Gregory's Pediatric Anesthesia E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 4939

Veröffentlichungsjahr: 2020

Beschreibung

As the field pediatric anesthesia advances and expands, so too does the gamut of challenges that are faced by today's anesthesiologists. Gregory's Pediatric Anesthesia aims to fully prepare trainees and experienced professionals for modern practice by equipping them with the knowledge and cutting-edge techniques necessary to safely and successfully anesthetize children for a range of different surgeries and other procedures. Supporting their work with current data and evidence, the authors explore topics including basic principles, potential complications, and best practice, and illustrate their findings with detailed case studies that cover all major subspecialties. This essential new edition includes access to illustrative videos and features new and expanded sections, such as: * Anesthesia for Spinal Surgery complications including postoperative blindness * Robotic surgery for Pediatric Urological Procedures * Anesthesia for Non-Cardiac Surgery in Patients with Congenital Heart Disease (new chapter) * Extensive additional ultrasound images for regional anesthesia * Neonatal Resuscitation * The Pediatric Surgical Home and Enhanced Recovery after Surgery (new chapter) Now in its sixth edition, Gregory's Pediatric Anesthesia continues to provide reliable and easy-to-follow guidance to all anesthesiologists caring for younger patients.

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Table of Contents

Cover

List of Contributors

Preface

List of Abbreviations

CHAPTER 1: Ethics and Professionalism in Pediatric Anesthesia

Introduction

The informed consent process for children

Forgoing potentially life‐sustaining treatment

Special circumstances in pediatric anesthesia

Professionalism in pediatric anesthesia

Annotated references

CHAPTER 2: History of Pediatric Anesthesia

Introduction

The beginning of anesthesia as a specialty and the first drugs used, 1842–1921

Early regional anesthesia in children, 1909–1933

Delivery systems and anesthetic machines, 1916–1937

New drugs in the 1930s, 1940s, and 1950s

Neonatal anatomical and physiological factors in relation to anesthesia and monitoring

Early anesthesiologists interested in children: pediatric anesthesia emerges into the specialist era, 1920s to 1950s

The specialty of pediatric anesthesia develops further, 1950s to 1970s

The beginning of intensive care

Unraveling mysteries and challenges: malignant hyperthermia, massive hyperkalemia, and anaphylaxis

Newer drugs in the development period (1950s to 1970s)

Adjuncts which were useful in difficult procedures

Pain management

Outpatient anesthesia and non‐operating room anesthesia

Pediatric anesthesia societies and meetings

Pediatric Anesthesia

journal

Training in pediatric anesthesiology

Conclusion

Annotated references

CHAPTER 3: Education in Pediatric Anesthesiology: Practice in the Present with the Future in Mind

Introduction

Why pediatric anesthesiology education? The needs assessment

The “How” of pediatric anesthesiology education: theory and strategy

The “What:” pediatric anesthesiology education in practice

Conclusion

Annotated references

CHAPTER 4: An Introduction to the Ethical Design, Conduct, and Analysis of Pediatric Clinical Trials

Introduction

What is a clinical trial?

Getting started

Ethical aspects of clinical trials

Operational planning and trial execution

Other clinical research study designs

Levels of evidence for clinical research studies

Conclusion

Annotated references

CHAPTER 5: Development of the Cardiovascular System

Introduction

Development of the cardiovascular system

Cardiac stem cell therapy and heart regeneration

Conclusion

Acknowledgment

Annotated references

Further reading

CHAPTER 6: Developmental Physiology of the Cardiovascular System

Introduction

Development from fetus to neonate

Development from neonate to older infant and child

Development from child to adult

Normal values for physiological variables by age

Myocardial sequelae of long‐standing congenital heart disease

Cardiomyocyte receptor function in normal and diseased hearts

Regulation of vascular tone in systemic and pulmonary circulations

Receptor signaling in myocardial dysfunction, congenital heart disease, and heart failure

Myocardial preconditioning

Acknowledgment

Annotated references

CHAPTER 7: Developmental Physiology of the Respiratory System

Introduction

Embryology of the lungs, chest wall, and diaphragm

Physiology and anatomy of the upper and lower airways in infants and children

Lung fluid physiology

Pulmonary cell types, development, and release of surfactant

Physiological changes in lung liquid and pulmonary blood flow at birth

Lung development after birth

Control of breathing

Normal values for pulmonary function with age

Pathophysiology of important respiratory diseases affecting infants and children

Annotated references

CHAPTER 8: Developmental Physiology of the Central Nervous System

Introduction

Embryology of the developing brain and spinal cord, changes from fetus to neonate to child

The intracranial compartment

Vascular anatomy of the central nervous system

Cerebral vascular physiology

Electroencephalogram

Evoked potential monitoring

Conclusion

Annotated references

CHAPTER 9: Developmental Physiology of the Liver, Gastrointestinal Tract, and Renal System

The liver

Developmental physiology of the gastrointestinal tract

Developmental physiology of the renal system

Annotated references

Further reading

CHAPTER 10: Pharmacology

Introduction

Development of uptake, distribution, protein binding, metabolism, and excretion systems for drugs in the fetus, newborn, infant, and child [1]

Pharmacokinetics and pharmacodynamics of inhaled anesthetics

Pharmacokinetics and pharmacodynamics of intravenous anesthetics

Opioids

Muscle relaxants and reversal agents

Local anesthetics

Anesthetic pharmacology in obese children

Annotated references

CHAPTER 11: Fluids, Electrolytes, and Nutrition

Introduction

Physiology

Intravenous fluid therapy

Disorders of fluids and electrolytes

Conclusion

Annotated references

CHAPTER 12: Coagulation, Bleeding, and Blood Transfusion

Introduction

The coagulation process

Maturation of the coagulation system

Evaluation of the coagulation system

Congenital hematological disorders

Transfusion therapy

Blood conservation

Annotated references

CHAPTER 13: Cardiopulmonary Resuscitation

Introduction

Epidemiology of pediatric cardiac arrest

Phases of resuscitation

Interventions during the cardiac arrest (no‐flow) and cardiopulmonary resuscitation (low‐flow) phases

Postresuscitation interventions

Other considerations

Conclusion

Annotated references

CHAPTER 14: Anxiety, Psychological Preparation, Awareness, and Behavior Change

Introduction

Anxiety

Psychological preparation

Awareness

Behavior change

Conclusion

Annotated references

CHAPTER 15: Principles of the Pediatric Perioperative Surgical Home

Introduction

Goal and objectives

The value proposition

Integration with the medical home and primary care providers

Critical steps for implementation

Types of procedures for pediatrics

Enhanced recovery after surgery

Education and training

Payment models

Annotated references

CHAPTER 16: Pediatric Airway Management

Introduction

Developmental anatomy

Anatomical structures of the upper airway and their relation to the practice of pediatric anesthesia

