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4. Awake Supraglottic Airway Placement in Pediatric Patients for Airway Obstruction or Difficult Intubation: Insights From an International Airway Registry (PeDI)

Author

Longacre, Mckenna, Park, Raymond S., Staffa, Steven J., Rowland, Matthew J., Meserve, Jonathan, Lord, Charles, Templeton, T. Wesley, Garcia-Marcinkiewicz, Annery G., Peyton, James M., Fiadjoe, John E., Kovatsis, Pete G., Stein, Mary Lyn, Bruins, Benjamin B., Stricker, Paul, Laverriere, Elizabeth K., Lockman, Justin L., Struyk, Brian, Ward, Christopher, Nishisaki, Akira, Kodavatiganti, Ramesh, Guris, Rodrigo J. Daly, Sequera-Ramos, Luis, Teen, Mark S., Oke, Ayodele, Hsu, Grace, Lingappan, Arul, Egbuta, Chinyere, Flynn, Stephen, Sarmiento, Lina, Battles, Rhae, Bocanegra, Ashley D., Goldfarb, Tally, Kiss, Edgar E., Olomu, Patrick N., Szmuk, Peter, Mireles, Sam, Murray, Andrea, Whyte, Simon, Jain, Ranu, Khan, Sabina A., Matuszczak, Maria, Hunyady, Agnes, Holmes, Christopher, McCann, Alexander, Sabato, Stefano, Matava, Clyde, Dalesio, Nicholas, Greenberg, Robert, Lucero, Angela, Desai, Sapna, Tennessee, Nashville, Rosander, Sondra, Samba, Sindhu, Schrock, Charles, Nykiel-Bailey, Sydney, Marsh, Jennifer, Brooks Peterson, Melissa, Johnson Lee, Amy Colleen, Bhattacharya, Somaletha, Burjek, Nicholas E., Jagannathan, Narasimhan, Lardner, David, Crockett, Christy, Robertson, Sara, Sathyamoorthy, Madhankumar, Chiao, Franklin, Patel, Jasmine, Sharma, Aarti, Echeverry Marin, Piedad, Pérez-Pradilla, Carolina, Singh, Neeta, Taicher, Brad, von Ungern-Sternberg, Britta S., Sommerfield, David, Hauser, Neil, Hesselink, Emily, Lewkowitz-Shpuntoff, Hilana, Castro, Pilar, Riveros Perez, N. Ricardo, Leite, Fernanda, Vega, Eduardo, González, Alejandro, Ostermann, Paola, Rubin, Kasia, Lee, Angela, Valairucha, Songyos, Dalal, Priti, Tran, Thanh, Anspach, Taylor, Lee, Lisa K., Ayad, Ihab, Rehman, Mohamed, Fernandez, Allison, Zamora, Lillian, Ravula, Niroop, Shaik, Sadiq, Szolnoki, Judit, Mathew, Preethy J., Yaddanapudi, Sandhya, Sen, Indu, Gupta, Aakriti, Handlogten, Kathryn, Sroka, J. Michael, Caldeira Quintao, Vinicius, and Vieira Carlos, Ricardo

Published
2024
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5. Patient and Process Outcomes among Pediatric Patients Undergoing Appendectomy during the COVID-19 Pandemic: An International Retrospective Cohort Study

