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Electrocardiographic changes before CPR. a Initial electrocardiogram: HR=75 bpm. b Approximately one minute and few seconds after induction: HR=20 bpm. c Just before cardiopulmonary resuscitation: HR=0 bpm
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This report describes a case of transient cardiac arrest in a child with Down syndrome. The cardiac arrest occurred during induction of anesthesia with sevoflurane. To the best of our knowledge, this is the first such report. Case presentationA 14-year-old boy was scheduled to undergo dental treatment under general anesthesia because of...
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Introduction: Patients with Down syndrome (DS due to relative macroglossia and dynamic airway collapse) are vulnerable to significant upper airway complications. Obstructive sleep apnea (OSA) is a common condition and noted in about 79% of these children . Children with OSA, with or without DS, are sensitive to respiratory depression by drugs such as sedatives, opioids and hypnotics. Abnormalities of the cardiovascular system are also common in Down syndrome. Case Report: A nine_ day old male preterm newborn with DS (e.g. gestational age of 35 weeks) was brought to operation room (OR) for insertion of central venous line and surgery of duodenal atresia. During transportation to NICU, in OR he arrested and then after 45 minutes resuscitation, he returned to life. Conclusion: The placement of CVL could precipitate triggers of cardiac arrest, particularly in preterm newborn.
Background: Assessment fluid adequacy in pediatric patients underwent surgery is a challenge for anesthesiologists. Hemodynamic parameters used as fluid monitoring sometimes don't accurately provide valid information. Ultrasonic Cardiac Output Monitor (USCOM) is one of the non-invasive methods that are easy to operate and may provide various hemodynamic parameters monitoring information.
Objective: Analyze the effectiveness of Stroke Volume Variation (SVV) and Stroke Volume Index (SVI) by using USCOM in assessing fluid responsiveness in preoperative pediatric patients who underwent emergency surgeries.
Method: This study was conducted on 16 pediatric patients underwent emergency surgeries. Before general anesthesia is given, blood pressure, mean arterial pressure, heart rate, cardiac index, SVV, SVI were recorded before and after administration of 10 mL/kg of fluid given within 20 minutes
Results: 10 subjects responded with SVV and SVI changes of more than 10% compared to 6 non-responders. SVV changes between responders and non-responders were 31.5±1.58 and 7.5±1.04, respectively. SVV percentage changes between responders and non-responders were 38.04±0.47 and 5.24±4.89, respectively.
Conclusion: SVV and SVI recorded by USCOM showed significant fluid responsiveness changes in pediatric patients underwent emergency surgeries in 62.5% of the subjects.
