Introduction Patients engage the healthcare system seeking help—help managing pain, help regaining function, and help restoring some level of homeostasis in their lives. Unfortunately, for many patients, the system designed to help instead introduces new risks, new ailments, and new…
Background and historical context Pediatric critical care began with the pediatric intensive care unit (PICU) created by Dr. Jack Downes in 1967 at Children’s Hospital of Philadelphia, many years after the initial attempts to palliate or repair congenital cardiac anomalies…
Introduction: Critical care medicine Critical care medicine is a requisite aspect of the perioperative course for a significant portion of children presenting for surgery and other procedures necessitating anesthesia. Accordingly, the pediatric anesthesiologist’s understanding of the tenets of critical care…
Cardiac arrest during anesthesia Incidence of cardiac arrest during anesthesia This chapter provides an overview of incidence, etiologies and outcomes of pediatric perioperative cardiac arrest, the physiology of cardiopulmonary resuscitation, current therapeutic recommendations as well as physiologic and scientific underpinnings…
Introduction: The challenge of healthcare-associated infection In the landmark 1999 report “To Err is Human,” the Institute of Medicine identified safety in healthcare as a significant contributor to avoidable morbidity and mortality ( ). Among the preventable categories of safety…
Introduction Pediatric cutaneous disorders are of significant importance to the anesthesiologist. Many dermatologic signs may signal potential anesthesia pitfalls or complications. Infectious disorders must be recognized to protect not only the patient but also the physicians and the staff caring…
Autism spectrum disorder Autism spectrum disorder (ASD) is a biologically based neurodevelopmental disorder characterized by impairments in two major domains: (1) deficits in social communication and social interaction in multiple settings and (2) restricted repetitive patterns of behavior, interests, and…
Introduction The dramatic rise in pediatric obesity has made it a common consideration for the pediatric anesthesiologist and surgeon. For the first time in human history, obesity now rivals malnutrition as the most life threatening global disorder among children (…
History Malignant hyperthermia (MH) is a serious and possibly fatal syndrome of skeletal muscle hypermetabolism and calcium dysregulation that occurs when genetically susceptible individuals are exposed to certain anesthetic “triggering” agents, specifically the potent halogenated inhaled volatile anesthetics and the…
Genetic work during the past several years has led to a clearer understanding of the molecular causes of genetic-based muscle diseases. In most cases, the identification of the proteins altered in the disease states has added to our understanding of…