Author

Matava, Clyde T, Tighe, Nathaniel TG, Baertschiger, Reto, Wilder, Robert T, Correll, Lynnie, Staffa, Steven J, Zurakowski, David, Kato, Meredith A, Meier, Petra M, Raman, Vidya, Reddy, Srijaya K, Roque, Remigio A, Peterson, Melissa Brooks, Zhong, John, Edala, Thejovathi, Greer, Timothy J, von Ungern-Sternberg, Britta S, Cravero, Joseph, Simpao, Allan F, Ali, Anita Akbar, Al-Rabbat, Mohamad F, Brzenski, Alyssa B, Casey, William F, Chhabada, Surendrasingh, Collin, Michael, Dhumak, Vipul J, D’Mello, Ajay, Echeverry, Piedad C, Ellison, Pavithra R, Fernandez, Allison M, Fisher, Jake A, Fuller, Clinton L, Glover, Chris D, Guruswamy, Velu, Hesselink, Emily B, Hunyady, Agnes I, Lorinc, Amanda N, King, Michael, Mihaila, Lavinia, Nelson, Jonathon H, Ng, Ann S, Ramjist, Joshua K, Ravula, Nirop R, Beel, Elizabeth Rossmann, Rugnathx, Rahil, Shaw, Robert E, Sheth, Michelle M, Sinha, Tripiti, Sommerfield, Aine, Soneru, Codruta, Templeton, Thomas W, and Williams, RJ

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Pediatric, Patient Safety, Prevention, Good Health and Well Being, Humans, Child, COVID-19, Retrospective Studies, Pandemics, Appendicitis, Appendectomy, COVID-19 Testing, Postoperative Complications, SARS-CoV-2, Length of Stay, PEACOC Collaborators, Anesthesiology, Clinical sciences
Abstract

BackgroundCOVID-19 forced healthcare systems to make unprecedented changes in clinical care processes. The authors hypothesized that the COVID-19 pandemic adversely impacted timely access to care, perioperative processes, and clinical outcomes for pediatric patients undergoing primary appendectomy.MethodsA retrospective, international, multicenter study was conducted using matched cohorts within participating centers of the international PEdiatric Anesthesia COVID-19 Collaborative (PEACOC). Patients younger than 18 yr old were matched using age, American Society of Anesthesiologists Physical Status, and sex. The primary outcome was the difference in hospital length of stay of patients undergoing primary appendectomy during a 2-month period early in the COVID-19 pandemic (April to May 2020) compared with prepandemic (April to May 2019). Secondary outcomes included time to appendectomy and the incidence of complicated appendicitis.ResultsA total of 3,351 cases from 28 institutions were available with 1,684 cases in the prepandemic cohort matched to 1,618 in the pandemic cohort. Hospital length of stay was statistically significantly different between the two groups: 29 h (interquartile range: 18 to 79) in the pandemic cohort versus 28 h (interquartile range: 18 to 67) in the prepandemic cohort (adjusted coefficient, 1 [95% CI, 0.39 to 1.61]; P < 0.001), but this difference was small. Eight centers demonstrated a statistically significantly longer hospital length of stay in the pandemic period than in the prepandemic period, while 13 were shorter and 7 did not observe a statistically significant difference. During the pandemic period, there was a greater occurrence of complicated appendicitis, prepandemic 313 (18.6%) versus pandemic 389 (24.1%), an absolute difference of 5.5% (adjusted odds ratio, 1.32 [95% CI, 1.1 to 1.59]; P = 0.003). Preoperative SARS-CoV-2 testing was associated with significantly longer time-to-appendectomy, 720 min (interquartile range: 430 to 1,112) with testing versus 414 min (interquartile range: 231 to 770) without testing, adjusted coefficient, 306 min (95% CI, 241 to 371; P < 0.001), and longer hospital length of stay, 31 h (interquartile range: 20 to 83) with testing versus 24 h (interquartile range: 14 to 68) without testing, adjusted coefficient, 7.0 (95% CI, 2.7 to 11.3; P = 0.002).ConclusionsFor children undergoing appendectomy, the COVID-19 pandemic did not significantly impact hospital length of stay.Editor’s perspective

Published
2023

17. Airway management in the paediatric difficult intubation registry: a propensity score matched analysis of outcomes over time

