Search

The laryngeal adductor reflex (LAR) represents the thyroarytenoid muscle response to electrical, mechanical or chemical stimulation of the laryngeal mucosa and is been considered to be a mechanism of laryngeal protection, preventing material from inappropriately entering the upper airway. The intraoperative recording of LAR has been recently proposed in patients undergoing thyroid and cervical spine surgeries. In the last years, intraoperative neurophysiology (IN) has been extensively applied in the surgery of IV ventricle tumors in children. In particular, brainstem mapping (BSM) and corticobulbar tract (CBT) monitoring have demonstrated to be effective in order to reduce the risk of severe post-operative neurologic sequelae. IN techniques (BSM and CBT monitoring) were applied during the removal of a large IV ventricle tumor in a 4 yrs. old child under TIVA/TCI anesthesia. LAR was elicited by electrical stimulation of left or right vocal cord (train of 5 stimuli, 200 μs duration, ISI 2–4 ms, intensity

Background: This prospective surveillance study was designed to estimate the incidence of healthcare-associated infections (HAIs) and to analyze the risk factors for their development in a pediatric neurosurgical unit. Methods: The study was performed in an Italian teaching hospital from October 2008 through March 2010. All children (0–18 years) undergoing neurosurgery were included and monitored daily for the development of HAIs. Results: The study included 260 patients, with a mean age of 4.3 ± 4.7 years. Thirty-six HAIs were detected in 25 patients; catheter-related infections were the most frequent. Etiological identification was available in 22 cases; Gram-negative bacteria were the most commonly isolated pathogens. The incidence density was 11.0/1,000 patient days, and the incidence rate was 13.8/100 patients. The crude mortality was 0%. The risk of developing HAIs was related to the length of hospital stay, while the higher the age of the patients, the lower the risk of developing HAIs. Conclusion: To our knowledge, this survey is the first study to evaluate the overall incidence of HAIs and to explore the risk factors implicated in their development in neurosurgical pediatric patients. The most effective strategies to prevent these infections are reduction of the length of the hospital stay and improvement in device management.