Interventions to prevent hypothermia in extremely preterm low-weight infants undergoing cardiac catheterisation.

Background: In January 2019, a new device called the Amplatzer Piccolo Occluder was approved by the US Food and Drug Administration for percutaneous closure of patent ductus arteriosus in infants weighing more than 700 g and of postnatal age more than 3 days. Premature low-weight infants are predisposed to hypothermia when transported outside of the thermo-neutral environment. At our institution, 90% of extremely preterm low-weight infants developed transient moderate hypothermia in the cardiac catheterisation suite.

Does exposure to inhalation anesthesia gases change the ratio of X-bearing sperms and Y-bearing Sperms? A worth exploring project into an uncharted domain.

According to recent surveys performed in United States and India, anesthesia care providers were observed to have sired female offspring in a higher proportion than male offspring as their firstborn progeny; however, the reasons for the skew are not clear. Our hypothesis is that the underlying biological evidence may be elucidated by unraveling differences (if any) between the concentrations of X-bearing sperms and Y-bearing sperms in the semen samples obtained from males exposed to varied levels of anesthetics in their lifetimes. Therefore, the objectives of the envisaged study would be to conduct a three-stage investigative study on in-vitro human semen samples to determine (a) X-bearing sperms and Y-bearing sperms concentrations' ratio in male pediatric anesthesia care providers' semen samples, (b) changes in X-bearing sperms and Y-bearing sperms concentrations' ratios between the pre-rotation and post-rotation semen samples of male medical student volunteers/observers, and (c) changes in X-bearing sperms and Y-bearing sperms concentrations' ratios between the pre-operative and post-operative day-3 semen samples of male patients presenting for outpatient procedures under inhalational anesthesia.

SEVOFLURANE AS A CAUSE OF TORSADE DE POINTES IN PATIENT WITH THE LONG QT SYNDROME: Case Report.

Long QT syndrome (LQTS) is a rare condition that in certain circumstances can lead to severe and potentially lethal cardiac arrhythmia known as Torsade de Pointes (TdP). Inhalational anesthetics are among many medications and conditions known to prolong QT and thus potentially predispose the patient to TdP. Although studies have shown that sevoflurane should be safe for the healthy patients, the situation is unclear in patients with LQTS.

Spatial-temporal patterns of electrocorticographic spectral changes during midazolam sedation.

Objective: To better understand 'when' and 'where' wideband electrophysiological signals are altered by sedation.

Methods: We generated animation movies showing electrocorticography (ECoG) amplitudes at eight spectral frequency bands across 1.0-116 Hz, every 0.

STRAIGHT TO VIDEO: TONSILLAR INJURY DURING ELECTIVE GLIDESCOPE(ò)-ASSISTED PEDIATRIC INTUBATION.

Airway management in pediatric patients presenting for tonsillectomy and adenoidectomy may prove challenging given the enlarged upper airway structures. Video Laryngoscopy (VL) can be very helpful but it does not come without risks. In this case report, we report an unfavorable outcome of VL in a pediatric patient with adenotonsillar hypertrophy.

Cerebral "hyperoxygenation" with inhalational induction of anesthesia in children: a retrospective comparison between vasoparalytic sevoflurane vs. vasoneutral fentanyl.

Background: The higher levels of oxygen in cerebrum may contribute to neuro-apoptosis, analogous to direct tissue injury induced by toxic levels of oxygen. Earlier report highlighted the possibility of cerebral "hyperoxygenation" secondary to inhalational induction of anesthesia with sevoflurane in small number of children.

Objective: The aim of this retrospective review was whether similar cerebral "hyperoxygenation" trends can be seen in larger and retrospective patients' database.

Aprotinin and transfusion requirements in pediatric craniofacial surgery.

Objective: To evaluate transfusion requirements in children receiving aprotinin during craniofacial surgery.

Background: Pediatric craniofacial procedures may involve massive blood loss. Aprotinin may decrease perioperative blood loss and transfusion requirements.

Airway management for rigid bronchoscopy via a freshly performed tracheostomy in a child with Goldenhar syndrome.

A case of tooth aspiration in a 6 year old boy with Goldenhar syndrome and known difficult intubation is presented. A fresh tracheostomy was performed after a failed fiberoptic intubation and dental aspiration. The patient was transferred to our tertiary-care children's hospital for emergency bronchoscopy through the fresh tracheostomy for removal of an aspirated tooth.

