Scientific Letter
Atrial fibrillation in a 22-month-old patient during cleft palate surgery
Fibrilación auricular en paciente de 22 meses durante palatoplastia
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Eizaga Rebollar, M.V. García Palacios, J. Morales Guerrero, R. Gámiz Sánchez, L.M. Torres Morera" "autores" => array:5 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Eizaga Rebollar" "email" => array:1 [ 0 => "ramonchueizaga@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M.V." "apellidos" => "García Palacios" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Morales Guerrero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "R." "apellidos" => "Gámiz Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "L.M." "apellidos" => "Torres Morera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Puerta del Mar, Cádiz, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Preventiva y Salud Pública, Hospital Universitario Puerta del Mar, Cádiz, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fibrilación auricular en paciente de 22 meses durante palatoplastia" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Supraventricular tachycardias (SVTs) that occur during noncardiac paediatric surgery are usually sinus tachycardias, with a regular rhythm and secondary to pain, hypoxaemia, hypercapnia, hypovolaemia, hypothermia, or ion or acid-base imbalances. Non-sinus SVTs occur less frequently and may be associated with cardiac abnormalities.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a boy aged 22 months, weighing 9<span class="elsevierStyleHsp" style=""></span>kg and classified as ASA II scheduled to undergo surgical repair of a congenital cleft palate. The salient aspects of his medical history included Pierre Robin sequence and tetralogy of Fallot (TOF), which was repaired at age 8 months with a favourable outcome. ECG revealed a sinus rhythm of 150<span class="elsevierStyleHsp" style=""></span>bpm and a 90° axis. Echocardiography revealed good contractility. There was no evidence of cardiac or right ventricular outflow tract (RVOT) dilatation. The interventricular patch was intact. The patient had mild pulmonary stenosis (PS) and tricuspid regurgitation (TR).</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was premedicated with oral midazolam. Materials for the management of a difficult airway were prepared: flexible fibreoptic bronchoscope, Frova<span class="elsevierStyleSup">®</span> introducer and supraglottic airway devices. Sevoflurane was chosen for anaesthesia induction, maintaining spontaneous breathing during the assessment of the airway by direct laryngoscopy. The patient was given atropine and propofol prior to intubation, which was performed by means of a Frova<span class="elsevierStyleSup">®</span> introducer without complications. Sevoflurane and remifentanil were used for the maintenance of anaesthesia; lactated Ringer's solution for fluid therapy; and dexamethasone and magnesium sulphate as adjuvants. The monitoring values were the following: oxygen saturation (SatO<span class="elsevierStyleInf">2</span>), 99%; end-tidal carbon dioxide (EtCO<span class="elsevierStyleInf">2</span>), 40<span class="elsevierStyleHsp" style=""></span>mmHg; ECG, ectopic atrial rhythm (missing P wave) with regular QRS complexes; heart rate (HR), 110–120<span class="elsevierStyleHsp" style=""></span>bpm; systolic blood pressure (SBP), 75–80<span class="elsevierStyleHsp" style=""></span>mmHg; bispectral index (BIS), 45–50; body temperature, 36.5<span class="elsevierStyleHsp" style=""></span>°C. Surgery was initiated after placing the patient in a 30° Trendelenburg position. Two hours later, the ECG started to show isolated supraventricular extrasystoles, while the rhythm, HR and SBP remained unchanged. Thirty minutes after, a chaotic atrial rhythm was observed, with a HR of 135–145<span class="elsevierStyleHsp" style=""></span>bpm and a SBP of less than 70<span class="elsevierStyleHsp" style=""></span>mmHg, leading to injection of 10<span class="elsevierStyleHsp" style=""></span>mL of hydroxyethyl starch and assessment of the haemodynamic response: SBP below 60<span class="elsevierStyleHsp" style=""></span>mmHg, SatO<span class="elsevierStyleInf">2</span> of 91%, no response to 100% O<span