A Practice of Anesthesia for Infants and Children E-Book by Cote, Charles J. -- Read -- Imperial Library of Trantor

Index

Instructions for online access Cover image Title Page Copyright Dedication Contributors Preface Acknowledgments Video Contents Section I Introduction 1 The Practice of Pediatric Anesthesia

Preoperative Evaluation and Management Informed Consent Operating Room and Monitoring Induction and Maintenance of Anesthesia Clinical Monitors Airway and Ventilation Fluids and Perfusion Conduct of the Anesthesia Team The Postanesthesia Care Unit Postoperative Visit Summary

2 Growth and Development

Normal and Abnormal Growth and Maturation Gestational Age Assessment Airway and Respiratory System Cardiovascular System Renal System Digestive and Endocrine System Hematopoietic and Immunologic System Neurologic Development and Cognitive Development Issues Acknowledgment References

3 Perioperative Behavioral Stress in Children

Developmental Issues Preoperative Anxiety Postoperative Outcomes Intraoperative Clinical Outcomes Summary References

4 Preoperative Evaluation, Premedication, and Induction of Anesthesia

Preparation of Children for Anesthesia Premedication and Induction Principles Induction of Anesthesia Special Problems Acknowledgment References

5 Ethical Issues in Pediatric Anesthesiology

Informed Consent End-of-Life Issues Clinical and Academic Practice Issues References

Section II Drug and Fluid Therapy 6 Pharmacogenomics

Historical Perspectives Basic Concepts and Nomenclature Hepatic Metabolism and Developmental Pharmacogenetics Genomics of Drug Metabolism, Exposure, and Effects Pharmacogenomics of Pain and Analgesia Genetic Variations Affecting Opioid Pharmacokinetics Genetic Variations Affecting Opioid Pharmacodynamics Genes of Addiction Nonsteroidal Antiinflammatory Drugs and Genetics Acetaminophen and Genetics Chronic Pain, Persistent Postoperative Pain, and Genetics Pharmacogenomics Affecting Anesthesia Perioperative Outcomes Ancestry/Race and Genetics Pharmacogenomics Methods Genetic Counseling Clinical Translation: Bench to Bedside: Where Are We Now? Conclusion References

7 Pharmacokinetics and Pharmacology of Drugs Used in Children

Pharmacokinetic Principles and Calculations Population Modeling Pediatric Pharmacokinetic Considerations Pharmacodynamic Models Linking Pharmacokinetics With Pharmacodynamics Drug Distribution Absorption Bioavailability Metabolism and Excretion Central Nervous System Effects Pharmacodynamics in Children Drug Interactions The Drug Approval Process, the Package Insert, and Drug Labeling Inhalation Anesthetic Agents Oxygen Intravenous Anesthetic Agents Neuromuscular Blocking Drugs Depolarizing Neuromuscular Blocking Drugs Intermediate-Acting Nondepolarizing Neuromuscular Blocking Drugs Long-Acting Nondepolarizing Neuromuscular Blocking Drugs Antagonism of Neuromuscular Blocking Drugs Neuromuscular Blocking Drugs in Special Situations Opioids Acetaminophen Nonsteroidal Antiinflammatory Agents Benzodiazepine Sedatives Other Sedatives Antihistamines Antiemetics Anticholinergics Antagonists References

8 Total Intravenous Anesthesia and Target-Controlled Infusion

Pharmacokinetic and Pharmacodynamic Principles Pharmacodynamic Interaction Models Depth of Anesthesia Monitoring A Practical Approach in Children Acknowledgement References Suggested Websites

9 Fluid Management

Regulatory Mechanisms: Fluid Volume, Osmolality, and Arterial Pressure Maturation of Fluid Compartments and Homeostatic Mechanisms Fluid and Electrolyte Requirements Intraoperative Fluid Management Postoperative Fluid Management Pathophysiologic States and Their Management Acknowledgment References

10 Essentials of Hematology

The Basics Hemolytic Anemias Thrombocytopenia Coagulation Disorders Hematologic Malignancies References

11 Perioperative Management of the Oncology Patient

Principles of Cancer Therapy Preoperative Considerations by Organ System Hematopoietic Stem Cell Transplant Adoptive T-Cell Therapies in Children Preoperative Laboratory Testing and Evaluation Perioperative Considerations Transfusion Considerations Effects of Anesthetic Agents on Perioperative Immunomodulation Summary References

