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Research

Assessment of different techniques for the administration of inhaled salbutamol in children breathing spontaneously via tracheal tubes, supraglottic airway devices, and tracheostomies

Perioperative respiratory adverse events account for a third of all perioperative cardiac arrests, with bronchospasm and laryngospasm being most common. Standard treatment for bronchospasm is administration of inhaled salbutamol, via pressurized metered dose inhaler. There is little evidence on the best method of attaching the pressurized metered dose inhaler to the artificial airway during general anesthesia. The aim of this study is to investigate the best method to deliver aerosolized salbutamol via pressurized metered dose inhaler to the lungs of an anesthetized child.

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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. 

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Transcription factor p63 regulates key genes and wound repair in human airway epithelial Basal cells

The airway epithelium in asthma displays altered repair and incomplete barrier formation.

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The genetic and epigenetic landscapes of the epithelium in asthma

Genetic factors in airway epithelial cells that are functionally associated with asthma pathogenesis

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Impaired airway epithelial cell responses from children with asthma to rhinoviral infection

Human rhinovirus infection delays repair and inhibits apoptotic processes in epithelial cells from non-asthmatic and asthmatic children

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Identification of epithelial phospholipase A2 receptor 1 as a potential target in asthma

PLA2R1 is increased in the airway epithelium in asthma, and serves as a regulator of airway hyperresponsiveness, airway permeability, antigen sensitization, and airway inflammation

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Productive infection of human embryonic stem cell-derived nkx2.1+ respiratory progenitors with human rhinovirus.

Our experiments provide proof of principle for the use of PSC-derived respiratory epithelial cells in the study of cell-virus interactions.

Pre-surgery fasting tablet helping to keep kids comfortable

The Perioperative Medicine team has developed a unique chewable tablet that gives the child the sensation of having a full stomach, without compromising their fasting regime.

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Rebooting the anal sphincter: A retrospective cohort of children with intractable constipation receiving intrasphincteric botox injections

Chronic childhood constipation is a common problem that severely impacts quality of life. Recently, the efficacy of intrasphincteric botulinum toxin (botox) injection in breaking the cycle of constipation has been demonstrated. The current study aims to investigate response rate to treatment, symptom and examination finding associations, and identify associations between patient characteristics and outcome.

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Airway management in neonates and infants: Recommendations according to the ESAIC/BJA guidelines

Securing an airway enables the oxygenation and ventilation of the lungs and is a potentially life-saving medical procedure. Adverse and critical events are common during airway management, particularly in neonates and infants. The multifactorial reasons for this include patient-dependent, user-dependent and also external factors.

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Perioperative intravenous lidocaine use in children

Perioperative pain management impacts patient morbidity, quality of life, and hospitalization cost. In children, it impacts not only the child, but the whole family. Adjuncts for improved perioperative analgesia continue to be sought to minimize adverse side effects associated with opioids and for those in whom regional or neuraxial anesthesia is not suitable.

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Taste-Masked Diclofenac Sodium Microparticles Prepared by Polyelectrolyte Complexation: Formulation Using Different Fatty Acids and Taste Evaluation by Human Panel

Paediatric patients continue to lack access to age-appropriate oral medicines for their treatment and have to depend on the off-label use of medicines approved for adults, which compromises dosing accuracy and exposes children to unpleasant bitterness. 

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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

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An observational study of hypoactive delirium in the post-anesthesia recovery unit of a pediatric hospital

Hypoactive delirium is present when an awake child is unaware of his or her surroundings, is unable to focus attention, and appears quiet and withdrawn. This condition has been well-described in the intensive care setting but has not been extensively studied in the immediate post-anesthetic period. The aim was to determine if hypoactive emergence delirium occurs in the recovery unit of a pediatric hospital, and if so, what proportion of emergence delirium is hypoactive in nature.

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Prenatal Exposure to General Anesthesia and Childhood Behavioral Deficit

Exposure to surgery and anesthesia in early childhood has been found to be associated with an increased risk of behavioral deficits. While the US Food and Drug Administration (FDA) has warned against prenatal exposure to anesthetic drugs, little clinical evidence exists to support this recommendation.

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A qualitative exploration of the phenomenology of pain in children to inform pain assessment methods

Pain is a common experience associated with healthcare for children, who often recall it as the worst part of hospitalisation. Several factors make assessment of pain more challenging in children. Families have previously identified the development of improved tools to assess pain in children as a key priority. We therefore sough to investigate the nature of this experience from the perspective of children and their parents to inform the development of such tools.