Developmental physiology of the upper airway

Management of the normal pediatric airway

Tracheal intubation

Nasotracheal intubation

Tracheal tube selection

Rapid‐sequence induction and intubation in pediatric patients

Postoperative airway management

Upper airway complications and management

Airway management for tracheostomy insertion

The difficult pediatric airway

Indirect methods of tracheal intubation

Extubation of the difficult airway

Surgical and invasive airway management

Intentional muscle relaxation for difficult airway management

Annotated references

Further reading

Video clips

CHAPTER 17: Induction of, Maintenance of, and Emergence from Anesthesia

Evaluation of preoperative data and conditions

Preparation of operating room, equipment, and monitors

Methods for inducing anesthesia

Problems during induction of anesthesia

Maintenance of anesthesia

Emergence and recovery from anesthesia

Transport to the postanesthesia care unit and intensive care unit

Acknowledgment

Annotated references

CHAPTER 18: Postanesthesia Care Unit Management

Introduction

Essentials of the postanesthesia care unit

Potential postanesthesia problems and complications

Conclusion

Annotated references

CHAPTER 19: Monitoring and Vascular Access

Introduction

Venous access

Arterial access

Percutaneous pulmonary artery catheterization

Ultrasound guidance for vascular access

Interpretation of intravascular pressure waveforms

New techniques in pediatric intravascular monitoring

Emergency vascular access

Complications of vascular access

Respiratory monitoring

Temperature monitoring

Urinary monitoring

Blood gas and other point‐of‐care testing

Neuromuscular transmission monitoring

Central nervous system and somatic monitoring

Point‐of‐care ultrasound

Annotated references

Video clips

CHAPTER 20: Pediatric Regional Anesthesia

Introduction

Embryology and developmental physiology of the peripheral nervous system and age

Local anesthetics and toxicity

Blocks for infants and children

Choice of regional anesthesia in children

Regional blockade with or without general anesthesia

Techniques for performing regional anesthesia

Neuraxial blocks

Peripheral nerve blocks

Other nerve blocks

Complications of blocks and their treatment

Conclusion

Annotated references

Video clips

CHAPTER 21: Anesthesia for Fetal Intervention and Surgery

Introduction

Fetal surgery: indications, procedures, and outcomes

Anesthetic management of fetal procedures

Perioperative and procedural considerations

Future of fetal therapy and surgery

Annotated references

CHAPTER 22: Anesthesia for Premature Infants

Introduction

Background

Common problems associated with prematurity

Preoperative preparation

Induction of anesthesia

Maintenance of anesthesia

Recovery from anesthesia

Anesthesia for micropremies

Annotated references

CHAPTER 23: Anesthesia for the Full‐term and Ex‐premature Infant

Introduction

Residua and complications of prematurity

Operating room environment for the neonate

Postoperative extubation versus postoperative ventilation

Inguinal hernia

Abdominal wall defects

Esophageal atresia and tracheo‐esophageal fistula

Congenital diaphragmatic hernia

Meningomyelocele

Muscle biopsy

Resuscitation of the newborn

Annotated references

CHAPTER 24: Anesthesia for the Adolescent and Young Adult Patient

Introduction

Developmental/behavioral issues in the adolescent

Teen cigarette smoking

Pregnancy/reproductive issues in the adolescent and young adult

Chronic diseases in the adolescent and young adult, and transition to adult care

Obesity in the adolescent

Thyroid surgery in the adolescent

Conclusion

Annotated references

CHAPTER 25: Anesthesia for Neurosurgical Procedures

Introduction

Neuropharmacology

General anesthetic considerations

Specific anesthetic considerations

Anesthesia for pediatric epilepsy and movement disorders

Cerebrovascular anomalies

Interventional neuroradiology

CEREBRAL PROTECTION, RESUSCITATION, AND OUTCOME

Annotated references

CHAPTER 26: Anesthesia for Thoracic Surgery

Introduction

Pathophysiology of one‐lung ventilation

Anesthetic requirements for thoracic anesthesia

Analgesic requirements for thoracic surgery

Thoracoscopy

Robotic surgery

Lung resection

Thoracic surgical lesions

Conclusion

Acknowledgments

Annotated references

27 Anesthesia for Congenital Heart Disease

Introduction

Pathophysiology of congenital heart disease

Preoperative assessment and preparation

Principles of anesthetic management

Choice of anesthetic agents

Anesthesia for cardiac surgery

Anesthesia for non‐cardiac surgery

Anesthesia for interventional procedures

Pathophysiology and anesthetic management of specific lesions and procedures

Annotated references

CHAPTER 28: Anesthesia for Non‐cardiac Surgery in Patients with Congenital Heart Disease

Introduction

Congenital heart disease and perioperative risk

High‐risk lesions

Special scenarios

Antibiotic prophylaxis for infective endocarditis

Perioperative planning

Annotated references

CHAPTER 29: Anesthesia for Spinal Surgery in Children

Introduction

Developmental and gross anatomy of the spine

Surgical procedures on the pediatric spine

Preoperative and intraoperative care

Postoperative care including pain management

Summary

Annotated references

CHAPTER 30: Anesthesia for Transplantation

Introduction

Care of organ donors after neurological death

Donation after cardiac death

Immunosuppression for pediatric solid organ transplantation

Liver transplantation

Renal transplantation

Heart transplantation

Lung transplantation

Intestinal, multivisceral, and pancreatic transplantation

Complications following transplant

Post‐transplant surgery

Quality of life

Annotated references

CHAPTER 31: Anesthesia for Abdominal Surgery

Introduction

ABDOMINAL SURGICAL CONDITIONS

Intussusception

Biliary atresia

Malrotation of the bowel and intestinal atresia

Inflammatory bowel disease

Abdominal masses: major abdominal/liver tumors and pheochromocytoma

Inguinal hernia

Pyloric stenosis

Appendicitis

SPECIFIC INERVENTIONAL AND SURGICAL PROCEDURES

Gastrointestinal/endoscopic retrograde cholangiopanceatography/endoscopy procedures

Nissen fundoplication and gastrostomy

Laparoscopic surgery

Annotated references

CHAPTER 32: Anesthesia for Pediatric Urological Procedures

Introduction

Development of urological anomalies

Bladder exstrophy

Posterior urethral valves

Circumcision

Hypospadias

Cryptorchidism

Testicular torsion

Vesicoureteral reflux procedures

Ureteropelvic junction obstruction

Wilms tumor

Chronic renal failure and dialysis

Priapism

Robotic surgery

Annotated references

CHAPTER 33: Anesthesia for Orthopedic Surgery

Introduction

Clubfoot

Hip dysplasias/dislocations

Spica cast

Blount disease

Slipped capital femoral epiphysis

Hand surgery

Supracondylar femur fractures

Septic arthritis

Osteogenesis imperfecta

Arthrogryposis

Cerebral palsy

Neuromuscular diseases

Juvenile rheumatoid arthritis

Genetic syndromes and orthopedic surgery

Fractures in healthy children: supracondylar humerus fracture

Sports medicine procedures in teenaged athletes

Annotated references

CHAPTER 34: Otolaryngological and Dental Surgery

Introduction

Approach to the child with an upper respiratory tract infection

Anesthesia for specific surgical procedures

Ear surgery

Nasal and pharyngeal surgery

Endoscopy of the larynx, trachea and bronchial tree

Airway foreign bodies

Laser microlaryngeal surgery

Subglottic stenosis and tracheal reconstructive surgery

Dental procedures

Annotated references

CHAPTER 35: Anesthesia for Ophthalmological Surgery

Introduction

Anesthetic effects of commonly used ophthalmic drugs

Extraocular conditions

Intraocular conditions

Annotated references

CHAPTER 36: Anesthesia for Plastic and Craniofacial Surgery

Introduction

Craniofacial embryology

Facial anomalies

Physiological sequelae of craniofacial malformations

Craniofacial reconstruction: surgical procedures

Anesthesia for craniofacial reconstruction

Features of the craniofacial procedure

Anesthesia for cleft lip and cleft palate reconstruction

Postoperative management

Annotated references

Further reading

CHAPTER 37: Pain Management in Children

Introduction

Developmental neurophysiology of pain

Pain assessment in infants and children

Developmental analgesic pharmacology in infants and children

Local anesthetics and regional anesthesia

Acute pain services

Painful conditions in infants and children

Summary

Annotated references

CHAPTER 38: Outpatient Anesthesia

Introduction

Design and setting for outpatient surgery

Appropriate procedures

Patient selection

Preoperative evaluation/screening

Preoperative preparation

Anesthetic agents and techniques

Emergence agitation and delirium

Pain management

Postoperative nausea and vomiting

Recovery and discharge

Complications of outpatient anesthesia

Summary

Annotated references

CHAPTER 39: Anesthesia for Trauma

Introduction

Prehospital care

Organization of trauma services

Primary and secondary evaluation

Airway management

Vascular access

Massive transfusion and fluid resuscitation

Intraoperative management

Anesthetic considerations for specific injuries

Child abuse and trauma

Postoperative management and ICU transfer

Education and outcomes in pediatric trauma

Annotated references

CHAPTER 40: Anesthesia for Burns

Introduction

Pathophysiology

Fluid resuscitation in the acutely burned patient

Anesthetic management for acute burn procedures

Pain control

Anesthetic management for reconstructive procedures

Annotated references

CHAPTER 41: Anesthesia and Sedation Outside the Operating Room

Introduction

Specific NORA sites

Clinic and office procedures

Anesthetic management of NORA procedures

Resuscitation

Difficult airway management in NORA sites

Blood loss management outside the operating room

Selection of anesthetic technique and agents

Safety issues

Quality improvement and simulation in NORA locations

Future directions of pediatric sedation

Summary

Annotated references

CHAPTER 42: Pediatric Intensive Care

Pediatric intensive care unit team

Relationship between the PICU and operating room

Family‐centered care in the PICU

Continuous quality improvement in the PICU

Organ system function and failure

Cardiovascular disease

Respiratory disease

Extracorporeal life support

Neurological diseases

Renal diseases

Hematology/oncology

Transfusion therapy

Coagulopathy in the critically ill child

Endocrine disease

Gastroenterology and nutrition

Immunity and infection

Transport of the critically ill pediatric patient

PICU outcomes

Annotated references

CHAPTER 43: Anesthesia for the Patient with a Genetic Syndrome

General approach to patients with a genetic syndrome

Management of common important syndromes

Listing of 120 syndromes encountered by the pediatric anesthesiologist

Annotated references

CHAPTER 44: Pediatric Anesthesia in Developing Countries

Organization

Equipment procurement and maintenance

Evaluation of patients

Types of surgery

Anesthesia monitoring and drugs

Postoperative pain relief

Follow‐up care

Summary

Annotated references

CHAPTER 45: Clinical Complications in Pediatric Anesthesia

Introduction

Cardiac arrest

Control of temperature

Malignant hyperthermia

Propofol infusion syndrome

Local anesthetic toxicity and intralipid administration

Nerve and positioning injuries

Perioperative vision loss

Anaphylaxis and its treatment

Management and treatment

Latex allergy

Annotated references

CHAPTER 46: Impact of Pediatric Surgery and Anesthesia on Brain Development

Introduction

Nociception and stress in the neonate

Developmental anesthetic‐induced neurotoxicity

Safer anesthetic techniques and potential mitigating strategies

Interspecies comparison

Clinical evidence for anesthetic neurotoxicity

Confounders and anesthetic protection

Co‐morbidities and environmental factors

Ongoing and future research

Summary

Annotated references

CHAPTER 47: Patient Simulation and its Use in Pediatric Anesthesia

Introduction

History of simulation

Creating a simulation educational approach

Uses of simulation

Types of simulation

Organizing and running high‐fidelity simulation sessions

Pediatric anesthesia simulation

Measuring the effectiveness of simulation learning

Summary

Annotated references

CHAPTER 48: Databases, Registries, and Outcome Research in Pediatric Anesthesia

Introduction

Outcome research from data registries

“Big Data” in anesthesia research

Databases and registries specific to pediatric anesthesia

Pediatric anesthesia data‐based outcomes analysis from single institutions

Artificial intelligence and machine learning

Data registry concerns

Future uses of large registry data and outcomes analysis

Summary

Annotated references

CHAPTER 49: Electronic Anesthesia Records: Anesthesia Information Management Systems

Introduction

AIMS software, hardware, and “peopleware”

Clinical decision support in AIMS and EHRs

AIMS: potential benefits and perceived drawbacks

Secondary use of AIMS data

AIMS data quality and outcomes

AIMS and pediatric anesthesia research

Future directions

Annotated references

CHAPTER 50: Operating Room Safety, Communication, and Teamwork

Introduction

Non‐technical skills

Medical team training

Hand‐offs

Checklists

Medication safety

Value‐based programs

Safe systems in the operating room

Summary

Annotated references

APPENDIX A: Appendix: Pediatric Anesthesia Drugs and Other Treatments in the Perioperative Period

References

APPENDIX B: Appendix: Pediatric Normal Laboratory Values

Clinical chemistry reference values (United States/conventional units)

Hematology reference ranges (United States/conventional units)

Clinical coagulation laboratory reference ranges (United States/conventional units)

Reference

Index

End User License Agreement

List of Tables

Chapter 1

Table 1.1 Graduated involvement of minors in medical decision making

Table 1.2 Communicating quantitative risk to patients [19–21]

Chapter 3

Table 3.1 Pediatric anesthesiology fellowship case minimums

Chapter 5

Table 5.1 Stages of human development with corresponding events in cardiac de...