12 Strategies for Blood Product Management, Reducing Transfusions, and Massive Blood Transfusion

Blood Volume Blood Components and Alternatives Massive Blood Transfusion Methods to Reduce Patient Exposure to Allogeneic Blood Components Acknowledgment References

Section III The Chest 13 Essentials of Pulmonology

Respiratory Physiology Preoperative Assessment Pulmonary Function Tests Perioperative Etiology and Epidemiology Summary References

14 The Pediatric Airway

Developmental Anatomy of the Airway The Larynx Physiology of the Respiratory System Evaluation of the Airway Airway Management: The Normal Airway Airway Management: The Abnormal Airway Acknowledgments References

15 Anesthesia for Thoracic Surgery

General Perioperative Considerations Summary References

Section IV The Heart 16 Essentials of Cardiology

Congenital Heart Disease Acquired Heart Disease Heart Failure in Children Syndromes, Associations, and Systemic Disorders: Cardiovascular Disease and Anesthetic Implications Selected Vascular Anomalies and Their Implications for Anesthesia Evaluation of the Child With a Cardiac Murmur Basic Interpretation of the Electrocardiogram in Children Essentials of Cardiac Rhythm Interpretation and Acute Arrhythmia Management in Children Pacemaker and Defibrillator Therapy in the Pediatric Age Group Diagnostic Modalities in Pediatric Cardiology Perioperative Considerations for Children With Cardiovascular Disease Summary Acknowledgment References

17 Anesthesia for Children Undergoing Heart Surgery

Preoperative Evaluation Perioperative Challenges in Pediatric Cardiac Anesthesia Anesthesia Management for Surgery Requiring Cardiopulmonary Bypass Control of Systemic and Pulmonary Vascular Resistance During Anesthesia Anesthetic Drugs Used in Pediatric Cardiac Anesthesia Regional Anesthesia Fast Tracking Cardiopulmonary Bypass Stress Response to Cardiac Surgery Anesthesia Considerations for Specific Cardiac Defects Transport and Transfer to a Pediatric Intensive Care Unit Acknowledgment References

18 Cardiac Physiology and Pharmacology

Cardiovascular Physiology Incidence and Prevalence of Congenital Heart Disease Pathophysiologic Classification of Congenital Heart Disease Special Situations Cardiovascular Pharmacology Acknowledgments References

19 Cardiopulmonary Bypass and Management

Basic Aspects of Cardiopulmonary Bypass Special Coagulation and Hematologic Problems A Perspective on Blood Preservation: Cardiopulmonary Bypass in Jehovah's Witness Patients Myocardial Protection Phases of Cardiopulmonary Bypass Particular Aspects of Management on Cardiopulmonary Bypass Prebypass Anesthetic Management Anesthesia on Cardiopulmonary Bypass Special Techniques Effects of Cardiopulmonary Bypass Transport to the Intensive Care Unit Summary References

20 Medications for Hemostasis

Physiology of Coagulation Developmental Coagulation Coagulopathy and Major Surgery Alterations in Hemostasis During Pediatric Cardiac Surgery Medications Used for Hemostasis New Drug Development Summary Acknowledgment References

21 Mechanical Circulatory Support

Indications for Mechanical Circulatory Support Contraindications The Devices Extracorporeal Membrane Oxygenation Ventricular Assist Devices Perioperative Management of Mechanical Circulatory Support Outcomes and Complications The Future References

22 Interventional Cardiology

Types of Procedures Performed Complications and Limitations of Procedures Anesthesia Acknowledgment References

23 Anesthesia for Noncardiac Surgery in Children With Congenital Heart Disease

Preoperative Assessment Intraoperative Management Postoperative Care Perioperative Problems and Special Considerations Outcomes of Noncardiac Surgery Specific Congenital Heart Defects Summary References

Section V The Brain and Glands 24 Essentials of Neurology and Neuromuscular Disorders

General Considerations Static Neurologic Disorders Progressive Neurologic Disorders Neuromuscular Disorders Epilepsy Summary References

25 Surgery, Anesthesia, and the Immature Brain

Background Normal Brain Development Effects of Anesthetic Exposure on the Developing Brain Putative Mechanisms for Neurotoxicity Specific Anesthetic and Sedative Agents Exposure Time, Dose, and Anesthetic Combinations Deleterious Effects of Untreated Pain and Stress Potential Alleviating Strategies Anesthetic Neuroprotection Critical Evaluation of Animal Studies and Interspecies Comparisons Long-Term Outcome in Children Exposed to Anesthesia and Surgery Outcome After Exposure to Anesthesia Outside of the Operating Room Limitations of the Available Clinical Studies Future Research Recommendations for Clinical Practice References

