Pediatric anesthesiology 2016 reviews

Saturday Session II: Poster Presentations and Awards

Reviewed by Lisa Wise-Faberowski, MD
Stanford University School of Medicine and Lucille Packard Children's Hospital

Here is a summary of the awards presented to an excellent group of young investigators. Congratulations to the award winners and their mentor teams.

Young Investigator Awards

OCT1 genotypes predict opioid-related PONV and RD
Olbrecht V, Chidambaran V, Walter C, Balyan R, Zhang X, Vinks A, Sadhasivam S
University of Cincinnati and Cincinnati Children's Hospital, Cincinnati

The association of organic cation transporter 1 genotypes and morphine phenotypes was evaluated in 316 children. Changes in organic cation transporter 1 genotypes resulted in changes in morphine phenotypes, respiratory depression and nausea/vomiting. These genetic differences were more commonly observed in caucasion children and may explain the differences in pharmacokinetics and metabolism of morphine in various pediatric populations.

Isoflurane Anesthesia Causes Significant Alterations in Structure and Neurochemistry in the Neonatal Piglet Brain
Whitaker E, Bissonnette B, Zheng C, Koppert T, Tobias J, Pierson C, Tili E, Christofi F
The Ohio State University and Nationwide Children's Hospital, Columbus

Twenty neonatal piglets were exposed to 2% isoflurane in 50% oxygen for three hours, sacrificed at 48 hours and evaluated using histology, immunohistochemistry, transcriptome analysis and miRNA. Compared to the control group, an increase in glial progenital cells was observed. Several inflammatory markers and down regulation of several miRNA were observed in the animals piglets exposed to isoflurane. The long-term implications of these findings were not observed.

Resident Research Awards

1st Prize
Effect of surgical stimulation on anesthesia induced neuroapoptosis in the mid-gestation fetal ovine brain
Cruz S, Olutoye O, Akinkuotu A, Sheikh F, Zamora I, Adesina A, Olutoye O
Baylor College of Medicine and Texas Children's Hospital, Houston

Neuroapoptosis was evaluated in 29 fetal sheep exposed to 4% isoflurane for three hours with or without surgical stimulation. In the sheep randomized to surgical stimulation, neuroapoptosis was decreased in the dentate gyrus but unchanged in other areas of the brain. The implications on functional outcomes were not assessed.

2nd Prize
Incidence, independent predictors, and outcomes of unplanned, postoperative intubation in the pediatric patient
Paik K, Hajduk J, De Oliveira G, Suresh S, Jagannathan N, Cheon E
Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago

A series of 58 614 patients who underwent non-cardiac surgery in the American College of Surgeons Quality Improvement Program database the incidence of unplanned postoperative intubation was evaluated. Though the incidence of unplanned postoperative intubation was low, 0.2%, it occurred primarily in the first 72 hours after surgery and was associated with an increased 30-day all-cause mortality (OI 11.4;CI 5.8-22.4).

3rd Prize
Oropharyngeal oxygen and volatile anesthetic agent concentration during the use of laryngeal mask airway in children
Hakim M, Krishna S, Syed A, Lind M, Elmaraghy C, Tobias J
The Ohio State University and Nationwide Children's Hospital, Columbus

In a prospective cohort of 235 children with a laryngeal mask airway, the concentration of oxygen and volatile anesthetic in the oropharynx was determined. All patients received 100% oxygen and sevoflurane. The oropharyngeal concentration of oxygen and sevoflurane was determined during spontaneous and positive pressure ventilation. Each patient served as his own control. With positive pressure ventilation and 100% oxygen, the oropharyngeal oxygen concentration was sufficient to support oxygen combustion. Thus, one must use caution with the use of LMA’s in procedures at potential risk of fire.

Bosenberg Award

Ultrasound Use for Confirmation of Successful Trainee Caudal Block in Children: A Randomized Clinical Trial
Kamenetsky E, Long J, Sawardekar A, Birmingham P, Liu D, Hajduk J, De Oliveira Jr G, Suresh S
Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago

The use of ultrasound for the clinical evaluation of successful caudal injection, as evidenced by visualization of local anesthetic epidural spread was evaluated in 97 children undergoing lower abdominal procedures. Adequacy of analgesia was determined by intraoperative and postoperative analgesic requirements in patients prospectively randomized to the ultrasound guidance as opposed to the conventional route of caudal local anesthetic administration. There was no difference in the success of caudal epidural injection in the ultrasound assisted or control group.

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