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Background Thoracic bioreactance is a noninvasive and continuous method of cardiac output ( CO) measurement that is being developed in adult patients. Very little information is available on thoracic bioreactance use in children. Objective The aim of the study was to evaluate the ability of a bioreactance device ( NICOM®; Cheetah Medical, Tel Aviv, Israel) to estimate CO and to track changes in CO induced by volume expansion (VE) in children. Methods Cardiac output values obtained using the NICOM® device ( CONICOM) and measured by trans-thoracic echocardiography ( COTTE) were compared in pediatric neurosurgical patients during the postoperative period. Results Seventy-three pairs of measurements of CO obtained in 30 children were available for analysis. The bias (lower and upper limits of agreement) between CONICOM and COTTE was −0.11 (−1.4 to 1.2) l·min−1. The percentage error (PE) was 55%. The precision of the NICOM® device was 45%. A significant correlation was observed between the CO values obtained using the two methods ( r = 0.89, <0.001). The concordance percentage between changes in COTTE and CONicom induced by VE was 84% following exclusion of patients with changes in CO <15% ( n = 5). Conclusions The PE observed is too large, and the limits of agreement too wide, to enable us to comment on the equivalence of the two techniques of CO measurements. However, the NICOM® device performs well in tracking changes in CO following VE. [ABSTRACT FROM AUTHOR]

The surgical correction of craniosynostosis may be associated with extensive blood loss and transfusion. The aim of this study was to compare the efficacy of the perioperative use of the continuous autotransfusion system (CATS group) and of the postoperative use of the CBCII ConstaVac® system (CV group) to reduce homologous transfusion in infants during repair of craniosynostosis. Two groups of consecutive infants, weighing <10 kg, and scheduled for the surgical correction of craniosynostosis, were compared retrospectively according to the blood salvaging system used: CATS group and CV group. The primary endpoint was the comparison of the total volume of homologous blood transfused. There was no significant difference between the CV ( n = 69) and the CATS ( n = 135) groups with regard to physical, preoperative and postoperative data, except for the type of craniosysnostosis with more scaphocephaly in the CV group ( P = 0.03). No significant difference in blood loss and homologous transfusion was observed between the two groups during the perioperative period. Two subgroups of patients were also compared: a subgroup including patients operated on with a linear craniectomy for scaphocephaly, and a subgroup including all other patients. There was also no significant difference in blood loss and homologous transfusion between the CV and the CATS groups for these two subgroups of patients. Our results suggest that the postoperative use of the CBCII ConstaVac® system is as efficient as the perioperative use of the CATS® system for reducing homologous blood transfusion during repair of craniosynostosis in infants weighing <10 kg. [ABSTRACT FROM AUTHOR]

Investigates the criteria in the selection of tubes used for pediatric tracheal intubation. Advantages of cuffed tracheal tubes (CTT); Accounts on the limited use of CTT; Methods used by anesthesiologists for tracheal tube sizing.