Abstract:
BACKGROUND:Preoperative factors have been correlated with pre-incision hypotension (PIH) in children undergoing surgery, suggesting that PIH can be predicted through preoperative screening. We studied blood pressure (BP) changes in the 12 min following the induction of anesthesia to study the incidence of post-induction hypotension and to assess the feasibility of predicting PIH in low-risk children without preoperative hypotension or comorbid features. METHODS:We retrospectively evaluated 200 patients ranging in age from 2 to 8 years with American Society of Anesthesiologists' (ASA) physical status I or II, undergoing non-cardiac surgery. Patients were excluded if they had preoperative (baseline) hypotension (systolic blood pressure (SBP) < 5th percentile for age). BP and heart rate (HR) were recorded at 3 min intervals for 12 min after the induction of anesthesia. Pre-incision hypotension (PIH) was initially defined as SBP < 5th percentile for age: (1) at any timepoint within 12 min of induction; (2) for the median SBP obtained during the 12 min study period; or (3) at 2 or more timepoints including the final point at 12 min after the induction of anesthesia (sustained hypotension). In addition, we examined PIH defined as > 20% decrease in SBP from baseline: (4) at any timepoint within 12 min of the induction of anesthesia; (5) for the median SBP obtained during the 12 min study period; or (6) at two or more timepoints including the final point at 12 min after the induction of anesthesia. Agreement among the six definitions was analyzed, in addition to the effects of age, gender, type of anesthetic induction, use of premedication, preoperative BP, preoperative HR, and body mass index on the incidence of PIH according to each definition. RESULTS:Five patients were excluded due to baseline hypotension and six were excluded for missing data. In the remaining cohort, estimated PIH prevalence ranged from 4% [definition (Stewart et al., in Paediatr Anaesth 26:844-851, 2016), sustained PIH according to SBP percentile-for-age] to 57% [definition (Task Force on Blood Pressure Control in Children, in Pediatrics 79:1-25, 1987), at least one timepoint where SBP was > 20% lower than baseline]. Pairwise agreement among the six definitions ranged from 49 to 91% agreement. No sequelae of PIH were noted during subsequent anesthetic or postoperative care. On multivariable analysis, no covariates were consistently associated with PIH risk across all six definitions of PIH. CONCLUSION:The present study describes the incidence and prediction of PIH in a cohort of relatively healthy children. In this setting, accurate prediction of PIH appears to be hampered by lack of agreement between definitions of PIH. Overall, there was a low PIH incidence when the threshold of SBP < 5th percentile for age was used. LEVEL OF EVIDENCE:II.
journal_name
Pediatr Surg Intjournal_title
Pediatric surgery internationalauthors
Wani TM,Hakim M,Ramesh A,Rehman S,Majid Y,Miller R,Tumin D,Tobias JDdoi
10.1007/s00383-018-4359-5subject
Has Abstractpub_date
2018-12-01 00:00:00pages
1333-1338issue
12eissn
0179-0358issn
1437-9813pii
10.1007/s00383-018-4359-5journal_volume
34pub_type
杂志文章abstract::A 45,X/46,Xidic(Y)(q11.2) mosaicism was found in a 4-year-old boy. The clinical appearance was characterized by bilateral cryptorchidism, penoscrotal hypospadias, short penis, and coarctation of the aorta. The latter is the only abnormality also seen in Turner syndrome. A biopsy of the gonads revealed normal prepubert...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050731
更新日期:2000-01-01 00:00:00
abstract::Hirschsprung's disease is characterized by the absence of ganglion cells in the distal bowel and extends proximally for varying distances. In recent years, the purinergic P2Y receptors have begun to receive much attention as they have been recognised as major ATP receptors in many regions of the body, including the in...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-007-2044-1
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abstract::Bronchogenic cysts are congenital malformations of the tracheobronchial tree. We describe a 20-month-old male who presented with persistent non-bilious emesis; manometry and imaging were consistent with esophageal achalasia. During a planned laparoscopic Heller myotomy, an intramural bronchogenic cyst was discovered i...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-016-3994-y
更新日期:2017-01-01 00:00:00
abstract::Diagnostic evaluation and treatment of blunt liver trauma in children have changed essentially over the last decades. In the period between January 1975 and December 2002, a total of 45 children, 18 girls and 27 boys, between the ages of 1 and 16 years (mean 8.19) were treated for liver rupture following blunt abdomin...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-004-1276-6
更新日期:2004-12-01 00:00:00
abstract:AIMS AND OBJECTIVES:Hirschsprung's disease-associated enterocolitis (HAEC) is the most serious complication of Hirschsprung's disease (HSCR). HAEC occurs in 17-50% of patients with HSCR and may occur before or after a properly performed pull-through operation. The pathogenesis of HAEC is poorly understood. It is well r...
