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Erdoes G, Schindler E, Koster A, von Dossow V, Belciu IM, Meier S, El-Tahan MR, Nasr VG. European Pediatric Cardiac Anesthesia Fellowship Program: A First Proof of Concept. J Cardiothorac Vasc Anesth 2024; 38:1088-1091. [PMID: 38423885 DOI: 10.1053/j.jvca.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/22/2024] [Accepted: 02/03/2024] [Indexed: 03/02/2024]
Abstract
The Pediatric Cardiac Anesthesia (PCA) fellowship is a demanding training program in Europe and the United States. Successful completion of the program requires years of training in anesthesiology, a thorough understanding of cardiovascular anatomy and physiology, and extensive experience in the perioperative management of neonates and children with heart disease. In the context of the first candidate to successfully complete the PCA program in Europe, this article presents excerpts from the design and structure of the European PCA program. The PCA program is evaluated critically by both external and internal reviewers, and points are highlighted that could be included in the next version of the program.
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Affiliation(s)
- Gabor Erdoes
- Department of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Ehrenfried Schindler
- Department of Anesthesiology and Intensive Care Medicine, University Hospital Bonn, Bonn, Germany
| | - Andreas Koster
- Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center, North Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Vera von Dossow
- Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center, North Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Ioana Maria Belciu
- Institute of Anesthesiology and Pain Therapy, Heart, and Diabetes Center, North Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany
| | - Sascha Meier
- Department of Anesthesiology, University Medical Center Groningen, Groningen, The Netherlands
| | - Mohammed R El-Tahan
- Cardiothoracic Anesthesia, Anesthesia, Surgical Intensive Care and Pain Medicine, College of Medicine, Mansoura University, Mansoura, Egypt; King Fahd Hospital of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Viviane G Nasr
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA
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Zaleski KL, Nasr VG. Commentary on Anesthetic Management of an Infant with Dilated Cardiomyopathy and Congestive Heart Failure Undergoing Open Aortic Abdominal Aneurysm Repair: The Critical Role of a Dual-Trained Pediatric and Adult Cardiothoracic Anesthesiologist. J Cardiothorac Vasc Anesth 2024; 38:304-306. [PMID: 37968197 DOI: 10.1053/j.jvca.2023.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Katherine L Zaleski
- Department of Anesthesiology, Critical Care and Pain Medicine,Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Viviane G Nasr
- Department of Anesthesiology, Critical Care and Pain Medicine,Boston Children's Hospital, Harvard Medical School, Boston, MA.
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Twite MD, Nasr VG. Global training pathways in congenital cardiac anesthesiology. Paediatr Anaesth 2023; 33:999-1000. [PMID: 37697909 DOI: 10.1111/pan.14759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Affiliation(s)
- Mark D Twite
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Viviane G Nasr
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Wilkinson K, Taylor D, Murphy T. Pediatric Cardiac Anesthesia Training and Staffing in the National Health Service. Paediatr Anaesth 2023; 33:1029-1033. [PMID: 37470207 DOI: 10.1111/pan.14729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Considerable importance is attached to the process of training, appointing and retaining highly specialized pediatric anesthetists, such as those with a congenital heart disease practice. AIMS For the 10-year period from April 2012 to March 2022, we wished to establish changes in the absolute number of consultant pediatric cardiac anesthetic posts in NHS Level 1 Centres, turnover in such posts, and what training appointees had received. METHODS An email survey was sent to the Centre Representative from the Congenital Cardiac Anesthesia Network in each of the eleven NHS Level 1 Pediatric Congenital Heart Disease Centre. Further follow up was completed in order to confirm accuracy of responses. We defined a pediatric cardiac anesthetist as a consultant with a clinical practice including provision of anesthetic management for children undergoing cardiac surgery incorporating the use of cardiopulmonary bypass. RESULTS The response rate to our survey was 100%. Over the study period the number of consultants increased from 69 to 81, though three posts were unfilled as at March 2022. There were 55 departures and 65 appointees. Five consultants moved between NHS Units. 52 consultants received formal fellowship training and 13 switched into pediatric cardiac anesthesia from an existing general pediatric anesthetic post, with a period of supplementary training within their institution. Appointees reported extensive additional training variably including fellowships in general pediatric anesthesia, adult cardiac anesthesia and pediatric intensive care, both within and outside the United Kingdom. CONCLUSIONS There has been both an expansion in the number of posts, as well as considerable turnover in consultant posts in the last 10 years. Training standards which support and guide individuals as they develop a practice in this highly specialized field should reflect different routes into the speciality and could be established with the support and advice of the Congenital Cardiac Anesthesia Network.