class="elsevierStyleInf">2</span>. The patient was given 50<span class="elsevierStyleHsp" style=""></span>mg of amiodarone (over 5<span class="elsevierStyleHsp" style=""></span>min) and 10<span class="elsevierStyleHsp" style=""></span>mg of furosemide, the external defibrillator was set up, the patient taken out of Trendelenburg, and a urinary catheter placed. Five minutes after administration of the bolus of amiodarone was completed, the ECG showed a sinus rhythm, the HR was 120–130<span class="elsevierStyleHsp" style=""></span>bpm, the SBP 80–85<span class="elsevierStyleHsp" style=""></span>mmHg, and the SatO<span class="elsevierStyleInf">2</span> 98%. Subsequently, an amiodarone infusion of 150<span class="elsevierStyleHsp" style=""></span>mg/24<span class="elsevierStyleHsp" style=""></span>h was started. The decision was made to proceed with the surgery, which was completed 30<span class="elsevierStyleHsp" style=""></span>min later, after which the patient was moved under sedation to the paediatric intensive care unit (PICU). The procedure lasted a total of 4<span class="elsevierStyleHsp" style=""></span>h. Analgosedation was maintained for 20<span class="elsevierStyleHsp" style=""></span>h, and the patient was extubated without complications and discharged from the PICU 24<span class="elsevierStyleHsp" style=""></span>h later. He remained in the ward for 48<span class="elsevierStyleHsp" style=""></span>h without complications, after which he was discharged, pending a Holter monitoring. The ECG showed good contractility. The patient had a mild dilatation of the right chambers of the heart. Mild PE and TR.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Tetralogy of Fallot is the most common cyanotic congenital heart disease (5–10% of congenital heart diseases). It is managed by means of surgical repair, which consists of the closure of the ventricular septal defect and the widening of the right ventricular outflow tract. Surgical repair carries a mortality of less than 2% and a survival rate of 90% in the adult age group.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In patients with repaired TOF, SVTs may appear in the immediate postoperative period; and while more than half of the patients develop supraventricular extrasystoles, the incidence of tachyarrhythmias is less than 10%. They are caused by haemodynamic and local factors resulting from surgery and extracorporeal circulation, and the most common type is junctional ectopic tachycardia.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> They may also develop during puberty and after as a late complication, with an incidence of more than 30%. They are produced by reentry circuits around the atriotomy scar and by pressure or volume overload in the right chambers. The most common forms are atrioventricular nodal reentrant tachycardia, fibrillation and atrial flutter. Their development may increase the risk of sudden death.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The anaesthesia of patients with repaired TOF in noncardiac surgery poses a challenge, as there are no large studies on surgeries with significant changes in volume, intracardiac pressure (thoracoscopy or laparoscopy) or surgical positioning (Trendelenburg or prone). Its management must prioritize the identification of patients at high risk of perioperative morbidity (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) and preventing pressure overload (raised intrathoracic pressure, hypoxia or hypercapnia) and volume overload (fluid therapy or Trendelenburg) of the right chambers.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The only risk factor in our patient was his age of less than 2 years, and he experienced no complications during the induction of anaesthesia or the difficult airway management, which leads us to believe that the sustained Trendelenburg position caused a volume overload in the right chambers that eventually resulted in atrial fibrillation and the drop in cardiac output. The symptoms responded to postural and pharmacological interventions without the need for defibrillation, which would have been the treatment of choice if the patient had not responded or his condition had worsened.