The pharmacokinetics of methadone and its metabolites in neonates, infants, and children.

Background: The lack of methadone pharmacokinetic data in children and neonates restrains dosing to achieve the target concentration in these populations. A minimum effective analgesic concentration of methadone in opioid naïve adults is 0.058 mg·l(-1) , while no withdrawal symptoms were observed in neonates suffering opioid withdrawal if plasma concentrations of methadone were above 0.

Face-to-face handoff: improving transfer to the pediatric intensive care unit after cardiac surgery.

The goal was to develop and implement a comprehensive, primarily face-to-face handoff process that begins in the operating room and concludes at the bedside in the intensive care unit (ICU) for pediatric patients undergoing congenital heart surgery. Involving all stakeholders in the planning phase, the framework of the handoff system encompassed a combination of a formalized handoff tool, focused process steps that occurred prior to patient arrival in the ICU, and an emphasis on face-to-face communication at the conclusion of the handoff. The final process was evaluated by the use of observer checklists to examine quality metrics and timing for all patients admitted to the ICU following cardiac surgery.

Propofol for pediatric tracheal intubation with deep anesthesia during sevoflurane induction: dosing according to elapsed time for two age groups.

Study Objective: To determine, for two different age groups, the effect of duration of sevoflurane administration on the amount of propofol needed when performing tracheal intubation.

Design: Classic Dixon's Up-and-Down sequential method.

Setting: University based operating rooms.

High-fidelity simulation is superior to case-based discussion in teaching the management of shock.

Background: Case-based discussion (CBD) is an established method for active learning in medical education. High-fidelity simulation has emerged as an important new educational technology. There is limited data from direct comparisons of these modalities.

The pharmacokinetics of methadone in adolescents undergoing posterior spinal fusion.

Background: The optimal methadone dosing regimen for children undergoing spinal surgery is uncertain because of sparse pediatric pharmacokinetic data and a paucity of analgesic effect data. The minimum effective analgesic concentration of methadone in opioid naïve adults is 58 mcg · L(-1).

Methods: Adolescents aged 12-19 years undergoing idiopathic scoliosis correction were administered 0.

Pressure frequency characteristics of the pericardial space and thorax during subxiphoid access for epicardial ventricular tachycardia ablation.

Background: Nonsurgical subxiphoid pericardial access may be useful in ventricular tachycardia ablation and other electrophysiologic procedures but has a risk of right ventricular puncture.

Objective: The purpose of this study was to identify a signature pressure frequency that would help identify the pericardial space and guide access.

Methods: The study consisted of 20 patients (8 women and 12 men; mean age 59.