Author

Bruins, Benjamin, Stricker, Paul, Laverriere, Elizabeth, Lockman, Justin L., Struyk, Brian, Ward, Christopher, Nishisaki, Akira, Kodavatiganti, Ramesh, Guris, Rodrigo Daly, Sequera-Ramos, Luis, Teen, Mark, Oke, Ayodele, Hsu, Grace, Lingappan, Arul, Battles, Rhae, Bocanegra, Ashley, Goldfarb, Tally, Kiss, Edgar, Szmuk, Peter, Mireles, Sam, Murray, Andrea, Whyte, Simon, Jain, Ranu, Matuszczak, Maria, Holmes, Christopher, McCann, Alexander, Matava, Clyde, Dalesio, Nicholas, Greenberg, Robert, Lucero, Angela, Desai, Sapna, Rosander, Sondra, Samba, Sindhu, Schrock, Charles, Nykiel-Bailey, Sydney, Marsh, Jennifer, Peterson, Melissa Brooks, Lee, Amy, Bhattacharya, Somaletha, Burjek, Nicholas, Jagannathan, Narasimhan, Lardner, David, Crockett, Christy, Robetson, Sara, Patel, Jasmine, Sharma, Aarti, Templeton, Thomas, Marín, Piedad Echeverry, Pérez-Pradilla, Carolina, Singh, Neeta, Sommerfield, David, Hauser, Neil, Hesselink, Emily, Lewkowitz-Shpuntoff, Hilana, Castro, Pilar, Riveros Perez, N. Ricardo, Vega, Eduardo, González, Alejandro, Ostermann, Paola, Rubin, Kasia, Meserve, Jonathan, Lord, Charles, Lee, Angela, Valairucha, Songyos, Dalal, Priti, Tran, Thanh, Anspach, Taylor, Lee, Lisa K., Ayad, Ihab, Rehman, Mohamed, Fernandez, Allison, Zamora, Lillian, Ravula, Niroop, Shaik, Sadiq, Szolnoki, Judit, Mathew, Preethy, Yaddanapudi, Sandhya, Sen, Indu, Gupta, Aakriti, Handlogten, Kathryn, Sroka, J. Michael, Quintão, Vinícius Caldeira, Carlos, Ricardo Vieira, Leite, Fernanda, Stein, Mary Lyn, Sarmiento Argüello, Lina Andrea, Staffa, Steven J., Heunis, Julia, Egbuta, Chinyere, Flynn, Stephen G., Khan, Sabina A., Sabato, Stefano, Taicher, Brad M., Chiao, Franklin, Bosenberg, Adrian, Lee, Angela C., Adams, H. Daniel, von Ungern-Sternberg, Britta S., Park, Raymond S., Peyton, James M., Olomu, Patrick N., Hunyady, Agnes I., Garcia-Marcinkiewicz, Annery, Fiadjoe, John E., and Kovatsis, Pete G.

Published
2024
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30. A survey of the global impact of COVID‐19 on the practice of pediatric anesthesia: A study from the pediatric anesthesia COVID‐19 Collaborative Group