Chapter 6

Table 6.1 Normal heart rates and systolic blood pressure as a function of age

Table 6.2 Summary of major differences between neonatal and mature hearts

Chapter 7

Table 7.1 Composition of human fetal lung fluid compared to other body fluids

Table 7.2 Standards for lung mechanics and pulmonary function in infants, chi...

Chapter 8

Table 8.1 Central nervous system embryogenesis

Table 8.2 Main physiological responses to pain

Table 8.3 Perioperative electrophysiological monitoring [157–167]

Chapter 9

Table 9.1 Common abnormalities of the urinary tract and their embryological o...

Table 9.2 Etiology of acute kidney injury in neonates and children

Table 9.3 Etiology and prevalence of established renal failure in children in...

Chapter 10

Table 10.1 Hepatic metabolism of the agents used in anesthesia and perioperat...

Table 10.2 Hepatic metabolism of the agents used in anesthesia and perioperat...

Table 10.3 Gases and volatile anesthetics: physicochemical properties and pha...

Table 10.4 Benzodiazepines and intravenous anesthetics. Physicochemical prope...

Table 10.5 Propofol and ketamine infusion scheme

Table 10.6 Opioids and acetaminophen. Physicochemical properties and pharmaco...

Table 10.7 Muscle relaxants and reversal agents. Physicochemical properties a...

Table 10.8 Physicochemical properties of local anesthetics

Table 10.9 Bupivacaine, levobupivacaine, and ropivacaine pharmacokinetics aft...

Chapter 11

Table 11.1 Composition of body fluid compartments

Table 11.2 Estimate of circulating blood volume

Table 11.3 Hourly or daily maintenance fluid requirements of children based o...

Table 11.4 American Society of Anesthesiologists (ASA) NPO guidelines

Table 11.5 Composition of frequently used intravenous fluids [33]

Table 11.6 Clinical manifestations of dehydration

Chapter 12

Table 12.1 Coagulation factor numbers and synonyms

Table 12.2 von Willebrand disease

Table 12.3 Organ system involvement in sickle cell disease

Table 12.4 ABO blood group system

Table 12.5 ABO compatibility

Table 12.6 Available blood products

Table 12.7 Laboratory tests used to screen donated blood for pathogens

Table 12.8 Immune‐mediated hazards of transfusion

Chapter 13

Table 13.1 Phases of cardiac arrest and resuscitation

Chapter 14

Table 14.1 mYPAS short form

Table 14.2 Comparison of classes of drugs available for premedication [31,133...

Table 14.3 The pediatric anesthesia emergence delirium (PAED) scale

Chapter 15

Table 15.1 Outcomes of the pediatric perioperative surgical home

Chapter 17

Table 17.1 American Society of Anesthesiologists physical status classificati...

Table 17.2 Fasting intervals before elective surgery

Table 17.3 Tissue/blood partition coefficients for inhaled agents and nitrous...

Table 17.4 Time to wash out inhalational anesthetics to less than 10 ppm

Table 17.5 Airway equipment

Chapter 18

Table 18.1 I‐SBARQ communication tool.

Table 18.2 I PASS the BATON communication tool

Table 18.3 Modified Aldrete score. Nine or more points are required for recov...

Table 18.4 Post Anesthetic Discharge Scoring System (PADSS) discharge criteri...

Table 18.5 Pediatric Anesthesia Emergence Delirium (PAED) scale

Table 18.6 The face, legs, activity, cry, consolability (FLACC) scale [110]

Chapter 19

Table 19.1 Recommended central venous catheter sizes and lengths according to...

Table 19.2 Recommended length of superior vena cava central venous catheter (...

Table 19.3 Recommended arterial catheter sizes: radial, dorsalis pedis, poste...

Table 19.4 Recommended arterial catheter sizes: femoral, axillary arteries

Table 19.5 Derived hemodynamic parameters

Table 19.6 Derived oxygen delivery/consumption parameters

Table 19.7 Hourly intraoperative values for Wilms tumor case study

Chapter 20

Table 20.1 Adjuvants to local anesthetics for regional anesthesia in children

Table 20.2 Different regional block procedures according to patient’s age: re...

Table 20.3 Different regional block procedures according to patient’s age: re...

Table 20.4 Different regional block procedures according to patient’s age: re...

Table 20.5 Statements of evidence and grades of recommendation for ultrasound...

Table 20.6 Reduction of local anesthetic volume with ultrasound guidance

Table 20.7 Postoperative neurological syndrome (children versus adults).

Table 20.8 Local anesthetic systemic toxicity (children versus adults)

Chapter 21

Table 21.1 Postnatal survival rate in fetuses with left‐sided congenital diap...

Table 21.2 Staging of twin–twin transfusion syndrome severity

Table 21.3 Maternal complications for MOMS trial patients*

Chapter 22

Table 22.1 White blood cell count and differential count during the first 2 w...

Table 22.2 Serum bilirubin concentrations for exchange transfusion

Table 22.3 Normal arterial blood gases

Table 22.4 Arterial blood gases in normal preterm infants

Table 22.5 Heart rate in preterm infants with patent ductus arteriosus

Table 22.6 Body temperature of preterm infants during transport to and from t...

Table 22.7 Relation between heart rate and systolic blood pressure in preterm...

Table 22.8 Serum and urine glucose values and urine volume in a 1 kg infant

Table 22.9 Blood and urine glucose concentrations in term and preterm infants du...

Table 22.10 Effects of adding glucose to intravenous fluid of infants and chi...

Table 22.11 Neurological and developmental outcome of micropremies

Table 22.12 Arterial blood pressures determined non‐invasively and from an in...

Table 22.13 Vital signs during fentanyl and halothane anesthesia (23–26 weeks...

Chapter 23

Table 23.1 Recommended doses of local anesthetic agents for awake regional an...

Table 23.2 Classification of esophageal atresia and tracheo‐esophageal fistul...

Chapter 24

Table 24.1 Considerations in preoperative urine pregnancy testing in adolesce...

Table 24.2 Long‐term effects of childhood cancer

Table 24.3 Summary of recommended treatment approaches for sickle cell diseas...

Table 24.4 Characteristics of Crohn’s disease and ulcerative colitis

Table 24.5 Dosing for commonly used drugs in pediatric inflammatory bowel dis...

Table 24.6 Pathophysiological changes in organ systems associated with obesit...

Table 24.7 Effect of the pathophysiological changes in childhood obesity on d...

Table 24.8 Recommendations for dosing of commonly used drugs for obese patien...

Table 24.9 Selection criteria for bariatric surgery in adolescents

Table 24.10 Demographic and clinical characteristics of pediatric patients un...

Chapter 25

Table 25.1 Effects of volatile anesthetic agents on cerebral metabolic rate f...

Table 25.2 Effect of intravenous anesthetic agents on cerebral metabolic rate...

Table 25.3 Signs and symptoms of increased intracranial pressure (ICP) in inf...

Table 25.4 Perioperative concerns for infants and children with neurological ...

Table 25.5 Physiological effects of patient positioning for neurosurgical pro...

Table 25.6 Relative risk for venous air embolism (VAE) in neurosurgical proce...

Table 25.7 General neuroprotective principles for elevated intracranial press...

Chapter 26

Table 26.1 Device selection for one‐lung ventilation (OLV) in children

Table 26.2 Pediatric thoracic lesions

Table 26.3 Risk stratification system for pediatric patients with anterior me...

Chapter 27

Table 27.1 Simple shunts, no obstructive lesions

Table 27.2 Complex shunts (shunt and obstructive lesion)

Table 27.3 Manipulations altering pulmonary vascular resistance

Table 27.4 Effects of central shunting and pulmonary blood flow on oxygenatio...

Table 27.5 The effect of a positive pressure mechanical breath on afterload a...

Table 27.6 A classification for congenital cardiac surgical repairs

Table 27.7 Complications in specific interventional procedures undertaken in ...

Table 27.8 Parallel circulation physiology: management considerations

Table 27.9 Management considerations following a modified Fontan procedure

Table 27.10 Circumstances, etiology, and treatment strategies for patients wi...

Table 27.11 Long‐term follow‐up considerations after tetralogy of Fallot repa...

Chapter 28

Table 28.1 Cardiac lesions conferring greatest mortality and morbidity risk w...

Table 28.2 Classification of risks of Williams syndrome

Table 28.3 Risk of complications with degree of pulmonary hypertension

Table 28.4 European Society of Cardiology classification of cardiomyopathies

Table 28.5 Alternatives to pediatric sedation in magnetic resonance (MR) imag...

Table 28.6 Antibiotic regimens for dental procedures

Chapter 29

Table 29.1 Scoliosis classification and associated conditions

Table 29.2 Properties pertinent to neuromonitoring of commonly used anestheti...

Chapter 30

Table 30.1 Immunosuppression therapies used in pediatric patients following o...

Table 30.2 Clinical characteristics of pediatric liver transplant recipients,...

