had T allele. Of the patients with celiac and T1DM, 42.5% (n=17) and 57.5% (n=23) had T and C alleles, respectively. Of the individuals in control group, 67% (n=134) had C allele, whereas 33% (n=66) had T allele. Conclusions There was no significant difference in the genotype and allele frequencies between the patient and control groups (p>0.05). There was no significant association between the disease risk and the polymorphism in our study group.

scholarly journals Virtual Reality vs. Tablet Video as an Experiential Education Platform for Pediatric Patients Undergoing Chest Radiography: A Randomized Clinical Trial

2021 ◽  
Vol 10 (11) ◽  
pp. 2486
Author(s):  
Jung-Hee Ryu ◽  
Jin-Woo Park ◽  
Sang Il Choi ◽  
Ji Young Kim ◽  
Hyunju Lee ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Virtual Reality ◽  
Randomized Clinical Trial ◽  
Experiential Education ◽  
Chest Radiography ◽  
Pediatric Patients ◽  
Procedure Time ◽  
Parental Presence ◽  
Education Platform ◽  
Procedural Outcomes

Virtual reality (VR), which offers an immersive experience, has been implemented into the education of pediatric patients to reduce peri-procedural anxiety. This randomized clinical trial evaluated the effect of VR, compared with standard video, on reducing anxiety and distress in pediatric patients undergoing chest radiography. A total of 120 children aged 4 to 8 years with scheduled chest radiography appointments were randomized into either the tablet or the VR group. Children in the tablet group experienced chest radiography indirectly with a 3 min tablet video, whereas those in the VR group received the same content via a VR experience. The distress of children was measured using the Observational Scale of Behavioral Distress (OSBD) scale. Parental presence and procedural outcomes were also recorded. The number of less distressed children (OSBD score < 5) was significantly higher in the VR group than in the tablet group (49 [81.7%]) vs. 32 [53.3%]) (p = 0.001). The OSBD scores, the need for parental presence, the procedure time, and the number of repeated procedures were all lower in the VR group. The immersive VR experience appears to decrease the degree of anxiety in children and increase the efficiency of the procedures compared with the tablet video with the same content.

Increased Plasma YKL-40 Level and Chitotriosidase Activity in Cystic Fibrosis Patients

2021 ◽  
Author(s):  
Dilara Bal Topcu ◽  
Gökcen Tugcu ◽  
Berrin Er ◽  
Sanem Eryilmaz Polat ◽  
Mina Hizal ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pediatric Patients ◽  
Adult Patients ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Children ◽  
Plasma Samples ◽  
Stable Period ◽  
Valuable Marker ◽  
Chitotriosidase Activity ◽  
Relevant Factors

Abstract Background We investigated plasma YKL-40 levels and chitotriosidase (CHIT1) activity in patients with cystic fibrosis (CF) lung disease and evaluated clinically relevant factors that may affect their levels. Methods Plasma samples were obtained from pediatric (n = 19) and adult patients (n = 15) during exacerbation, discharge and stable period of the disease. YKL-40 levels and chitotriosidase activity were measured by enzyme-linked immunosorbent assay and fluorometric assay, respectively. Data were compared with healthy children and adults of similar age. Results YKL-40 levels of pediatric and adult CF patients at all periods were significantly higher than controls (p < 0.001 and p < 0.05). CHIT1 activities of adult patients at all periods were significantly higher compared to controls (p < 0.05). On the other hand, CHIT1 activities of pediatric CF patients were similar with controls. YKL-40 levels of exacerbation period of adult CF patients were negatively correlated with % FVC (r= -0.800, p = 0.014) and % FEV1 (r= -0.735, p = 0.008). YKL-40 levels in the exacerbation period of pediatric CF patients were negatively correlated with % FVC (r= -0.697, p = 0.0082) and % FEV1 (r= -0.720, p = 0.006). Conclusions CHIT1 activity may be a valuable marker of chronic inflammation in adult CF patients who suffer from CF for a longer period of time compared to pediatric patients. Increased YKL-40 levels in both pediatric and adult patients compared to controls may point to a role in between CF pathology. Furthermore, as YKL-40 levels are correlated with FEV1 and FVC in patients, it may be useful for the monitoring of pulmonary function in CF patient.

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