Anesthetic management of children with Rubinstein-Taybi syndrome--case reports.

A limited number of cases of anesthetic management of Rubinstein-Taybi Syndrome (RTS) have been reported since this syndrome was first diagnosed in 1963. After some well-publicized complications following anesthesia for patients with RTS, there has been great interest in avoiding all precipitant factors and careful monitoring during intraoperative and postoperative periods. This case series examines the cases of three pediatric patients with RTS who presented to the Children's Hospital of Michigan for different surgeries.

Airway and ventilation management during repair of a large acquired tracheoesophageal fistula: the novel use of a readily available tool.

Acquired tracheoesophageal fistula (TEF) is a life-threatening disorder of the airway that requires early diagnosis and treatment. The case of an infant who had delayed development of a TEF following endoscopic removal of a disc battery lodged in the midesophagus is reported. A repeat bronchoscopy, performed for respiratory distress 4 days later, showed a large defect in the posterior wall of the distal trachea, including the carina.

Guidelines for elective pediatric fiberoptic intubation.

Fiberoptic intubation in pediatric patients is often required especially in difficult airways of syndromic patients i.e. Pierre Robin Syndrome.

A novel rescue technique for difficult intubation and difficult ventilation.

We describe a novel non surgical technique to maintain oxygenation and ventilation in a case of difficult intubation and difficult ventilation, which works especially well with poor mask fit. Can not intubate, can not ventilate" (CICV) is a potentially life threatening situation. In this video we present a simulation of the technique we used in a case of CICV where oxygenation and ventilation were maintained by inserting an endotracheal tube (ETT) nasally down to the level of the naso-pharynx while sealing the mouth and nares for successful positive pressure ventilation.

Pediatric laryngospasm: prevention and treatment.

Purpose Of Review: The purpose of this review is to discuss the risk factors associated with laryngospasm and the techniques used for prevention and treatment. We also summarize the prevention and treatment modalities in organized algorithms.

Recent Findings: According to recent endoscopic studies, laryngospasm is always complete, thus airway management and intravenous therapy are indicated.

Electrocautery-induced fire during adenotonsillectomy: report of two cases.

We describe two cases of flash fires in the oropharynx, secondary to electrocautery during adenotonsillectomies. We believe that in both cases, the leak around the uncuffed endotracheal tubes raised the oxygen concentration in the oropharynx. Cuffed endotracheal tubes provide many advantages, and their use should strongly be considered during adenotonsillectomy in children when electrocautery is to be used.

Comparison of phenoxybenzamine to sodium nitroprusside in infants undergoing surgery.

Objectives: The purpose of this study was to compare the effects of a direct-acting arterial dilator, sodium nitroprusside, to an alpha-adrenergic receptor blocker, phenoxybenzamine, in infants with congenital heart defects undergoing cardiac repairs on cardiopulmonary bypass.

Design: A prospective, multicenter, observational study.

Setting: Tertiary care center.

Parental satisfaction with anesthesia without intravenous access for myringotomy.

Objective: To evaluate the effect of intravenous (i.v.) access in children undergoing bilateral myringotomy with pressure-equalizing tube placement.

Propofol decreases waste anesthetic gas exposure during pediatric bronchoscopy.

Objective: This study compared the anesthetic gas exposure and operating conditions during insufflation anesthesia with halothane-alone versus halothane-propofol in children undergoing direct laryngobronchoscopy.

Study Design: Forty-six children were enrolled in this randomized prospective study, with institutional review board approval and informed consent.

Methods: All children were anesthetized by halothane mask induction and anesthesia was maintained using spontaneous ventilation with insufflation.

A Workshop in Physician-Patient Communication for Anesthesiology Trainees.

Background: Although abundant literature demonstrates the importance of effective physician-patient communication, most research and teaching models in this area are based on a primary care setting, and may not apply to procedural specialties. Some research demonstrates that patients perceive their surgeons' and anesthesiologists' communication skills to be less effective than those of primary care specialists. In order to improve the effectiveness of anesthesiology trainee communication skills and simultaneously address the new ACGME general competency requirements pertaining to such skills, faculty from the Departments of Anesthesiology and Internal Medicine collaborated in the development of a workshop tailored to the needs of this group.