Table 30.3 Pathophysiology of end‐stage liver disease

Table 30.4 Classification of the severity of acute and chronic hepatic enceph...

Table 30.5 Disease‐specific anesthetic considerations for pediatric liver tra...

Table 30.6 Common complications during the preanhepatic (dissection) period

Table 30.7 Anesthetic goals during the anhepatic period

Table 30.8 Anesthetic goals during the reperfusion period

Table 30.9 Graft survival rates for pediatric renal transplantation by cohort...

Table 30.10 Heart failure staging in pediatric cardiac disease

Table 30.11 Evidence‐based indications for pediatric heart transplantation

Table 30.12 Evidence‐based indications for pediatric heart retransplantation

Table 30.13 Categorization of diagnosis for pediatric heart transplants

Table 30.14 Diagnosis in pediatric cardiac transplant recipients with congeni...

Table 30.15 Status designation for pediatric heart transplantation. Status 7 ...

Table 30.16 Multivariable analysis of continuous risk factors for mortality a...

Table 30.17 Pediatric lung transplant indications by age group, 2000–2016

Table 30.18 Contraindications to pediatric lung transplantation

Table 30.19 Recommendations regarding timing of referral to lung transplant c...

Table 30.20 Cumulative morbidity rates in pediatric lung transplant survivors...

Table 30.21 Classification of bronchiolitis obliterans syndrome

Table 30.22 Causes of intestinal failure in children

Table 30.23 Cumulative incidence of chronic renal failure according to type o...

Table 30.24 Incidence of hypertension in pediatric solid organ transplantatio...

Chapter 31

Table 31.1 Characteristics of inguinal hernias

Chapter 32

Table 32.1 Occurrence of characteristic congenital anomalies in Wilms tumor p...

Table 32.2 Wilms tumor survival rates from the Children’s Oncology Group stud...

Table 32.3 Incidence of surgical complications following surgery for Wilms tu...

Table 32.4 Comparison of the advantages and disadvantages of continuous renal...

Table 32.5 Summary of the respiratory effects of pneumoperitoneum

Table 32.6 Summary of the cardiovascular and renal effects of pneumoperitoneu...

Table 32.7 Detection and management of CO

2

embolism

Table 32.8 Detection and treatment of acute vascular injury/hemorrhage

Chapter 33

Table 33.1 Nerve supply to the hand: three branches of the brachial plexus

Table 33.2 Regional anesthetic techniques appropriate for hand surgery

Table 33.3 Osteogenesis imperfecta

Table 33.4 Preoperative considerations in osteogenesis imperfecta

Table 33.5 Anesthesia implications in arthrogryposis (consider etiology – neu...

Table 33.6 Perioperative considerations in cerebral palsy

Table 33.7 Features of myotonic dystrophy type I (Steinert’s disease)

Table 33.8 Orthopedic syndromes with potential anesthetic implications

Chapter 34

Table 34.1 Respiratory events that may occur during polysomnography

Table 34.2 Features of supraglottitis, laryngotracheobronchitis, and tracheit...

Table 34.3 Severity ranking system of obstructive sleep apnea (OSA) based on ...

Chapter 35

Table 35.1 Anesthetic effects of commonly used ophthalmological drugs

Chapter 36

Table 36.1 Nomenclature of craniosynostosis

Table 36.2 Craniosynostosis syndromes

Table 36.3 Intracranial pressure (ICP) before surgery

Table 36.4 Reported adverse events, complications, and outlier outcomes (all ...

Table 36.5 Laboratory values determined before and at each hour during cranio...

Chapter 37

Table 37.1 Premature infant pain profile (PIPP)*

Table 37.2 The faces, legs, activity, cry, and consolability (FLACC) scale

Table 37.3 Dosing guidelines for non‐opioid analgesics

Table 37.4 Initial dosing guidelines for opioids for patients over 1 year of ...

Table 37.5 Typical starting doses for patient‐controlled and nurse‐controlled...

Table 37.6 Management of common opioid side‐effects

Table 37.7 Recommended epidural infusion rates*

Chapter 38

Table 38.1 Estimates for outpatient surgery and other outpatient procedures i...

Table 38.2 Summary of the American College of Surgeons Childrens' Surgery Ver...

Table 38.3 Summary of classifications of pediatric anesthesiologists in the A...

Table 38.4 Surgical scheduling categorization system for ear, nose, and throa...

Table 38.5 Fasting guidelines for all ages in healthy patients undergoing ele...

Table 38.6 Modified Aldrete score for children

Table 38.7 Steward postanesthetic recovery score

Table 38.8 Criteria for fast‐tracking children

Chapter 39

Table 39.1 The five leading causes and number of non‐fatal unintentional inju...

Table 39.2 Flow rates* of peripheral IV catheters [34,124]

Table 39.3 Modified Glasgow coma scale for young children and infants

Table 39.4 Guidelines for acute management of pediatric traumatic brain injur...

Table 39.5 Association of inflicted trauma with physical exam findings

Chapter 40

Table 40.1 Pathophysiological changes due to burn injury

Table 40.2 Rocuronium onset, twitch recovery, and quality of intubating condi...

Table 40.3 Therapeutics studied in perioperative pain management of pediatric...

Chapter 41

Table 41.1 Anesthetic cases outside the operating room (OR), Boston Children’...

Table 41.2 Multidisciplinary programs involving the department of anesthesiol...

Table 41.3 MRI safety zones

Table 41.4 Current terminology used to label implants and devices [42]

Table 41.5 Documents from various societies about sedation services

Table 41.6 Continuum of depth of sedation: definition of general anesthesia a...

Table 41.7 “Red flags” for sedation

Chapter 42

Table 42.1 PEdiatric Logistic Organ Dysfunction 2 (PELOD‐2) score elements

Table 42.2 Continuous vasoactive medications

Table 42.3 Oxygen delivery by non‐invasive means

Table 42.4 Respiratory mechanics

Table 42.5 Adjunct therapies for status asthmaticus

Table 42.6 Pediatric acute respiratory distress syndrome (PARDS) definition

Table 42.7 At risk of pediatric acute respiratory distress syndrome (PARDS) d...

Table 42.8 Adult and pediatric Glasgow coma scales

Table 42.9 Neonatal infant pain scale (NIPS)

Table 42.10 Kidney Disease Improving Global Outcomes (KDIGO) criteria for acu...

Table 42.11 Blood component therapy

Table 42.12 Laboratory tests for the diagnosis of disseminated intravascular ...

Table 42.13 Main pathophysiological mechanisms of critical illness‐related co...

Table 42.14 Signs and symptoms of critical illness‐related corticosteroid ins...

Chapter 43

Table 43.1 Phenotypic features of the CHARGE syndrome

Table 43.2 Common presentations of the autism spectrum disorder and their man...

Chapter 44

Table 44.1 Anesthetic mortality per 100,000 and the year reported [25,121,130...

Chapter 45

Table 45.1 Causes of cardiac arrest 1998–2004 in 193 cases

Table 45.2 Mechanisms of heat loss in anesthetized infants and children (see ...

Table 45.3 Order of appearance of clinical signs

a

during 255

b

malignant hyper...

Table 45.4 Descriptive risk of malignant hyperthermia (MH)*

Table 45.5 Evolution of propofol dose and acid–base status (hours after admis...

Table 45.6 Simplified clinical identification of major peripheral nerve injur...

Chapter 46

Table 46.1 Preclinical studies in non‐human primates and human neuronal cultu...

Table 46.2 Interspecies comparison of toxic and non‐deleterious doses for inj...

Table 46.3 Behavioral or cognitive assessment following anesthetic exposure i...

Table 46.4 Outcomes studies following major surgery in neonates and infants

Chapter 47

Table 47.1 Comparison of non‐technical and team skill characteristics from th...

Table 47.2 Factors associated with effective learning

Table 47.3 High‐fidelity pediatric simulators are available in premature, neo...

Table 47.4 Debriefing “dos” and “don'ts” – factors that can facilitate or det...

Table 47.5 Example of a performance checklist for timed elements in a lost ai...

Chapter 48

Table 48.1 Pediatric Regional Anesthesia Network (PRAN) summary of single inj...

Table 48.2 Cardiac diagnoses in children with anesthesia‐related cardiac arre...

Table 48.3 Unadjusted outcomes of patients receiving versus not receiving dex...

Table 48.4 Medication errors by phase of delivery in the Wake Up Safe Registr...

Table 48.5 Selected perioperative outcomes in patients younger than versus ol...

Table 48.6 Adverse events from the Pediatric Sedation Research Consortium Rep...

Table 48.7 Association between airway management techniques and complications...

Chapter 49

Table 49.1 Adverse event classification

Chapter 50

Table 50.1 Types of medication error

List of Illustrations

Chapter 1

Figure 1.1 Obligations of pediatric anesthesiologists. Pediatric anesthesiol...

Chapter 2

Figure 2.1 Pediatric Schimmelbusch masks (left), with gauze insert in the mi...

Figure 2.2 John Snow and his inhaler showing the waterbath (right).

Figure 2.3 Edward Henry Embley.

Figure 2.4 CIG Boyle machine, 1963.

Figure 2.5 Ergonomic anesthetic machine with Claire ventilator and monitor o...

Figure 2.6 Philip Ayre, Newcastle upon Tyne, England.

Figure 2.7 Jackson Rees T piece modification with his prolonged intubation t...

Figure 2.8 Ventilating with the open‐ended bag of the Jackson Rees T piece. ...

Figure 2.9 Changes in intracellular and extracellular fluid compartments (IC...

Figure 2.10 Prominent pediatric anesthetists: Canada, USA, and Britain. (A) ...

Figure 2.11 Prominent pediatric anesthetists: Australia, New Zealand. (A) Ma...