</p><p id="par0040" class="elsevierStylePara elsevierViewall">We conclude with some key points for the management of any type of anaesthesia in patients with repaired TOF (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Eizaga Rebollar R, García Palacios MV, Morales Guerrero J, Gámiz Sánchez R, Torres Morera LM. Fibrilación auricular en paciente de 22 meses durante palatoplastia. An Pediatr (Barc). 2016;84:172–173.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">– Age<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>2 years \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">– Urgent surgery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">– Major surgery (intrathoracic, intra-abdominal or with considerable volume changes) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">– Cardiovascular sequelae (arrhythmias, pulmonary hypertension, cyanosis or heart failure) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab996948.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Perioperative high-risk factors.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">– Identify high-risk patients \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">– Exhaustive monitoring and observation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">– Approach any postural, surgical or pharmacological interventions or fluid therapy that may alter the haemodynamic condition of the patient with caution \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">– Keep in mind the potential for arrhythmias and their early treatment in case of haemodynamic compromise \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab996947.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Key points for the use of anaesthesia in patients with repaired tetralogy of Fallot.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Supraventricular tachycardia during pediatric anesthesia: a case series and qualitative analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.C. Cripe" 1 => "A.R. Patel" 2 => "S.D. Markowitz" 3 => "T.S. Behringer" 4 => "R.S. Litman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jclinane.2013.11.020" "Revista" => array:6 [ "tituloSerie" => "J Clin Anesth" "fecha" => "2014" "volumen" => "26" "paginaInicial" => "257" "paginaFinal" => "263" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24882607" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of intensive care unit morbidity and midterm follow-up after primary repair of tetralogy of Fallot" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.C. Egbe" 1 => "K. Nguyen" 2 => "A.J. Mittnacht" 3 => "U. Joashi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5090/kjtcs.2014.47.3.211" "Revista" => array:6 [ "tituloSerie" => "Korean J Thorac Cardiovasc Surg" "fecha" => "2014" "volumen" => "47" "paginaInicial" => "211" "paginaFinal" => "219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25207217" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early postoperative arrhythmias after pediatric cardiac surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Talwar" 1 => "K. Patel" 2 => "R. Juneja" 3 => "S.K. Choudhary" 4 => "B. Airan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0218492315585457" "Revista" => array:6 [ "tituloSerie" => "Asian Cardiovasc Thorac Ann" "fecha" => "2015" "volumen" => "23" "paginaInicial" => "795" "paginaFinal" => "801" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25972292" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Right atrial volume is increased in corrected tetralogy of Fallot and correlates with the incidence of supraventricular arrhythmia: a CMR study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Sohns" 1 => "C. Rosenberg" 2 => "A. Zapf" 3 => "C. Unterberg-Buchwald" 4 => "W. Staab" 5 => "A. Schuster" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00246-015-1152-2" "Revista" => array:6 [ "tituloSerie" => "Pediatr Cardiol" "fecha" => "2015" "volumen" => "36" "paginaInicial" => "1239" "paginaFinal" => "1247" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25862665" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contemporary predictors of death and sustained ventricular tachycardia in patients with repaired tetralogy of Fallot enrolled in the INDICATOR cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Valente" 1 => "K. Gauvreau" 2 => "G.E. Assenza" 3 => "S.V. Babu-Narayan" 