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Clinical utility of preoperative pulmonary function testing in pediatrics

Perioperative respiratory adverse events pose a significant risk in pediatric anesthesia, and identifying these risks is vital. Traditionally, this is assessed using history and examination. However, the perioperative risk is multifactorial, and children with complex medical backgrounds such as chronic lung disease or obesity may benefit from additional objective preoperative pulmonary function tests.

Risk assessment and optimization strategies to reduce perioperative respiratory adverse events in pediatric anesthesia—Part 1 patient and surgical factors

Pediatric surgery cases are increasing worldwide. Within pediatric anesthesia, perioperative respiratory adverse events are the most common precipitant leading to serious complications.

Primum non nocere (“first do no harm”) with oxygen therapy

Britta Regli-von Ungern-Sternberg AM FAHMS MD, PhD, DEAA, FANZA Chair of Paediatric anaesthesia, University of Western Australia; Consultant

Research priorities for paediatric peri-operative medicine identified by Australian children and young people

Parents and caregivers play a critical role in the care of their child peri-operatively. Our team undertook previous research with parents/carers, which identified Australian parents' top 10 research priorities for paediatric anaesthesia and peri-operative medicine. 

Numerical simulation of aerosolised medicine delivery through tracheostomy airways

The administration of inhaled antibiotics to patients with upper or lower respiratory infections is sometimes conducted via a tracheostomy airway. However, precise dosing via this route remains uncertain, especially in spontaneously breathing paediatric patients. 

Inhaled nebulised adrenaline delivery in children and adults: A simulation study

Sometimes, there is an urgent need to administer inhaled adrenaline to children, awake, sedated or anaesthetised to treat asthma, bronchospasm, croup, and suspected laryngeal/pharyngeal oedema or stridor, which can become severe or even life-threatening. To better inform emergency dosing and administration guidelines, we aimed to quantify the amount of adrenaline delivered for inhalation from a nebuliser, in a simulated experimental delivery set-up for spontaneously breathing children and adults, either via an anaesthetic face mask, a Laryngeal Mask Airway or an Endotracheal tube.

Using head-mounted augmented and virtual reality devices for anaesthesia education: a scoping review

Head-mounted devices (HMDs) have been explored in anaesthesia education for their unique ability to have head-tracked immersive simulations adaptable to diverse clinical scenarios. This scoping review examines how HMD-based augmented or virtual reality enhances anaesthetic skill learning in clinicians, trainees, and students.

Critical Events in Anaesthetised Kids Undergoing Tracheal Intubation (CRICKET)—study protocol for an international multicentre prospective observational study

Critical Events in Anaesthetised Kids undergoing Tracheal Intubation (CRICKET) is a prospective, international multicentre observational study with the objective of capturing, assessing, and analysing critical events associated with tracheal intubation in children.

Association of preoperative nocturnal hypoxaemia nadir and fentanyl ventilatory sensitivity in children with obstructive sleep apnoea undergoing general anaesthesia

Obstructive sleep apnoea (OSA) has been thought to increase the risk of respiratory depression from opioids. The primary aim of this study was to assess whether preoperative hypoxaemia by sleep study pulse oximetry imparts greater opioid sensitivity.

Feasibility of the pre-operative measurement of fractional exhaled nitric oxide and respiratory mechanics to predict respiratory outcomes in children undergoing general anaesthesia

Peri-operative respiratory adverse events remain a major cause of morbidity and mortality in children undergoing general anaesthesia; those with asthma are at higher risk. The aim of this feasibility study was to determine whether pre-operative measurements of fractional exhaled nitric oxide and the forced oscillation technique are feasible in children, and to explore whether these measurements can predict peri-operative respiratory adverse events.