The Urogenital System
1. The development of the urogenital system can conceptually be divided into its urinary portion and genital portion. 2. Specific anesthetic considerations for patients with Wilms tumor include a thorough imaging evaluation…
Vascular Biology and Vascular Anomalies
1. Development of the vascular system starts in early embryogenesis. • Mesenchymal cells develop into hemangioblasts, some of which become angioblasts. • The formation of de novo vessels is referred to as vasculogenesis;…
The Central Nervous System: Pediatric Neuroanesthesia
1. The Monro–Kellie hypothesis states that the sum of all intracranial contents—brain and interstitial fluid (80%), cerebrospinal fluid (CSF; 10%), blood (10%)—remains constant. 2. Maintenance of cerebral perfusion pressure (CPP) is essential…
Fetal Medicine and Anesthesia for Fetal Surgery
1. Fetal surgery is a rapidly evolving specialty with multiple fetal interventions being performed at different stages of pregnancy. 2. Pregnancy results in various anatomic and physiologic changes that impact anesthetic management….
The Hindgut
1. About 45% to 75% of ulcerative colitis patients eventually need surgery. Indications are divided into emergency, urgent, and elective. Emergency procedures are done for life-threatening complications of fulminant colitis unresponsive…
Gut Development: Surgical and Anesthetic Implications
1. The endoderm is divided into the foregut, midgut, and hindgut based on its vascular supply. 2. The tongue’s complex muscular and nervous innervation is a result of its development from branchial…
Abdominal Tumors
1. Liver tumors are rare in children and generally present as a painless mass. 2. Hepatoblastoma is the most common liver tumor in children. 3. Regional analgesia may be contraindicated in patients with…
Anesthesia Outside the Operating Room
1. Because pediatric anesthetics outside the operating room are performed with increasing frequency, it is important for any institution to have a system in place to meet the service needs and…
Anesthesia and Childhood Obesity
1. The global pandemic of obesity is a serious public health concern that has affected both adults and children. 2. The etiology of childhood obesity is multifactorial and involves complex interactions between…
Metabolic Diseases and Inborn Errors of Metabolism
1. Hypoglycemia is a common concern. Preoperative fasting must be minimized, and intravenous dextrose must be supplemented in the perioperative period. 2. Lactated Ringer solution should not be used in patients with…
