The Pediatric Anesthesia Article of the Day and the journal Pediatric Anesthesia
Myron Yaster MD, Melissa Brooks Peterson MD, and Justin L. Lockman MD, MSEd
“It is simply impossible for busy clinicians to keep up with relevant medical literature. Even a narrow-focused specialty like pediatric anesthesiology overwhelms our ability to “keep up” with novel medical breakthroughs, revisited research in the field, important quality improvement initiatives, interesting editorials, and updated clinical guidelines. The late Dr. Ron Litman recognized this conundrum during the isolation of his own cancer treatment and set out to do something about it. He subsequently started the Pediatric Anesthesia Article of the Day (PAAD). His initial goal was to help provide concise summaries of important new articles for his colleagues at Children's Hospital of Philadelphia (CHOP), while appropriately referencing works for readers who wanted to see the originals in their full form. Naturally, he added his voice and shared his views on the significance of each publication he reviewed.1
After Dr. Litman's death, some of his friends continued the PAAD in his honor as a free resource to the worldwide pediatric anesthesia community. To date, the PAAD has over 5600 daily readers, reaching across the United States as well as into 99 countries. A multi-institutional Executive Council was formed after his death to further broaden PAAD's editorial reviews and scope, to ensure continuity and quality of the content, and to guide the long-term success of this unique endeavor.
“The PAAD Executive Council, led by Myron Yaster and his co-leads Justin Lockman and Melissa Brooks Peterson, is thrilled to announce a partnership with Pediatric Anesthesia wherein we will work in close partnership with the Journal's Editorial Board to establish a PAAD-generated list of articles of interest from across the published spectrum, as well as a recurring “best of PAAD” feature to be published in the Journal. We are hopeful that this new Journal content, based on the partnership between PAAD and Pediatric Anesthesia, will serve as a welcome fresh approach to conquering that stack of medical journals in your home or office, preserving the nature of high-quality peer reviewed research, and ultimately serving our readers and our most vulnerable patients well. We invite any interested readers to sign up for the free PAAD directly via email (https://ronlitman.substack.com).”1
Beginning today, we will on a monthly basis repost the “editors picks” from the Pediatric Anesthesia website. This may also be a good opportunity to revisit some of the PAADs by simply clicking on the attached links.
Yours in life long learning!
Myron Yaster MD, Melissa Brooks Peterson MD, and Justin L. Lockman MD MSEd
Editor's picks for the pediatric anesthesia article of the day: February 2024
Brooks Peterson M, Lockman JL, and Yaster M: Editor's picks for the pediatric anesthesia article of the day: February 2024
https://onlinelibrary-wiley-com.proxy.hsl.ucdenver.edu/doi/10.1111/pan.14899
TITLE: CRISPR/Cas: The revolution has arrived!
LINK: https://ronlitman.substack.com/p/crisprcas-the-revolution-has-arrived
Original article: Tabb M, Gawrylewki A, Delviscio J. What Is CRISPR, and Why Is It So Important? This revolutionary gene-editing system has taken science by storm. Scientific American June 22, 2021. https://www-scientificamerican-com.proxy.hsl.ucdenver.edu/video/what-is-crispr-and-why-is-it-so-important/
Original article: Kolata G. F.D.A. Approves Sickle Cell Treatments, Including One That Uses CRISPR. New York Times2023.
Summary
We are on the cusp of a revolutionary new therapy—CRIPR/Cas—which is designed to scan millions of lines of genetic code in DNA to search for new therapeutic targets for genetic diseases like sickle cell anemia, beta thalassemia, or Duchene's muscular dystrophy that were “incurable.” It may make it possible to remove genes that cause problems and insert normal genes as a fix. It will also play a role in nongenetic diseases like pain management. This PAAD provides a primer for clinicians and nonscientists alike.
TITLE: “You have chosen wisely”
LINK: https://ronlitman.substack.com/p/you-have-chosen-wisely
Original article: Lockman JL, Ambardekar AP. An Open Letter to Our Residents about Pediatric Anesthesia. American Society of Anesthesiologists Resident Component Resources, January 2024. https://www.asahq.org/education-and-career/asa-resident-component/fellowship-and-residency-insights/an-open-letter-to-our-residents-about-pediatric-anesthesia
Summary
In the United States, we are in the midst of a pediatric anesthesia fellowship crisis. Application rates are falling right at a time when many centers are short-staffed. Why are so many fellowship positions unfilled? Why are more graduates of our training programs not going into pediatric anesthesia fellowships? This PAAD is an open letter to anesthesia residents dispelling myths about fellowship training and explains the concept of “Ikigai” and how it applies to careers in pediatric anesthesiology.
TITLE: Resuscitation of infants: Can different algorithms both be right? Exploring the use of NRP vs. PALS guidelines
LINK: https://ronlitman.substack.com/p/resuscitation-of-infants-can-different
Original article: Sawyer T, McBride ME, Ades A, Kapadia VS, Leone TA, Lakshminrusimha S, Ali N, Marshall S, Schmölzer GM, Kadlec KD, Pusic MV, Bigham BL, Bhanji F, Donoghue AJ, Raymond T, Kamath-Rayne BD, de Caen A. Considerations on the Use of Neonatal and Pediatric Resuscitation Guidelines for Hospitalized Neonates and Infants: On Behalf of the American Heart Association Emergency Cardiovascular Care Committee and the American Academy of Pediatrics. Pediatrics. 2024 Jan 1;153(1):e2023064681. doi: 10.1542/peds.2023-064681. PMID: 38105696.
Summary
The single most important factor in successful newborn resuscitation is having physicians, advanced practice nurses, and nurses who come together to work as a team, with such a shared mental model. The American Heart Association CPR guidelines for neonates, particularly in the delivery room, are different for neonates (NRP) and infants (PALS). This article discusses when to make the transition from NRP to PALS.
TITLE: Airway topicalization
LINK: https://ronlitman.substack.com/p/airway-topicalization
Original article: Iliff HA, Baxter A, Chakladar A, Endlich Y, McGuire B, Peyton J. Airway topicalization in pediatric anesthesia: An international cross-sectional study. Paediatr Anaesth. 2024 Feb;34(2):145–152. doi: 10.1111/pan.14783. Epub 2023 Oct 11. PMID: 37818989.
Summary
Airway topicalization with lidocaine is commonly used in pediatric anesthesia prior to tracheal intubation and by pediatric anesthesiologists, ENT surgeons, and pulmonologists prior to laryngoscopy and bronchoscopy procedures. The recommended amount of lidocaine varies widely, ranging from 1 to 10 mg/kg. This article discusses what dose to use and the incidence of local anesthetic systemic toxicity (LAST) when the trachea is topicalized
References
1. Brooks Peterson M, Yaster M, Lockman JL. The Pediatric Anesthesia Article of the Day (PAAD): A new solution to a ubiquitous problem. Paediatric anaesthesia 2024;34(7):589. (In eng). DOI: 10.1111/pan.14879.