Evidence map›Paper›PMID 28217718›Full record

ArticleTranslational perioperative and pain medicine2017

Pediatric Perioperative Stress Responses and Anesthesia.

Koichi Yuki, Erika Matsunami, Kazumasa Tazawa, Wei Wang, James A DiNardo, Sophia Koutsogiannaki

Registry-linked trialAbstract read
PubMed Full text at PMC
In one paragraph

Article in Translational perioperative and pain medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06052878 (Association Between Prenatal Anesthesia Exposure and Neurodevelopmental Outcome), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06052878 completednot on this mapstarted 2023, after this paper: background citation

Association Between Prenatal Anesthesia Exposure and Neurodevelopmental Outcome : an Ambi-directional Cohort Study

Typeobservational_patient_registrySponsorUniversity Hospital, CaenRan2023 to 2024Enrolled106ConditionsNeurodevelopmental Disorders, Child BehaviorArmsParental telephone interview with standardized parental questionnaire from the "Behaviour Rating Inventory of Executive Function" (BRIEF), Parental questionnaire about their child's cognitive functioning in their daily life and medical history.
3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  18. The effect of anesthetics on toll like receptor 9.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Koichi YukiDepartment of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, USA; Harvard Medical School, Boston, USA.
Erika MatsunamiDepartment of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, USA; Harvard Medical School, Boston, USA.
Kazumasa TazawaDepartment of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, USA; Harvard Medical School, Boston, USA.
Wei WangDepartment of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, USA; Harvard Medical School, Boston, USA.
James A DiNardoDepartment of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, USA; Harvard Medical School, Boston, USA.
Sophia KoutsogiannakiDepartment of Anesthesiology, Perioperative and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, USA; Harvard Medical School, Boston, USA.

Funding

The impact of anesthetic selection on sepsis outcome and its mechanismR01GM118277 · NIGMS · BOSTON CHILDREN'S HOSPITAL · PI YUKI, KOICHI · 2016 to 2020
$1.8M
Immunomodulatory mechanism of volatile anestheticsK08GM101345 · NIGMS · BOSTON CHILDREN'S HOSPITAL · PI YUKI, KOICHI · 2012 to 2016
$950k
NIGMS NIH HHS K08 GM101345NIGMS NIH HHS R01 GM118277
6 · The paper itself

Abstract

Surgical stress responses cause an array of endocrinological, metabolic and immunological changes in patients. The landmark studies in the 1980s showed that adequate anesthesia dramatically improved the outcomes of pediatric surgical patients by attenuating stress hormonal responses, pointing out the harm of 'inadequate' anesthesia. Subsequent studies questioned the role of administering very high-dose anesthetics to further attenuate stress responses. Here we review the feature of surgical stress responses in pediatric patients including their difference from those in adult patients. Overall, pediatric patients show minimal or no resting energy expenditure change postoperatively. In adult patients, increased resting energy expenditure has been described. Pediatric patients demonstrated robust cortisol and catecholamine responses than adult patients. However, the duration of these surges is often short-lived. Systemic proinflammatory and anti-inflammatory cytokine levels have been measured. Pediatric patients showed less proinflammatory cytokine elevation, but had similar anti-antiinflamatory responses. We also review in detail the immunological changes in response to surgical stress. Based on our current knowledge, we attempted to understand the underlying mechanism how adequate anesthesia dramatically improved the outcome of patients. Although more work is needed to be done, understanding how pediatric patients respond to perioperative stress, and its mechanism and consequence will allow us to direct us into a better, perioperative management in this population.

Indexed as

anesthesiacatecholamineCortisolimmunological signatureinflammation

Identifiers

PMID28217718
PMCPMC5310630

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.