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We implemented an evidence-based transfusion protocol in January 2011 and monitored the impact of this algorithm on blood product utilization, chest tube output during the first 12?h of intensive care unit (ICU) admission, and predischarge mortality. Ritonavir When compared with the 12?months preceding implementation, blood utilization per case in the operating room odds ratio (OR) for the 11?months following implementation decreased by 66% for red cells (P?=?0.001) and 86% for cryoprecipitate (P?SCH772984 price not shift the transfusion burden to the ICU. Postoperative bleeding, as measured by chest tube output in the first 12 ICU hours, did not increase following implementation of the algorithm. Monthly surgical volume did not change significantly following implementation of the algorithm (P?=?0.477). In a logistic regression model for predischarge mortality among the nontransplant patients, after accounting for surgical severity and duration of CPB, use of the transfusion algorithm was associated with a 0.247 relative risk of mortality (P?=?0.013). These results indicate that introduction of an objective transfusion algorithm in pediatric cardiac surgery significantly reduces perioperative blood product utilization and mortality, without increasing postoperative chest tube losses. ""Background:? Phenobarbital induces specific hepatic cytochrome P-450 enzyme pathways causing increased clearance of hepatically metabolized drugs. In this study, we investigated the duration and additional anesthetic requirement during Magnetic resonance imaging (MRI) in epileptic children with or without phenobarbital monotherapy. Methods:? In ASA I�CII, 128 children, aged 1�C10?years, were included. Group I: epileptic children without anti-epileptic click here therapy and Group II: children with phenobarbital monotherapy. The initial sedative drugs were 0.1?mg��kg?1 midazolam with 2?mg��kg?1 ketamine. An additional 1?mg��kg?1 ketamine was administrated if required. Rescue propofol (0.5?mg��kg?1) was provided and repeated to maintain sedation. The duration and consumption of additional sedative requirements was recorded. Results:? The duration of initial and two consequent additional sedative requirements was shorter in Group II (P?=?0.0001, P?=?0.001 and P?=?0.27, respectively). Additional ketamine doses required for adequate sedation were lower in Group I (P?=?0.016). Conclusion:? We suggest that the variability in response to the initial sedative agents during MRI requires titration of additive sedation with ketamine in epileptic children on phenobarbital monotherapy.