Figure 2.12 Pediatric anesthetic equipment designed by Margaret McClelland a...

Figure 2.13 Prominent anesthetists from Scandinavia, Europe, South Africa, N...

Figure 2.14 Improving results in esophageal atresia with the development of ...

Figure 2.15 Fixing a nasal tube with waterproof strapping around the tube an...

Figure 2.16 Ventilating with a low dead space mask. The mask is placed in th...

Figure 2.17 Intubation. (A) The neck is extended, the right thenar eminence ...

Figure 2.18 (A) The Stocks bullet. (B) Catheter inserted through the bullet,...

Figure 2.19 Jim Villiers.

Figure 2.20 Electromyograph recordings following 0.1 mg/kg succinylcholine i...

Figure 2.21 The position of the larynx (vocal cords) in relation to the cerv...

Figure 2.22 Lateral neck radiograph of a 2‐year‐old with Hurler syndrome sho...

Figure 2.23 Electromyographic responses in patients with abnormal cholineste...

Figure 2.24 Touring together – Great Ocean Road, Victoria, Australia. Making...

Figure 2.25 The author, Kester Brown, visiting Bangkok Children’s Hospital, ...

Figure 2.26 The first meeting of the Editorial Board and Committee of

Pediat

...

Figure 2.27 Archie Brain – inventor of the laryngeal mask airway.

Chapter 3

Figure 3.1 An example of a feedback‐related cognitive aid. This image is lam...

Figure 3.2 Parent evaluation form for pediatric anesthesiology fellows. A si...

Chapter 4

Figure 4.1 A clinical trial is a planned experiment that involves administra...

Figure 4.2 All studies investigating new drugs go through a process of precl...

Figure 4.3 The primary stages of a clinical trial. Each major phase shown as...

Figure 4.4 CONSORT 2010 flow diagram of the progress through the phases of a...

Chapter 5

Figure 5.1 Cardiogenesis in a condensed form starts with mesoderm (pink) and...

Figure 5.2 Formation of three cell layers. Cross‐section through the cranial...

Figure 5.3 Diagrammatic representation of the formation of the heart, foregu...

Figure 5.4 Folding of the embryo and formation of the heart tube. (A) The em...

Figure 5.5 Steps in looping of the heart tube. The heart tube forms ventral ...

Figure 5.6 Handedness of the cardiac loop. Scanning electron micrographs of ...

Figure 5.7 Atrial septation. Diagrammatic sketches illustrating progressive ...

Figure 5.8 Fate of the sinus venosus. (A) Dorsal view of the heart (approxim...

Figure 5.9 Formation of the cardiac chambers. (A–D) Developmental series of ...

Figure 5.10 Development of the atrioventricular (AV) and outflow tract (OFT)...

Figure 5.11 Derivatives of the cardiac neural crest cells. Cardiac neural cr...

Figure 5.12 Schematic representation of the looped heart tube. The second he...

Figure 5.13 Steps in aortic wedging. The aortic side of the outflow tract ne...

Figure 5.14 Left (LCA) and right (RCA) coronary artery development. (A) Mult...

Figure 5.15 Schematic drawings illustrating the arterial changes that result...

Figure 5.16 Diagram of Edwards’ developmental model of the aortic arch. (A) ...

Figure 5.17 Development of the pulmonary veins. (A) At 27–29 days of gestati...

Figure 5.18 Illustrations of the primordial veins of bodies (trunks) of embr...

Figure 5.19 Development of the venous system. Dorsal views of the developing...

Figure 5.20 Schematic of the general plan of the innervation of the heart. D...

Figure 5.21 Schematic presentation of cellular contribution to heart develop...

Chapter 6

Figure 6.1 Transition from fetal to mature circulation. (A) Fetal circulatio...

Figure 6.2 Changes in pulmonary artery pressure, pulmonary blood flow, and p...

Figure 6.3 (A) Isometric resting and active length–tension relationships in ...

Figure 6.4 Longitudinal sections through an adult rabbit cardiac myocyte (A)...

Figure 6.5 Anatomy of the cardiac sarcomere. (A) Basic organization of the s...

Figure 6.6 Major complexes and components of the cardiac intercalated disk. ...

Figure 6.7 Linear regression of mean arterial pressure in 1‐day‐old neonates...

Figure 6.8 Reference curves for noninvasive blood pressure for boys and girl...

Figure 6.9 Molecular structure of the β‐adrenergic receptor, demonstrating i...

Figure 6.10 A schematic classification of adrenergic receptors.

Figure 6.11 Calcium cycling and its relationship to the β‐adrenergic recepto...

Figure 6.12 Normal, mature cardiac myocyte structure.

Figure 6.13 (A) Single thick and thin filament showing the S1 cross‐bridge a...

Figure 6.14 Schematic of some major mediators of vascular tone in the pulmon...

Figure 6.15 Phospholipase C system. Diagram summarizing the major receptor‐a...

Figure 6.16 Desensitization and downregulation of the β‐adrenoreceptor (β‐AR...

Chapter 7

Figure 7.1 Schematic diagram of the fetal and postnatal stages of lung devel...

Figure 7.2 Inflammatory and remodeling responses in asthma with activation o...

Figure 7.3 (A and B) Classifying asthma severity and initiating treatment in...

Figure 7.4 Radiographic picture of bronchopulmonary dysplasia (BPD). (A) Old...

Figure 7.5 The pathogenesis of cystic fibrosis lung disease is characterized...

Figure 7.6 Factors that may contribute to small airways obstruction in early...

Chapter 8

Figure 8.1 Neurulation (see text for details). The arrows indicate the direc...

Figure 8.2 Brain development from the neural tube. The neural tube gives ris...

Figure 8.3 Asymmetrical growth of the spine and its vertebral canal causes a...

Figure 8.4 Age‐related patterns of dendritic arborization of cortical pyrami...

Figure 8.5 Descending inhibitory pathways and spinal interneurons modulate p...

Figure 8.6 Neurotransmitters found in the spinal cord modulating activity of...

Figure 8.7 Intracranial pressure waves are schematized as a product of fixed...

Figure 8.8 The spinal cord blood supply: (1) posterior spinal arteries; (2) ...

Figure 8.9 Developmental changes in cerebral blood flow. At birth, blood flo...

Figure 8.10 Cerebral metabolism, quantified by the local cerebral metabolic ...

Figure 8.11 Cerebrovascular pressure autoregulation was quantified in childr...

Figure 8.12 Pressure autoregulation and vascular reactivity can be quantifie...

Figure 8.13 The lower limit of autoregulation (LLA) is not necessarily 50 mm...

Figure 8.14 Full‐flow bypass does not protect the brain from ischemia due to...

Figure 8.15 Middle cerebral artery flow velocity (CBFV) and arterial blood p...

Figure 8.16 Arterial blood pressure (ABP) and middle cerebral artery flow ve...

Figure 8.17 More than half of cerebral metabolism (CMR) is utilized for the ...

Figure 8.18 The electroencephalographic (EEG) waveforms are classically divi...

Figure 8.19 The standardized placement of scalp electrodes for a classical E...

Chapter 9

Figure 9.1 Development of the liver, gallbladder, and pancreas and their duc...

Figure 9.2 Roles for critical hepatic transporters in the formation of bile ...

Figure 9.3 Classification of biliary atresia. Type 1: atresia affecting the ...

Figure 9.4 Classification of choledochal cysts. Type I dilations may be cyst...

Figure 9.5 Basic structure and function of the gastrointestinal tract (duode...

Figure 9.6 Anatomical classification of anomalies of the esophagus and trach...

Figure 9.7 Rotation of embryonic gut.

Figure 9.8 Classification of jejunoileal atresia describes the pathology as ...

Figure 9.9 The three sets of excretory systems in an embryo during the 5th w...

Figure 9.10 Development of the permanent kidney. (A–D) Successive stages in ...

Figure 9.11 Excretion and reabsorption of water and electrolytes. Water is r...

Chapter 10

Figure 10.1 Predicted vancomycin clearances in individual premature babies. ...

Figure 10.2 The two enantiomers of bupivacaine. The chiral carbon is at the ...

Figure 10.3 α1‐Acid glycoprotein (AGP) concentrations in infants according t...

Figure 10.4 Unbound (A) and total (B) bupivacaine concentration in plasma af...

Figure 10.5 Cytochrome P450 isoforms in the liver. Relative content (A) and ...

Figure 10.6 Context‐sensitive decrement times in the rich vascularized compa...

Figure 10.7 Minimum alveolar concentration (MAC) of isoflurane, sevoflurane,...

Figure 10.8 BIS values in 6 (mean) ± 3 (SD)‐year‐old children as a function ...

Figure 10.9 Context‐sensitive decrement times of the principal agents used i...

Figure 10.10 Brain sections of the neocortex in the rhesus macaque (computer...

Figure 10.11 (A) Fentanyl and (B) morphine clearance as a function of age. I...

Figure 10.12 Morphine (

top

) and M‐6‐G (

bottom

) concentrations in the central...

Figure 10.13 A schematic representation of the neuromuscular junction. The e...

Figure 10.14 Difference in pharmacodynamics of muscles after injecting rocur...

Figure 10.15 Duration of sciatic nerve blocks in rats after an injection of ...

Figure 10.16 Simulations of the plasma concentration observed after extravas...

Chapter 11

Figure 11.1 Structure of the nephron.

Figure 11.2 Schematic representation of body fluid compartments as a percent...

Figure 11.3 Body compartments: fetus to adult. Total body water, extracellul...

Figure 11.4 The Starling hypothesis states that fluid flux at the capillary ...

Figure 11.5 Comparison of energy expenditure in basal and ideal state. Energ...

Figure 11.6 Hyponatremia. GI, gastrointestinal; SIADH, syndrome of inappropr...

Figure 11.7 Hypernatremia.