26 Pediatric Neurosurgical Anesthesia

Pathophysiology Management of Anesthesia Special Situations Acknowledgments References

27 Essentials of Endocrinology

Diabetes Mellitus* Diabetes Insipidus Syndrome of Inappropriate Antidiuretic Hormone Secretion Thyroid Disorders Parathyroid and Calcium Disorders Adrenal Disorders Pheochromocytoma References

Section VI The Abdomen 28 Essentials of Nephrology

Renal Physiology Disease States Preoperative Preparation of the Child With Renal Dysfunction Intraoperative Management References

29 General Abdominal and Urologic Surgery

General Principles of Abdominal Surgery General Principles of Urologic Surgery Laparoscopic Surgery Robot-Assisted Surgery Specific General Surgical and Urologic Conditions Bariatric Surgery in Children Acknowledgments References

30 Essentials of Hepatology

Anatomy Principles of Hepatic Drug Metabolism Anesthetic Agents Anesthetic Effects on Hepatic Cellular Functions Perioperative Considerations in Liver Disease References

31 Organ Transplantation

Liver Transplantation Renal Transplantation Cardiac Transplantation Pediatric Lung and Heart-Lung Transplantation References

Section VII Other Surgeries 32 Orthopedic and Spine Surgery

Scoliosis Surgery Risk Minimization and Improving Outcome From Surgical Intervention Spinal Cord Injury During Surgery Preoperative Assessment and Postoperative Planning Anesthetic and Intraoperative Management Tourniquets Acute Bone and Joint Infections Common Syndromes References

33 Otorhinolaryngologic Procedures

Anesthesia for Otologic Procedures Anesthesia for Rhinologic Procedures Adenotonsillectomy Anesthesia for Endoscopy Upper Airway Obstruction Tracheostomy Laryngotracheal Reconstruction Airway Trauma Acknowledgment References

34 Ophthalmology

Preoperative Evaluation Common Ophthalmologic Diagnoses Requiring Surgery Ophthalmologic Conditions Associated With Systemic Disorders Ophthalmologic Pharmacotherapeutics and Systemic Implications Specific Ophthalmologic Procedures Acknowledgment References

35 Plastic and Reconstructive Surgery

Cleft Lip and Palate Craniosynostosis Orbital Hypertelorism Midface Procedures Hemifacial Microsomia, Treacher Collins Syndrome, and Goldenhar Syndrome Orthognathic Surgery Cystic Hygromas and Hemangiomas Möbius Syndrome Congenital Intraoral Fibrous Bands Intraoral Tumors Brachial Plexus Surgery Otoplasty Congenital Hand Anomalies Tissue Expanders Hairy Pigmented Nevi Cosmetic Procedures Trauma Acknowledgments References

36 Burn Injuries

Pathophysiology Pharmacology Resuscitation and Initial Evaluation Guidelines to Anesthetic Management Summary Acknowledgment References

Section VIII Emergencies 37 The Extremely Premature Infant (Micropremie) and Common Neonatal Emergencies

Physiology of Prematurity Related to Anesthesia Anesthetics and the Neonate/Premature Infant Neonatal Surgical Emergencies Emergency Surgery References

38 Fetal Intervention and the EXIT Procedure

A Range of Anesthetic Options for Mother and Fetus Fetal Development Fetal Monitoring Physiologic Consequences of Pregnancy Fetal Preoperative Evaluation Maternal Evaluation Tocolysis and Tocolytic Agents Congenital Cystic Adenomatoid Malformation: the Open Procedure Other Diseases Eligible for Open Procedures Hypoplastic Left Heart Syndrome: Percutaneous and Fetoscopic Procedures Other Diseases Eligible for Fetoscopic Procedures The EXIT Procedure Movement Toward Intervention for Non–Life-Threatening Diseases: Myelomeningocele Future Considerations References

39 Trauma

Epidemiology of Pediatric Trauma Nonaccidental Trauma Prehospital Care of the Pediatric Trauma Patient Emergency Department Evaluation and Management of the Pediatric Trauma Patient Anesthesia Management of the Pediatric Trauma Patient Future Directions in Pediatric Trauma Summary Acknowledgment References

