Pediatric Anesthesia

Landsman, Ira S.; Vustar, Mirjana; Hays, Stephen R.

doi:10.1016/b978-0-323-02842-4.50016-4

Cited by 3 publications

(4 citation statements)

References 287 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[30][31][32] Fluid loss and electrolyte imbalance, metabolic acidosis, hypoglycemia, hypothermia results from inadequate warming during examination and/or negligence, respiratory distress and septicemia are the leading factors for high morbidity and mortality of intestinal obstruction. 33 Many of these neonates are brought to hospital several days or sometimes weeks after the onset of illness with severe fluid and electrolyte deficits, anemia, sepsis, and malnourishment. Frequently, even the neonates who are delivered in the hospitals are referred late to specialist centres, often not well resuscitated and transported in suboptimal conditions from far locations on bad roads.…”

Section: Discussionmentioning

confidence: 99%

Neonatal surgery: Demand and survival both are on increase- an experience of seventeen years in Dhaka Medical College Hospital, Bangladesh

Hanif

Hasina

Rouf³

et al. 2020

Bangladesh Med Res Counc Bull

View full text Add to dashboard Cite

Purpose: In order to achieve the Sustainable Development Goal (SDG) 3 target of reduction in under-five mortality below 25 per thousand live birth by the year of 2030, major reductions are going to be required in neonatal mortality. Congenital anomalies have become the fourth cause of neonatal deaths and most of these are curable. The largest public hospital of Bangladesh is serving the poor and lower middle class people where surgery and medical facilities are mostly free of cost. This study was done to see the types of neonatal surgical patients admitted in this hospital and their management out come with limited facilities and find out some new ideas and information and the ways to improve the scenario to contribute in achieving the SDG 3. Materials & Methods: This was a descriptive study with retrospective record review of all admitted neonates done over a period of 17 years from July 2001 to June 2018 and carried out in the Department of Pediatric Surgery. A total of 2492 neonates were admitted during this period and it was the 16.16% of total number of 15414 pediatric surgical admission upto12 years of age. Data was collected from hospital records and analyzed retrospectively. Detail history of each patient was collected and recorded in a pre-designed, semi-structured questionnaire. Statistical assessments were done by SPSS version 22. An Ethical clearance had been sought. Results: Out of these 2492 neonates, 1932 (77.53%) were admitted for Neonatal Intestinal Obstruction (NIO) and Intestinal atresia 246 (09.87%), Omphalocele 163 (06.54%), Meconium ileus 154 (06.18%), Volvulous neonatoram 125 (05.02%), Septicemia 114 (04.57%), Posterior urethral valve 78 (03.13%), Gastroschisis 75 (03.01%), Abscess 57 (02.29%), Congenital Diaphragmatic Hernia 54 (02.17%), Ectopia vesicae 50 (02.01%), Infantile pyloric stenosis 42 (01.68%), Tracheo-oesophageal fistula 24 (0.96%), Prune belly syndrome 8 (0.32%), Neonatal injury 5 (0.20%), Conjoint twin 4 (0.16%). The most common cause of NIO was anorectal malformation (ARM) 806 (32.34%). Among them 516 (64.02%) patients had high variety and 290 (35.98%) patients had low variety ARM. Next was Hirschsprungs disease and 487 (19.54%) neonates presented with this. One hundred and forteen (4.57%) patients presented with septicemia and 246 (9.87%) presented with intestinal atresia, 154 (6.18%) neonates had meconium ileus and 125 (5.02%) patients presented with volvulus neonatorum. Total 1791 (71.86%) patients were managed surgically. Most of the surgerical procedures were pelvic colostomy 541 (21.71%), transverse colostomy and biopsies 376 (15.09%), resection and anastomosis 261(10.47%), anoplasty 239 (9.59%), primary repair 135 (5.42%) and ileostomy 104(4.17%). Out of 2492 patients, 351 died, so mortality was 14.09%, before surgery 127 (5.10%) and after surgery was 224 (14.85%). Conclusion: Pediatric surgeons by their skill and teamwork greatly improved the neonatal surgical service and contributing significantly in reducing infant mortality rate to achieve SDG 3. But to improve further, neonatal intensive care unit (NICU) and other support systems are essential as well as support from UNICEF and World Health Organization (WHO) to include pediatric surgery and surgeons in their activities especially in developing countries. Due to socio-political and economic reasons of the developing countries the roll of pediatric surgeons are multidimensional. Bangladesh Med Res Counc Bull 2020; 46(1): 05-11

show abstract

Section: Discussionmentioning

confidence: 99%

Neonatal surgery: Demand and survival both are on increase- an experience of seventeen years in Dhaka Medical College Hospital, Bangladesh