journal_title:Pediatric surgery international
pub_type: 杂志文章,多中心研究
doi:10.1007/s00383-017-4178-0
更新日期:2018-02-01 00:00:00
abstract:PURPOSE:Adhesive small bowel obstruction (ASBO) is one of the most important cause of postoperative morbidity in children who underwent abdominal surgery. Laparoscopic management for ASBO in pediatric patients has been reported. However, its safety and efficacy has not been evaluated in details. The aim of this study i...
journal_title:Pediatric surgery international
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00383-017-4186-0
更新日期:2018-02-01 00:00:00
abstract::Recent reports indicate that extracellular matrix and cytoskeleton plasmalemmal elements are altered in infantile hypertrophic pyloric stenosis (IHPS). Desmin is a cytoskeletal protein that is important for the organization and function of muscular fibers. It has been found to be increased in the smooth muscle in chro...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050745
更新日期:2000-01-01 00:00:00
abstract::Pediatric osteomyelitis commonly occurs in the long bones and has rarely been reported in small bones such as the vertebrae and ribs. Rib osteomyelitis occurs in approximately 1% or less of all cases of hematogenous osteomyelitis, and is usually caused by Staphylococcus aureus. We present a case of acute osteomyelitis...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-006-1725-5
更新日期:2006-10-01 00:00:00
abstract::Adrenal cysts (AC) are rare, particularly in the newborn period. Almost all ACs in newborns were diagnosed on exploratory laparotomy or at autopsy. We report a newborn with an AC that was diagnosed after an exploratory laparotomy due to its rare presentation. This case shows that ACs should be considered in the differ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-002-0759-6
更新日期:2003-06-01 00:00:00
abstract:AIMS AND OBJECTIVES:Vascularized bio-engineered human dermo-epidermal skin substitutes (vascDESS) hold promise for treating burn patients, including those with severe full-thickness wounds. We have previously shown that vascDESS promote wound healing by enhanced influx of macrophages and granulocytes. Immediately follo...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-017-4179-z
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abstract::Interposing vascularized flaps between urethra and skin sutures is recommended in hypospadias surgery to decrease the rate of urethrocutaneous fistula. For this purpose nine patients with failed results after at least one hypospadias surgery and with insufficient foreskin were included in the study. Tubularized incise...
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pub_type: 杂志文章
doi:10.1007/s00383-003-0989-2
更新日期:2003-11-01 00:00:00
abstract:PURPOSE:Congenital lung abnormalities are rare malformations increasingly detected early by prenatal ultrasound. Whether management of these frequently asymptomatic lesions should be surgical or conservative is an unresolved issue. The necessary prospective studies are limited by the absence of a widely accepted practi...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s00383-017-4062-y
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abstract::A case of retrocecal appendicitis is described in a 6-year-old male child who presented with thigh abscess. The presence of a positive psoas stretch test, feculent discharge, an enteric growth on bacteriological examination, and intraabdominal fluid collection on abdominal ultrasound provided clues to the presence of ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-004-1356-7
更新日期:2005-04-01 00:00:00
abstract::"Variants of Hirschsprung's disease" are conditions that clinically resemble Hirschsprung's disease (HD), despite the presence of ganglion cells in rectal suction biopsies. The diagnosis and management of these patients can be challenging. Specific histological, immunohistochemical and electron microscopic investigati...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s00383-013-3351-3
更新日期:2013-09-01 00:00:00
abstract::Two patients who presented with a history of right inguinal hernia and a third with an impalpable left testis were found to have transverse testicular ectopia. Both testes were fixed in their own scrotum, through a modified Ombredanne operation in two patients and a subdartos pouch in one. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract::Congenital anterior penile urethral fistula is a rare anomaly; only seven cases have been reported to date. This report outlines the clinical presentation and the embryologic mechanism of a case associated with urethral duplication. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-003-1063-9
更新日期:2003-12-01 00:00:00
abstract::Necrotizing fasciitis (NF) is a potentially life-threatening infection of soft tissues. It is characterized by rapid spread of inflammation and infection with widespread necrosis of fascia, subcutaneous tissues, and overlying skin. NF is usually reported in adults with preexisting medical conditions or compromised imm...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-005-1481-y
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abstract::A 30-month-old twin with Beckwith-Wiedemann syndrome underwent exstirpation of a nephroblastoma from the right kidney. A Meckel's diverticulum (MD), an incidental finding intraoperatively, was resected because it was indurated and enlarged. Histologically, the MD contained ectopic gastric and pancreatic mucosa. Nesidi...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050038
更新日期:2000-01-01 00:00:00
abstract:AIM:The aim of this study was to examine the relationship between birth weight, pulmonary artery (PA) size, and outcome in congenital diaphragmatic hernia (CDH) to establish if PA size has prognostic value. METHODS:The subjects for this study were 39 consecutive left-sided CDH patients treated at our institution accor...