Figure 11.8 Hypokalemia.

Figure 11.9 Hyperkalemia. ACE, angiotensin‐converting enzyme; IV, intravenou...

Figure 11.10 Changes in electrocardiogram with increasing hyperkalemia.

Chapter 12

Figure 12.1 Primary hemostasis: platelet adhesion, activation, and aggregati...

Figure 12.2 Secondary hemostasis: the coagulation cascade.

Figure 12.3 Secondary hemostasis: the cell‐based model. (A) Initiation of th...

Figure 12.4 Comparison of the coagulation cascade and the cell‐based model o...

Figure 12.6 Coagulation factor levels in full‐term infants. vWF, von Willebr...

Figure 12.5 Coagulation factor levels in full‐term infants and with age. HMW...

Figure 12.7 Coagulation inhibitor levels in full‐term infants. AT, antithrom...

Figure 12.8 Portion of the coagulation cascade examined by the prothrombin t...

Figure 12.9 Portion of the coagulation cascade examined by the activated par...

Figure 12.10 Portion of the coagulation cascade examined by the thrombin tim...

Figure 12.11 TEG® tracing.

Figure 12.12 Pediatric massive transfusion protocol. Cryo, cryoprecipitate; ...

Chapter 13

Figure 13.1 Pediatric cardiac arrest algorithm. CPR, cardiopulmonary resusci...

Figure 13.2 Pediatric bradycardia with a pulse and poor perfusion algorithm....

Figure 13.3 Pediatric tachycardia with a pulse and adequate perfusion algori...

Figure 13.4 Pediatric tachycardia with a pulse and poor perfusion algorithm....

Figure 13.5 Pediatric septic shock algorithm. BP, blood pressure; HR, heart ...

Figure 13.6 Pediatric postresuscitation care. IO, intraosseous; IV, intraven...

Figure 13.7 Pediatric color‐coded length‐based resuscitation tape.

Figure 13.8 PALS systematic approach algorithm. CPR, cardiopulmonary resusci...

Chapter 14

Figure 14.1 Interactions between perioperative anxiety, awareness, behaviora...

Figure 14.2 Comparison of incidences obtained from differing methods of acci...

Figure 14.3 Year of accidental awareness under general anesthesia first repo...

Chapter 15

Figure 15.1 Elements of the pediatric perioperative surgical home.

Figure 15.2 Value equation for the surgical episode of perioperative care.

Figure 15.3 Structure of the perioperative surgical home (PSH). PCMH, patien...

Figure 15.4 Determination of case types with the greatest yield from a pedia...

Figure 15.5 Distribution of medical expense in pediatric practice.

Chapter 16

Figure 16.1 On the lateral surface of the 5‐week‐old, 4.0 mm embryo, one can...

Figure 16.2 The picture is viewed as if the patient is facing the examiner w...

Figure 16.3 Prior to the onset of puberty, boys and girls have relatively si...

Figure 16.4 Distance between vocal cords and carina as a function of weight ...

Figure 16.5 Although visualization of pharyngeal structures correlates with ...

Figure 16.6 Sizing the oral airway, showing the pharyngeal tip projecting ju...

Figure 16.7 Sizing the nasopharyngeal airway, showing the pharyngeal tip pro...

Figure 16.8 Two‐handed mask technique.

Figure 16.9 Oral and nasopharyngeal airways can be attached to a 15 mm trach...

Figure 16.10 The glottis can be externally manipulated by using the fifth fi...

Figure 16.11 Proper taping of the nasal RAE tracheal tube to avoid pressure ...

Figure 16.12 The Microcuff endotracheal tube. There is no Murphy eye, enabli...

Figure 16.13 Ultrasound of the larynx. (A) Transverse image at the level of ...

Figure 16.14 Ultrasound of the trachea. (A) This structure comes into sight ...

Figure 16.15 A simple acronym (AVAD: Anesthesia, Ventilation, Adjuncts, Devi...

Figure 16.16 One example of a standard equipment and medication set‐up for a...

Figure 16.17 A bronchoscope adaptor is placed on the 15 mm connector of the ...

Figure 16.18 Pediatric Airtraq® intubating device.

Figure 16.19 GlideScope® Cobalt and disposable plastic blade.

Figure 16.20 The tracheal tube on the left is “reverse loaded” by rotating t...

Figure 16.21 C‐MAC® videolaryngoscope. Fiberoptics and a high‐resolution vid...

Figure 16.22 The Bonfils (two scopes on the left) and Brambrink (two scopes ...

Figure 16.23 The Shikani Pediatric Optical Stylet. See text for details.

Figure 16.24 Lighted stylets for use with tube diameters less than 3.5 mm ca...

Figure 16.25 Difficult Airway Society algorithms. (A) Difficult mask ventila...

Chapter 17

Figure 17.1 Inhalational induction without using a facemask.

Figure 17.2 Algorithm to diagnose and manage laryngospasm in children.

Figure 17.3 Age and the minimum alveolar concentration (MAC) of isoflurane f...

Chapter 18

Figure 18.1 A modern pediatric PACU with open design, immediate adjacency to...

Figure 18.2 An alternative pediatric PACU providing more privacy and less no...

Figure 18.3 A standard emergency cart centrally located within the PACU with...

Figure 18.4 Lateral recovery position with airway open to encourage forward ...

Figure 18.5 Algorithm for prevention and treatment of emergence delirium (ED...

Figure 18.6 OUCHER pediatric pain scale for children ages 3–12 years. (A) Af...

Chapter 19

Figure 19.1 The fetal circulation. A catheter placed in the umbilical vein s...

Figure 19.2 Sites for central venous cannulation of the superior vena cava. ...

Figure 19.3 (A) Postoperative chest radiograph with the tip of a right inter...

Figure 19.4 Transesophageal echocardiographic image of the superior vena cav...

Figure 19.5 Insertion of a radial arterial catheter in an infant. (A) The ra...

Figure 19.6 Greater saphenous vein (GSV) peripheral access using ultrasound ...

Figure 19.7 (A) Ultrasound‐guided puncture of the internal jugular vein in a...

Figure 19.8 (A) Radial artery in short‐axis view. (B) Radial artery in long‐...

Figure 19.9 Progression of the arterial pressure tracing from the root of th...

Figure 19.10 (

Top panel

) The arterial pressure tracing with depressed (A) an...

Figure 19.11 ECG demonstrating normal sinus rhythm in the first third of the...

Figure 19.12 Plethysmographic signal variation versus pulse pressure variati...

Figure 19.13 Central venous oxyhemoglobin saturation (ScvO

2

) in the superior...

Figure 19.14 EZ IO® intraosseous infusion system. (A) Driver, needle selecti...

Figure 19.15 Common capnography variants. (A) Normal: note rapid upslope and...

Figure 19.16 Respiratory monitoring. (A) Standard modern anesthesia machine ...

Figure 19.17 Point‐of‐care monitor for blood gases, electrolytes, hematocrit...

Figure 19.18 Absorption spectrum of oxyhemoglobin, deoxyhemoglobin, water, a...

Figure 19.19 (A) Bilateral NIRS probes on an infant. (B) Four‐channel NIRS m...

Figure 19.20 NIRS method. A light or laser‐emitting diode emits light that p...

Figure 19.21 Different NIRS probes for neonate cerebral 1–4 kg (

far left

), n...

Figure 19.22 Typical changes in regional cerebral oxygen saturation (rSO

2

) d...

Figure 19.23 Principles of somatic NIRS. In a neonate or small infant, a NIR...

Figure 19.24 Relationship between somatic rSO

2

–cerebral rSO

2

difference, and...

Figure 19.25 Pattern of cerebral rSO

2

during deep hypothermic circulatory ar...

Figure 19.26 Frequency of rSO

2

values recorded at 1 min intervals in the fir...

Figure 19.27 Intracardiac air embolus diagnosed by portable transthoracic ec...

Figure 19.28 Ultrasound images of endotracheal tube placement. (A) Esophagea...

Figure 19.29 Lung ultrasound images in pediatric cardiac surgery patients. C...

Figure 19.30 Gastric ultrasound to assess fluid presence and content. (A) Em...

Chapter 20

Figure 20.1 The major proteins involved in binding and the relationship betw...

Figure 20.2 Rate dependence of QRS widening. QRS duration was measured at va...

Figure 20.3 QRS widening as a function of bupivacaine concentration in the p...

Figure 20.4 Bony landmarks for a caudal block. See text for further details....

Figure 20.5 Cutaneous landmarks and needle injection for a caudal block. See...

Figure 20.6 Ultrasound imaging of the caudal region. (A) Before local anesth...

Figure 20.7 Ultrasound imaging of the epidural region. (A) Transverse view. ...

Figure 20.8 The interscalene region. (A) Anatomy. (B) Ultrasound imaging. Th...

Figure 20.9 The supraclavicular region. (A) Anatomy. (B) Ultrasound imaging....

Figure 20.10 The axillary region. (A) Anatomy. (B) Ultrasound imaging. The u...

Figure 20.11 The femoral region. (A) Anatomy. (B) Ultrasound imaging. With t...

Figure 20.12 The gluteal sciatic region. (A) Anatomy. (B) Ultrasound image. ...

Figure 20.13 The popliteal sciatic region. (A) Anatomy. (B) Ultrasound image...

Figure 20.14 Anatomy and landmarks of a needle approach for a penile block. ...

Figure 20.15 Ultrasound imaging of the penile block region. (A) Placement of...

Figure 20.16 The abdominal region. (A) Anatomy. (B) Ultrasound imaging. Afte...

Figure 20.17 The transversus abdominis plane (TAP) region. (A) Anatomy. (B, ...

Figure 20.18 Anatomical view of quadratus lumborum (QL) block (anterior, lat...

