A retrospective analysis of the duration of mechanical ventilation in Scandinavian paediatric heart centres.

AIM: Early extubation after cardiac surgery shortens paediatric intensive care unit (PICU) length of stay (LOS) and decreases complications from mechanical ventilation (MV). We explored the duration of MV in Scandinavian paediatric heart centres. METHODS: We retrospectively reviewed the MV duration and PICU LOS of 696 children operated for atrial septal defect (ASD), ventricular septal defect (VSD), tetralogy of Fallot (TOF) or total cavopulmonary connection (TCPC) in four Scandinavian centres in 2015-2016. Neonates (n = 90) were included regardless of heart surgery type. RESULTS: Patients with ASD were extubated at a median of 3.25 h (interquartile range [IQR] 2.00-4.83), followed by patients with TCPC (median 5.00 h, IQR 2.60-16.83), VSD (median 7.00 h, IQR 3.69-22.25) and TOF (median 18.08 h, IQR 6.00-41.38). Neonates were not extubated early (median 94.42 h, IQR 45.03-138.14). Although MV durations were reflected in PICU LOS, this was not as apparent among those extubated within 12 h. The Swedish centres had shortest MV durations and PICU LOS. Extubation failed in 24/696 (3.4%) of patients. CONCLUSION: Scandinavian paediatric heart centres differed in the duration of postoperative MV. Deferring extubation up to 12 h postoperatively did not markedly prolong PICU LOS.

[Optical and video-assisted laryngoscopy in difficult paediatric airways]. / Optisk og videoassisteret laryngoskopi ved vanskelige luftveje hos børn.

Despite ongoing technological advances, direct laryngoscopy still remains the golden standard for endotracheal intubation in children and infants. However, in some infants it is almost impossible to obtain a view of glottis and the vocal cords. In this paper we present an overview of the recent advances in optical and video-assisted laryngoscopy in difficult paediatric airways.

[The use of ultrasound for nerve block in children seems beneficial]. / Lovende resultater ved ultralydvejledt anlæggelse af nerveblokade hos børn.

Nerve blocks play an increasingly important role in pediatric regional anaesthesia. The benefits are numerous compared to standard pain regimens. The use of ultrasound (US) for nerve blocks lowers the volume of local anaesthetics applied, shortens the on-set time and results in higher success rates. Furthermore, US has the potential to reduce the rate of complications. This review describes both classic and US guided techniques for the peripheral nerve blocks used for pediatric abdominal and thoracic surgery and briefly discusses the advantages and disadvantages of applying US.