journal_title:Pediatric surgery international
pub_type: 杂志文章
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abstract::Africa faces a triple burden of disease; HIV, tuberculosis and malaria. Despite this, its population is expected to double over the next 45 years. There is a dire shortage of medical specialists and many countries lack suitably qualified doctors to train medical specialists. Videoconferencing offers the opportunity to...
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abstract::Macrophages (MPs) produce increased levels of proinflammatory cytokines in Crohn's disease; these cytokines are thought to play a central role in the occurrence of the disease. Biologics are currently available for anti-cytokine therapy, but treating intestinal inflammation through direct suppression of proinflammator...
journal_title:Pediatric surgery international
pub_type: 杂志文章
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journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s003830050478
更新日期:1998-12-01 00:00:00
abstract::Retrocaval ureter is abnormal looping of the proximal ureter behind the inferior vena cava. The aberrant anatomy results in the compression of the ureter causing hydronephrosis. This is a very infrequent cause of hydronephrosis in children. Association of retrocaval ureter with a stone in the looping segment of the ur...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-010-2607-4
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abstract::Surgical repair of acquired tracheo-esophageal fistula may result in tracheal stenosis or esophageal stricture. We used fistula with esophageal cuff as flap to repair the tracheal defect. Esophageal repair was performed by rotating ends through 90° in opposite direction. This technique offers excellent repair in a sin...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-014-3498-6
更新日期:2014-05-01 00:00:00
abstract::A retrospective study of all cases (n = 21) of congenital lobar emphysema (CLE) treated at the Royal Hospital, Muscat, from September 1988 to August 1999 was performed. The presentation, diagnosis, treatment, and outcome are reviewed. All 21 patients were nonwhite. Thirteen had left-upper-lobe, 7 right-middle-lobe, an...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830000506
更新日期:2001-03-01 00:00:00
abstract::Umbilical hernias occur frequently in children but complications are very rare and thus surgery is not routinely indicated. In this literature review, we report 19 cases of spontaneous evisceration of abdominal contents through umbilical hernias. Precipitating causes included umbilical ulceration or sepsis, crying, re...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s00383-012-3076-8
更新日期:2012-05-01 00:00:00
abstract:PURPOSE:The aim of this study was to determine the incidence of gastroschisis-related complications (GRCs) after closure of the abdominal wall defect, with a focus on frequency, type and timing of required surgical interventions, and to identify the impact of these on further outcome. METHODS:All gastroschisis patient...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-014-3500-3
更新日期:2014-06-01 00:00:00
abstract::Congenital hepatic cysts are rare lesions of infancy. While operative management and outcomes have been extensively studied in adult patients with hepatic cysts, data in pediatric patients are limited. We discuss our experience in an infant and review relevant literature regarding operative technique and surgical outc...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s00383-013-3312-x
更新日期:2013-08-01 00:00:00
abstract:PURPOSE:To clarify the status of segmental dilatation of the intestine (SD) using a nationwide retrospective cohort survey. METHODS:Supported by the Ministry of Health, Labour and Welfare in Japan, preliminary questionnaires requesting the numbers of SD cases from 2000 to 2009 were sent to 161 Japanese major institute...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-015-3788-7
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:There are many advantages of a SMOF emulsion (SMOF-lipid), such as liver-protective properties and anti-inflammatory effects. The objective of this study was to compare the clinical outcomes of SMOF-lipid with medium-chain triglycerides (MCT) /long-chain triglycerides (LCT) in infants after intestinal surger...
journal_title:Pediatric surgery international
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00383-018-4422-2
更新日期:2019-03-01 00:00:00