The number of lung transplantations is progressively increasing worldwide, providing new challenges to interprofessional teams and the intensive care units. The outcome of lung transplantation recipients is critically affected by a complex interplay of particular pathophysiologic conditions and risk factors, knowledge of which is fundamental to appropriately manage these patients during the early postoperative course. As high-grade evidence-based guidelines are not available, the authors aimed to provide an updated review of the postoperative management of lung transplantation recipients in th ..read more

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Anesthetic agents disrupt neurodevelopment in animal models, but evidence in humans is mixed. The morphologic and behavioral changes observed across many species predicted that deficits should be seen in humans, but identifying a phenotype of injury in children has been challenging. It is increasingly clear that in children, a brief or single early anesthetic exposure is not associated with deficits in a range of neurodevelopmental outcomes including broad measures of intelligence. Deficits in other domains including behavior, however, are more consistently reported in humans and also reflect ..read more

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“In commemoration of the 70th anniversary of the discovery of ether anesthesia…the noble achievement of a great son of this grand old school,” the University of Pennsylvania (crest, upper left) posthumously awarded this medallion (lower right) not to William T. G. Morton, but to a quiet, country physician from Georgia, Crawford W. Long, M.D. The glowing orations from that day are preserved in the copy of Penn’s University Bulletin held in the Wood Library-Museum Collection. Inscribed to Long, “First to Use Ether as an Anaesthetic in Surgery, March 30, 1842,” the medallion accepted by his daugh ..read more

The son of a physician-entrepreneur, young Paul Janssen (1926 to 2003, right) dreamed of creating a company that would profit from its own research efforts. When Germany occupied Belgium during World War II, Janssen secretly enrolled in college, where his love for chemistry grew. While in medical school, Janssen traveled to the United States, seeking exposure to advanced pharmacology research and winning chess matches to fund his trip. After obtaining his medical degree, he worked with several European scientists, including Nobel laureate Corneille Heymans. In 1953, “Dr. Paul” set out to achie ..read more

Complex Information for Anesthesiologists Presented Quickly and Clearly ..read more

Background Perioperative hypersensitivity reactions may be difficult to diagnose during general anesthesia. Postinduction hypotension is the most common sign but is not specific. It was recently suggested that low end-tidal carbon dioxide (ETco2) might be a marker of anaphylaxis (Ring and Messmer grades III to IV immediate hypersensitivity reactions) in hypotensive patients under mechanical ventilation. To test this hypothesis, the authors compared ETco2 in patients with a diagnosis of anaphylaxis and in patients with severe hypotension from any other cause after the induction of anesthesia. M ..read more

Background The wakeful brain can easily access and coordinate a large repertoire of different states—dynamics suggestive of “criticality.” Anesthesia causes loss of criticality at the level of electroencephalogram waveforms, but the criticality of brain network connectivity is less well studied. The authors hypothesized that propofol anesthesia is associated with abrupt and divergent changes in brain network connectivity for different frequencies and time scales—characteristic of a phase transition, a signature of loss of criticality. Methods As part of a previously reported study, 16 voluntee ..read more