40 Cardiopulmonary Resuscitation

Historical Background Epidemiology, Prevention, and Outcome of In-Hospital Cardiopulmonary Arrest Diagnosis of Cardiac Arrest Mechanics of Cardiopulmonary Resuscitation Defibrillation and Cardioversion Vascular Access and Monitoring During Cardiopulmonary Resuscitation Medications Used During Cardiopulmonary Resuscitation Special Cardiac Arrest Situations Adjunctive Cardiopulmonary Resuscitation Techniques Postresuscitation Stabilization (Post–Cardiac Arrest Care) The 2015 AHA Pediatric Advanced Life Support Guidelines Update References

41 Malignant Hyperthermia

Clinical Presentation Patient Evaluation and Preparation Monitoring Diagnosis Management, Susceptibility Screening, and Counseling Genetics Physiology Laboratory Diagnosis Other Disorders and Malignant Hyperthermia Summary References

Section IX Pain 42 Regional Anesthesia

Pharmacology and Pharmacokinetics of Local Anesthetics Equipment Specific Procedures Summary Acknowledgment References

43 Ultrasound-Guided Regional Anesthesia

Principles of Ultrasound Essentials of Musculoskeletal Ultrasound Imaging Identification of Nerves, Tendons, Muscle, Fat, Bone, Fascia, Blood Vessels, and Pleura Special Techniques Specific Ultrasound-Guided Nerve Blocks Education and Training Summary Acknowledgment References

44 Acute Pain

Developmental Neurobiology of Pain Pain Assessment Strategies for Pain Management Pharmacologic Treatment of Pain Pain Management in the Cognitively Impaired Child Summary Acknowledgment References Appendix 44.1 Clinical Examples of Postoperative Analgesic Management Strategy

45 Chronic Pain

Chronic Pain in Children Multidisciplinary Approach General Approach to Management Chronic Pain Conditions Pain Pharmacotherapy Complementary Therapies Summary References

Section X Special Topics 46 Anesthesia Outside the Operating Room

Standards and Guidelines Off-Site Anesthesia: Structure Quality Assurance of Anesthesia Services and Outcome in the Off-Site Areas Anesthesia Versus Sedation for Non–Operating Room Procedures and Tests in Children Logistics of Managing Acute Emergencies and Cardiopulmonary Arrest Outside the Operating Room Difficult Airway Management in the Non–Operating Room (Off-Site) Environment Specific Locations for Non–Operating Room Anesthesia Summary Acknowledgment References

47 The Postanesthesia Care Unit and Beyond

Perioperative Environment Central Nervous System Respiratory System Cardiovascular System Renal System Gastrointestinal System Postoperative Care and Discharge Beyond PACU: Postoperative Monitoring in the General Care Setting Acknowledgment References

48 Sedation for Diagnostic and Therapeutic Procedures Outside the Operating Room

The Evolution of Pediatric Sedation and the Anesthesiologist's Role Sedation Depth Guidelines Goals of Sedation The Concept of “Safety” Specific Sedation Techniques Summary and Future of Pediatric Sedation References

49 Procedures for Vascular Access

Venous Cannulation Arterial Cannulation References

50 Infectious Disease Considerations for the Operating Room

Causative Agent Host Methods of Transmission Strategy for Preventing Infection Transmission in Health Care Institutions Measures for Prevention of Infection Transmission in the Operating Room References

51 Pediatric Anesthesia in Developing Countries

The Child Human Resources Pathology Drugs Blood Safety Equipment Visiting Providers Summary References

52 Pediatric Equipment

Heating and Cooling Systems Patient Warming Intravenous Therapy Airway Apparatus Intubation Equipment Suction Devices Anesthesia Workstation Equipment Cart Defibrillator and External Pacemakers Ultrasound for Regional Anesthesia and Vascular Cannulation Monitoring Equipment Purchasing Anesthesia Equipment References

53 Simulation in Pediatric Anesthesia

Simulation-Based Training in Anesthesia What Is Simulation? Technologies Used in Simulation Sites for Simulation Applications of Simulation in Perioperative Pediatric Education Comparing Traditional Learning With Simulation-Based Learning Aspects of a High-Fidelity Simulation What Is a Debriefing? Using Simulation for Evaluation Challenges Using Simulation Future of Simulation References

Index Endsheet 5 Endsheet 6 A Practice of Anesthesia for Infants and Children

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