RESPIRATORY PROBLEMS ARE COMMON in children. The anesthesiologist often encounters pulmonary complications ranging from mild acute respiratory tract infections to chronic lung disease with end-stage respiratory failure during perioperative consultations, intraoperatively, or in the intensive care unit. This chapter discusses…
DESPITE ADVANCES IN PEDIATRIC SURGERY, infants and children may sustain major operative blood loss, but little information is available about when coagulation defects will begin to appear in children. Most studies of massive blood transfusions have involved adult patients, with…
ALTHOUGH CHILDHOOD CANCER is not particularly common, it is the second most common cause of death in children younger than 15 years of age. The most common malignancies affecting children are different from those affecting adults. Leukemia, brain tumors, lymphomas,…
HEMATOLOGIC DISORDERS IN CHILDHOOD may present to an anesthesiologist in many ways. They may be the primary cause for a surgical procedure, such as hereditary spherocytosis (HS) in a child requiring splenectomy, or a factor complicating a common surgical procedure,…
ELECTROLYTE DISTURBANCES ARE COMMON in children because of their small size, large ratio of surface area to volume, and immature homeostatic mechanisms. As a result, fluid management can be challenging. On the ward, in the operating room, or in the…
THE MOST COMMON INDICATIONS for total intravenous anesthesia (TIVA) techniques in children are as follows: those at risk for malignant hyperthermia (in whom inhalational agents are contraindicated); children with a high risk of postoperative nausea and vomiting, brief radiologic or…
THE PHARMACOKINETICS AND PHARMACODYNAMICS of most medications in children, especially neonates, differ from those in adults. Children exhibit different pharmacokinetics (PK) and pharmacodynamics (PD) from adults because of their immature renal and hepatic function, different body composition, altered protein binding,…
U.S. PRESIDENT WILLIAM CLINTON, when announcing the relative completion of the Human Genome Project in July 2000, stated “With this profound new knowledge, humankind is on the verge of gaining immense new power to heal. Genome science will have a…
CLINICIANS MUST TAKE SERIOUSLY “the experience, perspective, and power of children.” Clinicians should treat every child and family with the grace and consideration with which they would want their own child and family treated. Taking the experience of children seriously…
Preparation of Children for Anesthesia Fasting Infants and children are fasted before sedation and anesthesia to minimize the risk of pulmonary aspiration of gastric contents. In a fasted child, only the basal secretions of gastric juice should be present in…