4 => "J. Schreier" 5 => "M.A. Gatzoulis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/heartjnl-2013-304958" "Revista" => array:6 [ "tituloSerie" => "Heart" "fecha" => "2013" "volumen" => "100" "paginaInicial" => "247" "paginaFinal" => "253" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24179163" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anaesthetic management of children with congenital heart disease for non-cardiac surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.C. White" 1 => "J.M. Peyton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Contin Educ Anaesth Crit Care Pain" "fecha" => "2012" "volumen" => "12" "paginaInicial" => "23" "paginaFinal" => "27" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000008400000003/v1_201602260011/S2341287916000028/v1_201602260011/en/main.assets" "Apartado" => array:4 [ "identificador" => "38181" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008400000003/v1_201602260011/S2341287916000028/v1_201602260011/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287916000028?idApp=UINPBA00005H" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 11 | 19 |
| 2024 October | 51 | 28 | 79 |
| 2024 September | 55 | 25 | 80 |
| 2024 August | 61 | 48 | 109 |
| 2024 July | 49 | 20 | 69 |
| 2024 June | 44 | 25 | 69 |
| 2024 May | 48 | 30 | 78 |
| 2024 April | 51 | 27 | 78 |
| 2024 March | 45 | 24 | 69 |
| 2024 February | 41 | 29 | 70 |
| 2024 January | 26 | 21 | 47 |
| 2023 December | 27 | 11 | 38 |
| 2023 November | 28 | 55 | 83 |
| 2023 October | 43 | 25 | 68 |
| 2023 September | 25 | 16 | 41 |
| 2023 August | 33 | 18 | 51 |
| 2023 July | 38 | 27 | 65 |
| 2023 June | 34 | 24 | 58 |
| 2023 May | 35 | 17 | 52 |
| 2023 April | 33 | 15 | 48 |
| 2023 March | 37 | 26 | 63 |
| 2023 February | 46 | 14 | 60 |
| 2023 January | 24 | 21 | 45 |
| 2022 December | 34 | 23 | 57 |
| 2022 November | 51 | 34 | 85 |
| 2022 October | 40 | 50 | 90 |
| 2022 September | 26 | 33 | 59 |
| 2022 August | 34 | 45 | 79 |
| 2022 July | 33 | 38 | 71 |
| 2022 June | 26 | 41 | 67 |
| 2022 May | 29 | 36 | 65 |
| 2022 April | 32 | 43 | 75 |
| 2022 March | 33 | 48 | 81 |
| 2022 February | 25 | 27 | 52 |
| 2022 January | 32 | 35 | 67 |
| 2021 December | 23 | 38 | 61 |
| 2021 November | 31 | 56 | 87 |
| 2021 October | 42 | 65 | 107 |
| 2021 September | 20 | 41 | 61 |
| 2021 August | 35 | 40 | 75 |
| 2021 July | 26 | 30 | 56 |
| 2021 June | 21 | 36 | 57 |
| 2021 May | 28 | 22 | 50 |
| 2021 April | 47 | 59 | 106 |
| 2021 March | 43 | 27 | 70 |
| 2021 February | 12 | 13 | 25 |
| 2021 January | 33 | 12 | 45 |
| 2020 December | 16 | 17 | 33 |
| 2020 November | 27 | 23 | 50 |
| 2020 October | 22 | 28 | 50 |
| 2020 September | 16 | 20 | 36 |
| 2020 August | 29 | 12 | 41 |
| 2020 July | 16 | 21 | 37 |
| 2020 June | 23 | 9 | 32 |
| 2020 May | 57 | 15 | 72 |
| 2020 April | 23 | 11 | 34 |
| 2020 March | 46 | 15 | 61 |
| 2020 February | 78 | 10 | 88 |
| 2020 January | 34 | 6 | 40 |
| 2019 December | 34 | 22 | 56 |
| 2019 November | 35 | 7 | 42 |
| 2019 October | 12 | 8 | 20 |
| 2019 September | 23 | 10 | 33 |
| 2019 August | 40 | 20 | 60 |
| 2019 July | 17 | 19 | 36 |
| 2019 June | 27 | 21 | 48 |
| 2019 May | 25 | 14 | 39 |
| 2019 April | 26 | 25 | 51 |
| 2019 March | 31 | 12 | 43 |
| 2019 February | 31 | 13 | 44 |
| 2019 January | 31 | 19 | 50 |
| 2018 December | 28 | 18 | 46 |
| 2018 November | 68 | 28 | 96 |
| 2018 October | 70 | 36 | 106 |
| 2018 September | 40 | 15 | 55 |
| 2018 August | 1 | 0 | 1 |
| 2018 June | 3 | 0 | 3 |
| 2018 May | 8 | 0 | 8 |
| 2018 April | 23 | 0 | 23 |
| 2018 March | 18 | 0 | 18 |
| 2018 February | 8 | 0 | 8 |
| 2018 January | 13 | 0 | 13 |
| 2017 December | 8 | 0 | 8 |
| 2017 November | 15 | 0 | 15 |
| 2017 October | 16 | 0 | 16 |
| 2017 September | 15 | 0 | 15 |
| 2017 August | 15 | 0 | 15 |
| 2017 July | 16 | 1 | 17 |
| 2017 June | 20 | 6 | 26 |
| 2017 May | 15 | 3 | 18 |
| 2017 April | 9 | 4 | 13 |
| 2017 March | 9 | 12 | 21 |
| 2017 February | 4 | 0 | 4 |
| 2017 January | 2 | 3 | 5 |
| 2016 December | 14 | 3 | 17 |
| 2016 November | 31 | 5 | 36 |
| 2016 October | 26 | 7 | 33 |
| 2016 September | 20 | 7 | 27 |
| 2016 August | 22 | 1 | 23 |
| 2016 July | 13 | 2 | 15 |
| 2016 June | 3 | 0 | 3 |
| 2016 March | 3 | 0 | 3 |
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