Author

Soneru, Codruta N, Fernandez, Allison M, Bradford, Victoria, Staffa, Steven J, Raman, Vidya T, Cravero, Joseph, Zurakowski, David, Meier, Petra M, Balakrishnan, Sindu, Bansal, Vipin, Torres, Angela Becerra, Beethe, Amy, Benzon, Hubert A, Bhandari, Angelina, Bocanegra, Ashley, Bould, Dylan, Peterson, Melissa Brooks, Brzenski, Alyssa, Busso, Veronica, Cain, James G, Cassidy, Myles, Cheon, Eric C, Chhabada, Surendrasingh, Correll, Lynnie R, Dalesio, Nicholas M, Davidson, Andrew, Derderian, Courtney, Dhumak, Vipul, Disma, Nicola, D'Mello, Ajay, Echeverry, Piedad, Ellison, Pavithra R, Erb, Thomas, Fajardo, Angelica, Falcon, Ricardo J, Frugoni, Brian, García, Javier, Giraldo, Olga Lucía, Glover, Chris D, Goeller, Jessica, Goobie, Susan M, Gooch, Ingrid, Granados, Lina Maria, Grivoyannis, Anastasia, Guruswamy, Velu, Hesselink, Emily, Hobbs, Jill, Hunyady, Agnes, Jain, Ranu, Jorge‐Reynolds, Lydia, Kato, Meredith A, King, Michael R, Kitzman, Jamie, Koh, Jeffrey, Lester, Andy, Lorinc, Amanda, Lozano, Constanza, Manupipatpong, Katherine, Matava, Clyde, McLuckie, Duncan, Merchant, Kanwal, Levy, Heather Mitzel, Muldowney, Bridget L, Navarro, Julian Andres, Nelson, Jonathon, Patel, Amish, Patel, Roshan, Ravula, Niroop, Reddy, Desigen, Reddy, Srijaya K, McCormick, Megan Rodgers, Roque, Remigio, Rosen, David, Beel, Elizabeth Rossmann, Rothschild, Leelach, Sarmiento, Lina, Shadrina, Anna, Shaw, Robert, Sheth, Michelle, Simpao, Allan F, Singh, Neeta, Smith, Timothy E, Soria, Claire, Szmuk, Peter, Taicher, Brad M, Tan, Gee Mei, Teng, Howard, Edala, Thejovathi, Tighe, Nathaniel, Tom, Simon, Trujillo, Alexander, Vishneski, Susan R, Vivas, Juan Pablo, Von Samek, Adam, von Ungern‐Sternberg, Britta S, Whyte, Simon, and Wilder, Robert T

Subjects
Clinical Research, Patient Safety, Pediatric, Generic health relevance, Good Health and Well Being, Anesthesia, Anesthesiologists, Anesthesiology, COVID-19, COVID-19 Testing, Child, Humans, Pandemics, Pediatricians, Pediatrics, Personal Protective Equipment, Practice Guidelines as Topic, Practice Patterns, Physicians', SARS-CoV-2, Societies, Medical, Surveys and Questionnaires, United States, hospital economics, pediatric anesthesia, personal protective equipment, preoperative testing, simulation, Pediatric Anesthesia COVID-19 Collaborative, Paediatrics and Reproductive Medicine
Abstract

BackgroundPediatric anesthesiology has been greatly impacted by COVID-19 in the delivery of care to patients and to the individual providers. With this study, we sought to survey pediatric centers and highlight the variations in care related to perioperative medicine during the COVID-19 pandemic, including the availability of protective equipment, the practice of pediatric anesthesia, and economic impact.AimThe aim of the survey was to determine how COVID-19 directly impacted pediatric anesthesia practices during the study period.MethodsA survey concerning four major domains (testing, safety, clinical management/policy, economics) was developed. It was pilot tested for clarity and content by members of the Pediatric Anesthesia COVID-19 Collaborative. The survey was administered by email to all Pediatric Anesthesia COVID-19 Collaborative members on September 1, 2020. Respondents had six weeks to complete the survey and were instructed to answer the questions based on their institution's practice during September 1 - October 13, 2020.ResultsSixty-three institutions (100% response rate) participated in the COVID-19 Pediatric Anesthesia Survey. Forty-one hospitals (65%) were from the United States, and 35% included other countries. N95 masks were available to anesthesia teams at 91% of institutions (n = 57) (95% CI: 80%-96%). COVID-19 testing criteria of anesthesia staff and guidelines to return to work varied by institution. Structured simulation training aimed at improving COVID-19 safety and patient care occurred at 62% of institutions (n = 39). Pediatric anesthesiologists were economically affected by a reduction in their employer benefits and restriction of travel due to employer imposed quarantine regulations.ConclusionOur data indicate that the COVID-19 pandemic has impacted the testing, safety, clinical management, and economics of pediatric anesthesia practice. Further investigation into the long-term consequences for the specialty is indicated.