Hanif

Hasina

Rouf³

et al. 2020

Bangladesh Med Res Counc Bull

View full text Add to dashboard Cite

show abstract

“…In this study, all cases were given pre-emptive analgesia with 0.5-1-ml/kg local anesthetic (both lignocain and bupivacain) in incision line before the incision was made. So for this simple but good pain management technique recovery from anesthesia was good as well as postoperative period was uneventful without any ventilatory support 25 -which this hospital could not provide due to absence of NICU. Thus this technique helps in reducing mortality.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Surgery: Demand and Survival Both are Increasing: Eight Years Experience in Dhaka Medical College Hospital, Bangladesh

Hanif

Hasina

Hossain

et al. 2014

J. paediatr. surg. Bangladesh

View full text Add to dashboard Cite

:Purpose: In order to achieve the Millennium Development Goal (MDG) 4 target of a two-thirds reduction in under-five mortality from 1990 to 2015, major reductions are going to be required in neonatal mortality. Congenital anomalies have become the fourth cause of neonatal deaths and most of these are curable. Dhaka Medical College Hospital is the largest public hospital of the country and serving the poor and lower middle class people where surgery and medical facilities are mostly free of cost. This study was done to see the types of neonatal surgical patients admitted in this hospital and their management out come with limited facilities and find out the ways to improve the scenario to contribute in achieving the MDG. Materials

show abstract

“…9 Preoperative evaluation of hemoglobin level is required in pediatric patients and it is required to be at least 30% or more. 8 The most frequent laboratory abnormality detected in this study was decreased Hb, which was identified in 117 patients (3.1%). Deep anemia was found in seven patients and they were transfused.…”

Section: Discussionmentioning

confidence: 56%

“…7 If the hematocrit level is less than 30% in preterm babies, it is suggested to wait before operation until the hematocrit is higher than this level. 8 White blood cell counts should be obtained in patients receiving chemotherapy and immunosuppressive therapy and who are suspected to have infection and who have hematological malignancy 7 . In one study it was found that 0.7-4.8% of the patients had abnormal hemoglobin levels; however, the test result was observed to make any change in the treatment only in 0.1-2.7%.…”

Section: Discussionmentioning

confidence: 99%

Routine Preoperative Laboratory Tests for Elective Surgery

Martin

Cifu

2017

JAMA

View full text Add to dashboard Cite

Preoperative laboratory tests are a component of the evaluation of the patient for the operation. The aim of this study is to evaluate the necessity of preoperative blood tests in outpatient surgery in children.This study was performed in the pediatric surgery clinic between January 2005 and June 2009 on 3,693 patients who underwent elective outpatient surgery. Results of the routine preoperative tests performed in all patients such as hemogram, liver enzymes, coagulation tests and anti-HCV antibody, hepatitis B antigen, and anti-HIV antibody were evaluated. Two thousand nine hundred of the patients were boys (78.5%) and 793 were girls (21.5%). Mean age was 33±38 months (median 19 months). One or more parameters were found to be abnormal in 194 patients (5.2%). Anemia was detected in 3.1% of the patients (n:117), liver enzymes were found to be elevated in 1.1% (n:40) of the patients and coagulation tests were found to be increased in 0.8% (n:30) of the patients. Operations were postponed in 1.9% (n:70) of the patients for evaluation or treatment. This study demonstrates that routine preoperative blood tests though they might be valuable in a small number of patients; however, they are unnecessary in 94.8% of the patients.

show abstract

Pediatric Anesthesia

Cited by 3 publications

References 287 publications

Neonatal surgery: Demand and survival both are on increase- an experience of seventeen years in Dhaka Medical College Hospital, Bangladesh

Neonatal surgery: Demand and survival both are on increase- an experience of seventeen years in Dhaka Medical College Hospital, Bangladesh

Neonatal Surgery: Demand and Survival Both are Increasing: Eight Years Experience in Dhaka Medical College Hospital, Bangladesh

Routine Preoperative Laboratory Tests for Elective Surgery

Contact Info

Product

Resources

About