Figure 20.19 Probe position for anterior quadratus lumborum block. The conve...

Figure 20.20 (A) Ultrasound image of anterior quadratus lumborum (QL) block ...

Figure 20.21 The paravertebral region. (A) Ultrasound anatomy. The paraverte...

Chapter 21

Figure 21.1 Schematic of video‐assisted fetal endoscopic (FETENDO) fetal bal...

Figure 21.2 (A) Fetoscopic images of tracheal balloon insertion. (

Left colum

...

Figure 21.3 (A) Normal angioarchitecture (cotyledon). (B) Superficial view o...

Figure 21.4 Direct insertion of the fetoscope through the sheath – without c...

Figure 21.5 Open selective extraction of an acardiac twin.

Figure 21.6 Open repair of fetal myelomeningocele.

Figure 21.7 (A) Primary closure of fetal myelomeningocele. (B) Closure of fe...

Figure 21.8 Fetoscope inserted into exteriorized uterus during “hybrid” appr...

Figure 21.9 (A) Open resection of fetal congenital pulmonary airway malforma...

Figure 21.10 Developmental consequences of fetal urethral obstruction. Sever...

Figure 21.11 Illustration of ideal fetal position and unobstructed course of...

Figure 21.12 Partial delivery during EXIT procedure with airway secured and ...

Figure 21.13 Early in development. Reflex responses to noxious stimuli occur...

Figure 21.14 Later in development. Noxious stimuli (1) activate peripheral s...

Chapter 22

Figure 22.1 The effects of alkalosis on mean arterial pressure in premature ...

Figure 22.2 Aortic blood pressure of a preterm infant during periods when a ...

Figure 22.3 Changes in functional residual capacity (FRC) with bradypnea and...

Figure 22.4 Chest x‐rays of a normal preterm infant (

left

) and one with resp...

Figure 22.5 Chest x‐rays of a normal preterm infant with respiratory distres...

Figure 22.6 Systolic, diastolic, and mean arterial blood pressures and pulse...

Chapter 23

Figure 23.1 Postoperative apnea risk (A) showing variation among centers, (B...

Figure 23.2 (A) Gastroschisis. (B) Silo for gastroschisis.

Figure 23.3 Omphalocele (exomphalos major).

Figure 23.4 Esophageal atresia and tracheo‐esophageal fistula variants. (A) ...

Figure 23.5 Bronchoscopic view of a large tracheo‐esophageal fistula (TEF) a...

Figure 23.6 (A) Neonate in semiprone position, with tip of scapula and three...

Figure 23.7 (A) Thoracoscopic view of tracheo‐esophageal fistula (TEF) befor...

Figure 23.8 Chest radiograph of left congenital diaphragmatic hernia. Note l...

Figure 23.9 Operative appearance of congenital diaphragmatic hernia via left...

Figure 23.10 Neonatal resuscitation algorithm.

Figure 23.11 Case study sequence of awake spinal caudal anesthesia. (A) Baby...

Chapter 24

Figure 24.1 Structural changes in gray matter over time derived from serial ...

Figure 24.2 The four types of shunts. CV, cardiac vein; IMV, inferior mesent...

Figure 24.3 Sickle cell disease complications by age. Width and color of the...

Figure 24.4 Common clinical complications of sickle cell disease. Acute comp...

Figure 24.5 Elements of the pathophysiology of sickle cell disease and inter...

Figure 24.6 Prevalence of obesity among youth age 2–19 years, by sex and age...

Figure 24.7 Bariatric surgery procedures for adolescents. (A) Sleeve gastrec...

Figure 24.8 Endotracheal tube equipped with two pairs of electrodes (NIM® Tr...

Chapter 25

Figure 25.1 Methods of venous air embolism (VAE) detection listed from highe...

Figure 25.2 Algorithm for management of a suspected venous air embolism (VAE...

Figure 25.3 This 12‐year‐old boy was noted to have increasing headache and v...

Figure 25.4 Digital flexible ventriculoscopic images of endoscopic third ven...

Figure 25.5 MRI of child with postmeningitic hydrocephalus before and after ...

Figure 25.6 Sagittal gadolinium‐enhanced T1‐weighted MR image showing a 5‐ye...

Figure 25.7 Axial and sagittal unenhanced T1‐weighted MR image of a 9‐year‐o...

Figure 25.8 A common iMRI setup. This system uses a movable magnet and stati...

Figure 25.9 Patient being placed into movable 1.5‐T iMRI. Note the degree of...

Figure 25.10 Workflow for iMRI with stationary MRI. (A) iMRI room doors have...

Figure 25.11 MRI of cervical spine demonstrates a large extradural hematoma....

Figure 25.12 Axial non‐contrast CT showing loss of gray/white differentiatio...

Figure 25.13 This non‐enhanced axial CT reveals a typical lens‐shaped epidur...

Figure 25.15 Non‐enhanced axial CT in a 20‐year‐old with history of congenit...

Figure 25.14 Non‐contrast axial CT in a 2‐year‐old comatose boy shows a larg...

Figure 25.16 Lateral CT scan of the cervical spine of a 3‐year‐old girl foll...

Figure 25.17 Intraoperative electrode grid placement.

Figure 25.18 MRI‐guided laser interstitial thermal therapy for epilepsy. The...

Figure 25.19 MRI of stereotactic laser ablation of hypothalamic hamartoma us...

Figure 25.20 (A) Head ultrasound – grayscale and color Doppler sagittal imag...

Chapter 26

Figure 26.1 The devices available for facilitation of one‐lung ventilation i...

Figure 26.2 4 Fr Fogarty catheter within a standard 3.5 endotracheal tube.

Figure 26.3 The components of the wire‐guided endobronchial blocker (WEB).

Figure 26.4 A standard 5.0 endotracheal tube with fiberoptic bronchoscope an...

Figure 26.5 A 5 Fr wire‐guided endobronchial blocker placed alongside a stan...

Figure 26.6 Wire‐guided endobronchial blocker with bend to facilitate manual...

Figure 26.7 (A, B) Placement of extraluminal wire‐guided endobronchial block...

Figure 26.8 Visualization of wire‐guided endobronchial blocker position.

Figure 26.9 The smallest 3.5 internal diameter Univent tube available next t...

Figure 26.10 Smallest double‐lumen tubes available. Top to bottom: 28 Fr (Ma...

Figure 26.11 Chest radiograph of a newborn with congenital pulmonary airway ...

Figure 26.12 Chest CT of a newborn with congenital pulmonary airway malforma...

Figure 26.13 Chest CT of an infant with congenital lobar emphysema complicat...

Figure 26.14 Chest radiograph of a 7‐month‐old patient with anterior mediast...

Figure 26.15 Chest CT of a 7‐month‐old patient with anterior mediastinal mas...

Figure 26.16 Chest CT of a 10‐year‐old patient with anterior mediastinal mas...

Figure 26.17 An algorithm for management of anterior mediastinal mass.

Figure 26.18 Chest radiograph of a 12‐year‐old patient with pectus excavatum...

Figure 26.19 Chest CT of a 12‐year‐old patient with severe pectus excavatum ...

Figure 26.20 Chest CT of a 2‐year‐old patient with empyema, coronal view.

Figure 26.21 Chest CT of a 2‐year‐old patient with empyema, transverse view....

Chapter 27

Figure 27.1 Effects of the many determinants on central cardiac shunting at ...

Figure 27.2 Determinants of the magnitude and direction of simple central sh...

Figure 27.3 Determinants of complex shunting with (A) systemic or (B) pulmon...

Figure 27.4 Changes in PVR with changes to in PaO

2

and arterial pH.

Figure 27.5 Normal and abnormal developmental changes in the pulmonary arter...

Figure 27.6 Central shunting and blood saturations that occur normally in th...

Figure 27.7 Developmental changes in the peripheral pulmonary arterial tree ...

Figure 27.8 Isoshunt graph depicting the relation between inspired FIO

2

and ...

Figure 27.9 Cardiac catheterization findings in a normal child. Numbers in c...

Figure 27.10 Mean ratio values of arterial to inspired halothane in patients...

Figure 27.11 Lung volume impacts pulmonary vascular resistance (PVR). In the...

Figure 27.12 Positive pressure ventilation (PPV) effects on the right ventri...

Figure 27.13 Transmural aortic pressure affects left ventricular afterload. ...

Figure 27.14 Schematic diagram of a cardiopulmonary bypass circuit. This sch...

Figure 27.15 Cellular and humoral response to cardiopulmonary bypass.

Figure 27.16 Algorithm for treating catheter‐induced arrhythmias during card...

Figure 27.17 Spectrum of congenital cardiac surgical procedures performed at...

Figure 27.18 Superior cavopulmonary connection. The superior vena cava is an...

Figure 27.19 Changes in systemic arterial O

2

saturation (sat) with mixing le...

Figure 27.20 Effect of changes in PVR potentially contributing to circulator...

Figure 27.21 (A) Lateral tunnel Fontan total cavopulmonary connection. A pol...

Figure 27.22 Incidence of pleural effusions and failure (i.e. take‐down or m...

Figure 27.23 Catheterization findings in a patient with tetralogy of Fallot....

Figure 27.24 Tricuspid atresia. A plate‐like obstruction exists in place of ...

Figure 27.25 Catheterization findings in a patient with d‐transposition of t...

Figure 27.26 Arterial switch operation. (A) The aorta (Ao) and pulmonary art...

Figure 27.27 Four major subtypes of total anomalous pulmonary venous return ...

Figure 27.28 Types of atrial septal defects.

Figure 27.29 Types of ventricular septal defect.

Figure 27.30 Catheterization findings in a patient with a VSD and pulmonary ...

Figure 27.31 Truncus arteriosus – Collett and Edwards classification. In typ...

Figure 27.32 Two surgical approaches for repair of coarctation of the aorta....