Published
2021

39. The Modified Clinical Progression Scale for Pediatric Patients: Evaluation as a Severity Metric and Outcome Measure in Severe Acute Viral Respiratory Illness

Author

Leland, Shannon B., Staffa, Steven J., Newhams, Margaret M., Khemani, Robinder G., Marshall, John C., Young, Cameron C., Maddux, Aline B., Hall, Mark W., Weiss, Scott L., Schwarz, Adam J., Coates, Bria M., Sanders, Ronald C., Jr, Kong, Michele, Thomas, Neal J., Nofziger, Ryan A., Cullimore, Melissa L., Halasa, Natasha B., Loftis, Laura L., Cvijanovich, Natalie Z., Schuster, Jennifer E., Flori, Heidi, Gertz, Shira J., Hume, Janet R., Olson, Samantha M., Patel, Manish M., Zurakowski, David, and Randolph, Adrienne G.

Published
2023
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45. Preoperative stimulation of resolution and inflammation blockade eradicates micrometastases

Author

Panigrahy, Dipak, Gartung, Allison, Yang, Jun, Yang, Haixia, Gilligan, Molly M, Sulciner, Megan L, Bhasin, Swati S, Bielenberg, Diane R, Chang, Jaimie, Schmidt, Birgitta A, Piwowarski, Julia, Fishbein, Anna, Soler-Ferran, Dulce, Sparks, Matthew A, Staffa, Steven J, Sukhatme, Vidula, Hammock, Bruce D, Kieran, Mark W, Huang, Sui, Bhasin, Manoj, Serhan, Charles N, and Sukhatme, Vikas P

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Immunology, Prevention, Cancer, Aetiology, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, 2.1 Biological and endogenous factors, Inflammatory and immune system, Animals, Docosahexaenoic Acids, Immunity, Cellular, Ketorolac, Male, Mice, Mice, Knockout, Neoplasm Metastasis, Neoplasm Recurrence, Local, Neoplasms, Experimental, Preoperative Care, T-Lymphocytes, Eicosanoids, Inflammation, Oncology, Surgery, Medical and Health Sciences, Biological sciences, Biomedical and clinical sciences, Health sciences
Abstract

Cancer therapy is a double-edged sword, as surgery and chemotherapy can induce an inflammatory/immunosuppressive injury response that promotes dormancy escape and tumor recurrence. We hypothesized that these events could be altered by early blockade of the inflammatory cascade and/or by accelerating the resolution of inflammation. Preoperative, but not postoperative, administration of the nonsteroidal antiinflammatory drug ketorolac and/or resolvins, a family of specialized proresolving autacoid mediators, eliminated micrometastases in multiple tumor-resection models, resulting in long-term survival. Ketorolac unleashed anticancer T cell immunity that was augmented by immune checkpoint blockade, negated by adjuvant chemotherapy, and dependent on inhibition of the COX-1/thromboxane A2 (TXA2) pathway. Preoperative stimulation of inflammation resolution via resolvins (RvD2, RvD3, and RvD4) inhibited metastases and induced T cell responses. Ketorolac and resolvins exhibited synergistic antitumor activity and prevented surgery- or chemotherapy-induced dormancy escape. Thus, simultaneously blocking the ensuing proinflammatory response and activating endogenous resolution programs before surgery may eliminate micrometastases and reduce tumor recurrence.

Published
2019

49. Prevalence of COVID-19 and Risk Factors for Infection Among Pediatric Anesthesia Patients: A Report From the PEACOC Research Network

Author

Kato, Meredith A., Zurakowski, David, Adams, AmandaMarie, Soelberg, Julie, Staffa, Steven J., Bradford, Victoria A., Efune, Proshad N., Rodgers McCormick, Megan E., Grivoyannis, Anastasia D., Rossmann Beel, Elizabeth, Correll, Lynnie R., Cheon, Eric C., Tan, Gee Mei, Thomas, James J., Fernandez, Allison M., Teng, Howard C., Khanna, Neha, Raman, Vidya T., Brzenski, Alyssa B., Frugoni, Brian J., Sheth, Michelle M., Rugnath, Rahil M., and Meier, Petra M.

Published
2023
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