Pediatric Anesthesia: A Guide for the Non-Pediatric Anesthesia Provider - Part II

Cover
Title
Copyright
End User License Agreement
Contents
Foreword
Preface
WHO CONTRIBUTED TO THIS BOOK
THANKS
SUMMARY
List of Contributors
Anesthesia for Pediatric Patients with Common Comorbidities Part I
Divya Dixit, M.D.1,* and Dinesh K. Choudhry2
UPPER RESPIRATORY TRACT INFECTION
Introduction
Perioperative Respiratory Adverse Events
Risk Factors
Preoperative Evaluation
Investigations
Postponement of Elective Surgery
Perioperative Management
Premedication
Anesthetic Induction
Airway Device
Emergence
ASTHMA
Introduction
Wheezing as a Risk Factor for PRAEs
Preoperative Evaluation
Investigations
Perioperative Management
Preoperative
Premedication
Anesthetic Induction
Airway Device
Ventilation Strategy During Anesthesia
Intraoperative Bronchospasm
Medications that may Precipitate Bronchospasm
Emergence
Conclusion
DOWN SYNDROME
Clinical Manifestations
Craniofacial Features
Neurological Features
Respiratory System
Musculoskeletal
Cardiac Anomalies
Behavioral Issues
Other Conditions
Preoperative Evaluation
Cardiac Assessment
Neurological Evaluation
Airway Abnormalities
Obstructive Sleep Apnea
Perioperative Management
Investigations and Premedication
Anesthetic Induction
Intubation
Pulmonary Hypertension
Positioning
Pain Management
Emergence
Conclusion
SICKLE CELL DISEASE
Introduction
Prevalence and Epidemiology
Pathophysiology
Clinical Features
Cerebrovascular
Acute Chest Syndrome
Cardiovascular
Aplastic Crisis
Genitourinary
Skeletal Complications
Laboratory Findings
Hemoglobin F and Hydroxyurea
Perioperative Management
Preoperative
Red Blood Cell Transfusion
Intraoperative
Pain Management
Postoperative
Conclusion
OBSTRUCTIVE SLEEP APNEA IN CHILDREN
Introduction
Central Sleep Apnea
Obstructive Sleep Apnea
Mixed Sleep Apnea
Hypopnea
Etiology
Pathophysiology
Clinical Features
Investigations
Perioperative Management
Preoperative
Intraoperative
Postoperative
Conclusion
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anesthesia for Pediatric Patients with Common Comorbidities Part II
Saranya Chinnappan1 and Monica Banerjee2,*
AUTISM
Introduction
Preoperative Concerns and Premedication
Intraoperative/Postoperative Management
ATTENTION DEFICIT HYPERACTIVITY DISORDER
Introduction
Pharmacologic Interactions
Perioperative Concerns
Children with ADHD are more uncooperative during induction [8] so premedication will be essential.
CYSTIC FIBROSIS
Introduction
Pathophysiology
Perioperative Management
EPIDERMOLYSIS BULLOSA
Introduction
Preoperative Evaluation
Perioperative Management
VON WILLEBRAND’S DISEASE
Disease Classification and Management
Perioperative Management
Conclusion
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anesthesia for Pediatric Patients with Common Comorbidities Part III
Pravin Taneja1 and Nathalie Peiris2,*
EX-PREMATURE PATIENTS
Introduction
Definitions
Morbidity and Mortality
Consequences of Prematurity
Ex-Premature Infants and Children
Respiratory and Airway Problems of the Ex-Premature Infant
Apnea of Prematurity
Neurologic Considerations
Intraventricular Hemorrhage
Cerebral Palsy
Retinopathy of Prematurity
Gastrointestinal Problems
Anesthetic Considerations
Pre-evaluation
Perioperative Concerns
Pain Control
Diabetes
Introduction
Preoperative Evaluation
Insulin Pump and Continuous Glucose Monitor Considerations
Hypoglycemia Management
Insulin Correction Factor
Intraoperative Management
Postoperative Management
OBESITY
Introduction
Preoperative Assessment
Intraoperative Management
Drug Dosing