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Affiliation(s)
- Kirstin Wilkinson
- Department of Anaesthesia, Southampton General Hospital, Southampton, UK
| | - Dan Taylor
- Department of Anaesthesia, Evelina London Children's Hospital, London, UK
| | - Tim Murphy
- Department of Anaesthesia, Bristol Royal Hospital for Children, Bristol, UK
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Goodmanson MM, Latham GJ, Landsem LM, Ross FJ. The Year in Review: Anesthesia for Congenital Heart Disease 2022. Semin Cardiothorac Vasc Anesth 2023; 27:114-122. [PMID: 37125730 DOI: 10.1177/10892532231173801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This review focuses on the literature published during the calendar year 2022 that is of interest to anesthesiologists taking care of children and adults with congenital heart disease (CHD). Four major themes are discussed: enhanced recovery after surgery(ERAS); diversity, equity, and inclusion; the state of pediatric cardiac anesthesiology as a subspecialty in the United States; and neuromonitoring for pediatric cardiac surgery.
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Affiliation(s)
- Matthew M Goodmanson
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Gregory J Latham
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Leah M Landsem
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Faith J Ross
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
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Becke-Jakob K, Disma N, Hansen TG. Practical and societal implications of the potential anesthesia-induced neurotoxicity: The safetots perspective. Best Pract Res Clin Anaesthesiol 2023; 37:63-72. [PMID: 37295855 DOI: 10.1016/j.bpa.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/01/2023] [Accepted: 04/19/2023] [Indexed: 06/12/2023]
Abstract
Key elements for safe and high-quality care in pediatric anesthesia are personal and institutional competence, perioperative maintenance of physiological homeostasis, prevention, prompt recognition, and appropriate treatment of critical situations as well as the reassurance of the parents and respecting the children's rights. Training in pediatric anesthesia should take place within the framework of harmonized curricular structures. International quality assessment and improvement projects should be encouraged and supported by collaborations. Healthy communication and providing information in a balanced way to the public and all stakeholders is an important task for pediatric anesthesia societies and individuals. The Safetots.org initiative was established to emphasize the role of the conduct of anesthesia to prevent harm, promote quality in the perioperative period, and provide safe and high-quality clinical care. This initiative considers that the prevention of complications and other well-known risk factors of perioperative care, as well as the quality of anesthesia management, have a far more important impact on outcomes following anesthesia and surgery than anesthetic drugs themselves.
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Affiliation(s)
- Karin Becke-Jakob
- Department of Anaesthesiology, Paediatric Anaesthesiology and Intensive Care, Cnopf Children's Hospital - Hospital Hallerwiese, Nürnberg, Germany.
| | - Nicola Disma
- Department of Anaesthesia, Unit for Research in Anaesthesia, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Tom Giedsing Hansen
- Department of Anaesthesiology and Intensive Care, Akershus University Hospital, Lørenskog Norway, and Faculty of Medicine, The University of Oslo, Oslo, Norway
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Erdoes G, Wouters PF, Alston RP, Schreiber JU, Bettex D, Antoniou T, Benedetto M, Bouchez S, Szegedi L, Wilkinson K, Landoni G, Treskatsch S, Matute P, von Dossow V, Van Beersel D, Unic-Stojanovic D, Momeni M, Gaudard P, Szekely A, Burtin P, Flo-Forner A, Neto CN, Fassl J, Granell M, Erb JM, Navarro-Ripoll R, Vives M, Fetouh FA, Howell SJ, Marczin N, Martinez AH, Vuylsteke A, El-Ashmawi H, de Arroyabe BML, Mukherjee C, Rex S, Paternoster G, Guarracino F, El-Tahan MR. European Association of Cardiothoracic Anesthesiology and Intensive Care (EACTAIC) Fellowship Curriculum: Second Edition. J Cardiothorac Vasc Anesth 2022; 36:3483-3500. [DOI: 10.1053/j.jvca.2022.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/11/2022]
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