Intraoperative Hypoxia in a Neonate with a Minimally Unbalanced Atrioventricular Canal for Emergent Laparotomy

Abstract This resource is a Problem Based Learning Discussion (PBLD), created for pediatric anesthesiologists and general anesthesiologists for the purpose of continuous medical education, but it is a good resource for pediatric anesthesia fellows, anesthesiology residents and pediatric critical care fellows, as well. The purpose of this PBLD is to teach participants the differential diagnosis of causes of hypoxemic hypoxia in neonates with congenital heart disease, and to provide an exercise in quickly recognizing and managing impaired pulmonary blood flow as well as to give a context in which this can happen. The PBLD format requires participants to prepare for the discussion by independently reading the given references and thinking through the management of the given case prior to the discussion. The questions built into the case presented before each key element help participants apply knowledge acquired previously and build arguments at dichotomous points. Limiting the size of the group to 5–12 participants to allow each member to contribute or ask questions is recommended. The resource was deployed at the International Assembly of Pediatric Anesthesiologists in Washington, D.C. in October 2012. The group members consisted of pediatric anesthesiologists of diverse backgrounds (cardiac vs. noncardiac, providers from small private practices vs. large academic institutions in and outside of the U.S.). The diversity of the group contributed significantly to the liveliness of the discussion.