Postoperative Management
ONCOLOGY PATIENTS
Introduction
Anesthetic Implications
Preoperative Evaluation
PEDIATRIC MALIGNANCIES
Leukemias
Clinical Presentation
Central Nervous System Tumors
Clinical Presentation
Lymphomas
Clinical Presentation
Intraoperative Considerations
Airway Considerations
Mediastinal Considerations
Intracranial Considerations
Systemic Effects of Malignancy
Chemotherapy and Radiotherapy Considerations
Myocardial Toxicity
Pulmonary Toxicity
Tumor Lysis Syndrome
Summary
POST CONGENITAL HEART DISEASE SURGERY PATIENTS FOR NON-CARDIAC SURGERY
Introduction
The Challenge
A Simple Classification
Preoperative Considerations
Intraoperative Considerations
A balanced Circulation
Right to Left Shunt
Left to Right Shunt
Pulmonary Hypertension
Single Ventricle Physiology
Anesthesia Considerations in “Fontan Circulation”
Infective Endocarditis Prophylaxis
Summary
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anesthetic Considerations for the Critically Ill Pediatric Patient
Vincent Lau, D.O.1, Levi Mulladzhanov, M.D.1, Srikant Patel, D.O.1, Irwin Gratz, D.O.1 and Bharathi Gourkanti, M.D.1,*
INTRODUCTION
INFECTIOUS DISEASE
Sepsis in Children
Diagnosis
Treatment of Shock
Empiric Broad-spectrum Antimicrobial Therapy
Invasive Ventilation
Anesthetic Considerations Duration Endotracheal Intubation and General Sedation
Goal-Directed Therapy
Perioperative Considerations
ENDOCRINE DISEASE
Diabetic Ketoacidosis
Diagnosis
Management
Propofol-Related Infusion Syndrome
Management
NEUROLOGIC DISEASE
Cerebral Edema
Status Epilepticus
Treatment
Perioperative Epilepsy Management
HEMATOLOGIC DISEASE
Sickle Cell Disease
Preoperative Considerations
Intraoperative Considerations
Postoperative Considerations
CONGENITAL HEART DISEASE
Patent Ductus Arteriosus
RESPIRATORY SYSTEM DISEASE
Assessment
Supplemental Oxygen Sources
Asthma
Acute Respiratory Distress Syndrome and Acute Lung Injury
ARDS Treatment Modalities
Surfactant Therapy
Inhaled Nitric Oxide
Corticosteroids
High-Frequency Oscillatory Ventilation
Tracheostomy Management During Respiratory Distress
GASTROINTESTINAL SYSTEM - NUTRITION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anesthesia-Related Genetic Disorders
Ian Brotman, M.D.1,* and David Youssef, M.D.1
INTRODUCTION
MALIGNANT HYPERTHERMIA
Inheritance
Clinical Features
Management of an MH Crisis
Anesthesia for High-Risk Malignant Hyperthermia Patients
Malignant Hyperthermia Testing
PSEUDOCHOLINESTERASE DEFICIENCY
OPIOID USE IN PEDIATRICS
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Pediatric Pain Management and Regional Anesthesia
Dinesh K. Choudhry 1,* and Kesavan Sadacharam2
INTRODUCTION
PATHOPHYSIOLOGY AND NEUROBIOLOGY
DEVELOPMENTAL PHARMACOLOGY
PAIN ASSESSMENT
PAIN IN NEONATES
APPROACH TO PAIN MANAGEMENT AND PHARMACOTHERAPY
Opioids
Non-opioid Medications
MULTIMODAL APPROACH TO PAIN MANAGEMENT
ENHANCED RECOVERY AFTER SURGERY
OPIOID-INDUCED HYPERALGESIA
REGIONAL ANALGESIA IN CHILDREN
Upper Extremity Blocks
Supraclavicular Approach
Interscalene Approach
Infraclavicular Approach
Truncal Blocks
Caudal Epidural Versus Truncal Blocks
Rectus Sheath Block
Quadratus Lumborum Block
Transverse Abdominis Plane Block
Ilioinguinal Block
Lower Extremity Blocks
Femoral Nerve Block
Adductor Canal Block
Fascia Iliaca Block
Sciatic Nerve Block
Lumbar Plexus Block
Spinal Anesthesia
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Research in Pediatric Anesthesia
Noud van Helmond, M.D.1 and Bharathi Gourkanti, M.D.1,*
INTRODUCTION
IS IT IMPORTANT TO CONDUCT RESEARCH IN PEDIATRIC ANESTHESIOLOGY?