Figure 27.33 Interrupted aortic arch. (A) Type A: interruption between the l...

Figure 27.34 Hypoplastic left heart syndrome (HLHS). HLHS involves a single ...

Figure 27.35 The Norwood stage I palliation with modified Blalock–Taussig sh...

Figure 27.36 Hybrid palliation in a neonate with hypoplastic left heart synd...

Figure 27.37 Pulmonary/systemic blood flow ratio versus systemic oxygen deli...

Figure 27.38 Systemic arterial oxygen saturation (SaO

2

) versus systemic oxyg...

Figure 27.39 Pulmonary/systemic blood flow ratio versus mixed venous oxygen ...

Figure 27.40 Pulmonary/systemic blood flow ratio versus systemic arterial ox...

Figure 27.41 Pulmonary/systemic blood flow ratio versus arteriovenous oxygen...

Chapter 28

Figure 28.1 Pathophysiology of left‐to‐right shunting lesions. The flow diag...

Figure 28.2 Hypoplastic left heart syndrome following the Norwood operation....

Figure 28.3 The bidirectional Glenn (superior cavopulmonary anastomosis) ope...

Figure 28.4 Fontan operation.

Figure 28.5 Fontan configurations for cases with (A) lateral tunnel Fontan, ...

Figure 28.6 Transthoracic echocardiographic apical four‐chamber view of pulm...

Figure 28.7 Pathophysiology of a pulmonary hypertensive crisis. A patient wi...

Figure 28.8 Inhaled nitric oxide (iNO) delivery system. (A) Screen showing F...

Figure 28.9 Iloprost nebulizer system. A vibrating mesh design produces the ...

Figure 28.10 Transthoracic echocardiogram of dilated cardiomyopathy. (Left) ...

Figure 28.11 Transthoracic echocardiogram of hypertrophic cardiomyopathy. Bo...

Figure 28.12 Transthoracic echocardiogram of restrictive cardiomyopathy. A s...

Figure 28.13 ECG in arrhythmogenic right ventricular dysplasia/cardiomyopath...

Figure 28.14 Balloon dilation of severe subglottic stenosis. (A) Sublgottic ...

Figure 28.15 Plastic bronchitis in a patient with Fontan circulation. (A) Br...

Chapter 29

Figure 29.1 Blood supply to the spinal cord. (A) Axial view. (B) Sagittal vi...

Figure 29.2 A “typical” thoracic vertebra. (A) Lateral aspect. (B) Superior ...

Figure 29.3 Radiographs showing the determination of the Cobb angle.

Figure 29.4 Standard long vertical posterior incision for instrumentation an...

Figure 29.5 Anterior approach for surgical exposure and instrumentation in t...

Figure 29.6 (A) Juvenile scoliosis after resection of a tumor in the chest w...

Figure 29.7 (A) Implantation of a Magec® magnetic growing rod. (B) Radiograp...

Figure 29.8 (A) Posterior–anterior and (B) lateral view of a vertical expand...

Figure 29.9 Jackson table for positioning of patients in the prone position ...

Figure 29.10 Specialized cushion or pillow used for positioning on the Jacks...

Figure 29.11 Wire reinforced endotracheal tube to prevent kinking during pro...

Figure 29.12 Two examples of intervention for MEP disappearance during scoli...

Chapter 30

Figure 30.1 Time line showing the different approaches for immunosuppression...

Figure 30.2 T‐cell activation and proliferation results from presentation of...

Figure 30.3 Surgical technique for liver transplantation. (A) Whole allograf...

Figure 30.4 Surgical technique for split‐liver graft. (A) Left lateral segme...

Figure 30.5 Primary diagnosis of pediatric renal transplant recipients by ag...

Figure 30.6 Renal transplantation in infants. The kidney is placed intra‐abd...

Figure 30.7 Heart transplant recipient diagnosis by age, 2009–2016.

Figure 30.8 Pediatric heart transplants by location, 2004–2016. CHD, congeni...

Figure 30.9 Pediatric heart transplants by recipient age distribution, 2004–...

Figure 30.10 Surgical technique for “bicaval” cardiac transplantation. (A) T...

Figure 30.11 Pediatric heart transplant survival by age.

Figure 30.12 Pediatric heart transplant survival by era, 1982–2015.

Figure 30.13 Risk factors for 1‐year mortality in pediatric heart transplant...

Figure 30.14 Relative incidence of leading causes of death in pediatric hear...

Figure 30.15 Pediatric heart transplant recipients bridged with mechanical c...

Figure 30.16 Survival of pediatric heart transplant recipients by mechanical...

Figure 30.17 Pediatric lung transplants by center volume.

Figure 30.18 Pediatric lung transplant recipient age distribution by year of...

Figure 30.19 (A) End‐to‐end right bronchial anastomosis. (B) End‐to‐end righ...

Figure 30.20 Key operative aspects involving bronchial artery revascularizat...

Figure 30.21 Freedom from bronchiolitis obliterans syndrome in pediatric lun...

Figure 30.22 Pedaitric lung transplant survival by recipient age group, 1990...

Figure 30.23 Relative incidence of leading causes of death in pediatric lung...

Figure 30.24 Types of intestinal transplantation. (A) Isolated intestinal tr...

Chapter 31

Figure 31.1 Ileocolic intussusception.

Figure 31.2 Ultrasound image of ileocolic intussusception demonstrating the ...

Figure 31.3 (A) Normal intestinal rotation. (B) Malrotation without volvulus...

Figure 31.4 Operative steps of Ladd procedure. (A) The bowel is assessed and...

Figure 31.5 Laparoscopic view of a right inguinal hernia in a 2‐month‐old ch...

Figure 31.6 Pyloromyotomy. Note that the pyloric muscle has been partially t...

Figure 31.7 Pathophysiology of pyloric stenosis.

Figure 31.8 Pathophysiology of appendicitis.

Figure 31.9 Advantages and disadvantages of open and laparoscopic procedures...

Chapter 32

Figure 32.1 Features of classic bladder exstrophy (A, male; B, female): low ...

Figure 32.2 Modified Buck’s traction. The child is positioned with weights m...

Figure 32.3 Placement of a tunneled caudal epidural catheter. (A) The sacorc...

Figure 32.4 Robotic surgical system. The surgeon sits at a control console r...

Figure 32.5 Patient positioning for robotic surgery. Lateral view of patient...

Figure 32.6 Intraoperative placement of the camera and instrument ports for ...

Figure 32.7 The surgical field after attachment of the robotic arms to the l...

Chapter 33

Figure 33.1 Clubfoot. (A) Anterior view of a baby with clubfoot. (B) Posteri...

Figure 33.2 Pavlik harness: (A) posterior and (B) anterior aspects.

Figure 33.3 (A) Spica cast table and (B) with a child on the table.

Figure 33.4 Chick table.

Figure 33.5 Hana® fracture table.

Figure 33.6 Upper extremity peripheral nerve and osteotome innervation. (A) ...

Figure 33.7 This patient with thumb polydactyly is undergoing an axillary ne...

Figure 33.8 Child with osteogenesis imperfecta. Note abnormal chest and extr...

Figure 33.9 (A) Gartland classification of supracondylar humerus fractures. ...

Chapter 34

Figure 34.1 Hypertrophied lingual tonsil, which is difficult to appreciate o...

Figure 34.2 Child positioned for tonsillectomy and/or adenoidectomy. The tra...

Figure 34.3 Ventilating bronchoscope, optical telescope, and foreign body fo...

Figure 34.4 Acute edematous supraglottis.

Figure 34.5 A variety of foreign bodies retrieved from the airway; clockwise...

Figure 34.6 Patterns of foreign body induced airway obstruction. (A) Bypass ...

Figure 34.7 Papillomas on the vocal cord.

Figure 34.8 Cricoid split procedure. (A) A midline vertical cartilaginous in...

Figure 34.9 Laryngotracheoplasty. (A) A horizontal skin incision is made inc...

Chapter 35

Figure 35.1 Oculocardiac reflex pathway.

Figure 35.2 Magnified view of ciliary body showing aqueous humor production ...

Figure 35.3 Anatomy of the anterior chamber of the eye.

Figure 35.4 Child with leucokoria in the left eye.

Figure 35.5 Superselective injection of the ophthalmic artery showing the oc...

Figure 35.6 Images obtained in five cases showing the response of a solid re...

Figure 35.7 Retinopathy of prematurity stages. (A) Grade I: a demarcation li...

Chapter 36

Figure 36.1 Stages in the embryonic development of the face. The median and ...

Figure 36.2 Single‐suture craniosynostosis results in specific cranial defor...

Figure 36.3 Scaphocephalic child with typical biparietal narrowing and resul...

Figure 36.4 Facial scoliosis in a child with anterior plagiocephaly.

Figure 36.5 Brachycephalic head caused by bicoronal craniosynostosis.

Figure 36.6 (A) Hypotelorism in metopic synostosis. (B) Frontal keel.

Figure 36.7 Six‐year‐old boy with typical features of Apert syndrome. (A) Do...

Figure 36.8 Infant with Saethre–Chotzen syndrome. (A) Brachycephaly. (B) Met...

Figure 36.9 Fifteen‐year‐old girl with mandibulofacial dysostosis. She has n...

Figure 36.10 Twelve‐year‐old boy with frontoethmoidal encephalocele with max...

Figure 36.11 Infant with frontonasal cleft and related encephaloceles and hy...

Figure 36.12 Tessier’s classification of facial clefts. (Left) Locations of ...

Figure 36.13 Various degrees of cleft palate and lip. (A) Cleft soft palate....

Figure 36.14 Anatomical features of the larynx. (A) Normal child. (B) Child ...

Figure 36.15 After bicoronal incision for intracranial upper and midface pro...