Pediatric Anesthesiologists Cannot Extrapolate Findings from Adult Research to Children
Scientists and physicians need to conduct research to increase safety and quality in pediatric anesthesiology
Research is an essential part of anesthesiology training
SPECIFIC CONSIDERATIONS FOR RESEARCH IN PEDIATRIC ANESTHESIA VS. RESEARCH IN ADULT ANESTHESIA
Ethical Justification
Minimizing Risk
Study Procedure-related Distress
Obtaining Assent and Consent
Practical Considerations when Carrying out a Research Project
CONCLUDING REMARKS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Principles of Quality and Patient Safety in Pediatric Anesthesiology
Keri Cronin1,* and Erin Pukenas1
INTRODUCTION
FUNDAMENTALS OF PATIENT SAFETY
Just Culture
HIGH RELIABILITY ORGANIZATIONS (HROS)
ERRORS IN PEDIATRIC ANESTHESIOLOGY
Medication Errors
Handoff Communication
Use of Cognitive Aids to Enhance Patient Safety
Reporting Adverse Events
FUNDAMENTALS OF QUALITY IMPROVEMENT
National/International Quality Improvement Programs
Wake Up Safe (WUS)
POCA Registry
The American College of Surgeons Children’s Surgery Verification and Quality Improvement Program
The Global Initiative for Children’s Surgery (GICS)
Developing a Quality Improvement Program
Quality Improvement in Developing Countries
The Use of Simulation to support Patient Safety and Quality Improvement Efforts
CONCLUDING REMARKS
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anesthetic Considerations For Covid-19 (Year 2020)
David Youssef, M.D.1,* and Bharathi Gourkanti, M.D.1
PREOPERATIVE CONSIDERATIONS AND SYMPTOMOLOGY
COVID-19 TESTING
Anesthesia Machine and Equipment Maintenance
Laryngoscopy & Intubation in a COVID-19 Patient
Ventilation Management
Patient Transfer and Post-operative Care
Regional Anesthesia
SUMMARY
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Muscular Dystrophies and Mitochondrial Myopathies
Divya Dixit, MD1,*, Dinesh K. Choudhry, MD2 and Kumar G. Belani3
MUSCULAR DYSTROPHIES
DUCHENNE MUSCULAR DYSTROPHY
Introduction
Clinical Manifestations
Cardiac Involvement
Pulmonary Issues
Gastrointestinal Issues
Diagnosis
Anesthetic Management
Rhabdomyolysis
Intraoperative Concerns
Conclusion
BECKER MUSCULAR DYSTROPHY
LIMB-GIRDLE MUSCULAR DYSTROPHY
EMERY-DREIFUSS MUSCULAR DYSTROPHY
MYOTONIC MUSCULAR DYSTROPHY
Introduction
Types of Myotonic Muscular Dystrophy
Congenital Myotonic Dystrophy Type 1
Childhood Onset of Myotonic Dystrophy Type 1
Classic Adult Onset of Myotonic Dystrophy Type 1
Clinical Manifestations
Respiratory System
Cardiovascular
Musculature
Perioperative Concerns
Airway Management
Anesthetic Induction
Use of Muscle Relaxants
Respiratory Issues
Cardiac Issues
Anesthetic Management
Preoperative
Intraoperative
Postoperative
Conclusion
MITOCHONDRIAL MYOPATHIES
Introduction
Clinical Features
Diagnostic Tests for Mitochondrial Myopathies
Anesthetic Management
Conclusion
CEREBRAL PALSY
Introduction
Surgical Epidemiology
Perioperative Concerns
Neurologic
Respiratory System
Cardiovascular
Gastrointestinal
Fluids and Electrolytes
Musculoskeletal
Thermoregulatory
Pharmacologic
Positioning
Anesthetic Management
Preoperative
Intraoperative
Intrathecal Baclofen Pump
Postoperative
Conclusion
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Anesthesia for Uncommon Pediatric Diseases
B. Randall Brenn1,2 and Dinesh K. Choudhry1,3
ANTERIOR MEDIASTINAL MASSES
Introduction
Prevalence
Mediastinal Compartments
Pathophysiology of AMM
Airway Effects
Systemic Venous System
Heart and Great Vessels
Risk Factors for Anesthesia Complications
Preoperative Testing
Risk Stratification
Management
CONCLUSION
CONGENITAL PULMONARY AIRWAY MALFORMATION
Introduction
Etiopathogenesis
Clinical Presentation
Anesthetic Management
Conclusion
ARTHROGRYPOSIS MULTIPLEX CONGENITA
Introduction
Etiopathogenesis
Classification
Diagnostic Workup
Perioperative Concerns
ANESTHETIC MANAGEMENT
PHEOCHROMOCYTOMA
Introduction
Epidemiology
Pathophysiology
Risks Assessment
Preoperative Management
Intraoperative Management
Postoperative Management
Conclusion
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Subject Index