The History of Pediatric Anesthesiology
Christine L. Mai, MD, Paul G. Firth, MD, Myron Yaster, MD
Perhaps the first articles describing the application of
DISCUSSION ON ANÆSTHETICS IN CHILDREN. Harold Sington. Proc R Soc Med. 1926; 19(Sect Anaesth): 1–4.
BASIC PRINCIPLES OF PAEDIATRIC ANAESTHESIA. C. R. Stephen, M.D.C.M., D.A. and H. M. Slater, M.D. Montreal, Que. Canad. M.A.J. June 1949, vol. 60, p566-572.
Recalling the history of creating a sub-specialty of Anesthesiology
A history of pediatric anesthesia: a tale of pioneers and equipment Christine L. Mai and Charles J. Coté Pediatric Anesthesia Volume 22, Issue 6, pages: 511–520 June 2012
The history of pediatric anesthesia is fascinating in terms of how inventive anesthesiologists became over time to address the needs for advances in surgery. We have many pioneers and heroes. We hope you will enjoy this brief overview and that we have not left out any of the early contributors to our specialty. Obviously there is insufficient space to include everyone.
The development of Pediatric Critical Care Medicine at The Children’s Hospital of Philadelphia: an interview with Dr. John J. ‘Jack’ Downes Christine L. Mai, Mark S. Schreiner, Paul G. Firth and Myron Yaster Pediatric Anesthesia Volume 23, Issue 7, July 2013, pages: 655–664
Dr. John J. ‘Jack’ Downes (1930–), the anesthesiologist-in-chief at The Children’s Hospital of Philadelphia (1972–1996), has made numerous contributions to pediatric anesthesia and critical care medicine through a broad spectrum of research on chronic respiratory failure, status asthmaticus, postoperative risks of apnea in premature infants, and home-assisted mechanical ventilation. However, his defining moment was in January 1967, when The Children’s Hospital of Philadelphia inaugurated its pediatric intensive care unit—the first of its kind in North America. During his tenure, he and his colleagues trained an entire generation of pediatric anesthesiologists and intensivists and set a standard of care and professionalism that continues to the present day. Based on an interview with Dr. Downes, this article reviews a career that advanced pediatric anesthesia and critical care medicine and describes the development of that first pediatric intensive care unit at The Children’s Hospital of Philadelphia. [See video of Dr. Jack Downes]
The development of continuous positive airway pressure: an interview with Dr. George Gregory Pediatric Anesthesia Volume 23, Issue 1, January 2013, Pages: 3–8 Christine L. Mai, Myron Yaster and Paul Firth
George Gregory, M.D. (1934-), Professor Emeritus at the University of California, San Francisco, has made numerous contributions to neonatology and pediatric anesthesia through his research efforts and authoritative textbook, Gregory’s Pediatric Anesthesia. However he identified his defining moment as the occasion he saved the life of an infant suffering from neonatal respiratory distress syndrome by using continuous positive airway pressure (CPAP) ventilation. The development of CPAP by Gregory revolutionized the treatment of premature infants with respiratory failure. Prior to the creation of this treatment, the mortality rate of neonates with respiratory distress syndrome was >50%. The innovation markedly improved the ventilation of infants with respiratory distress and led to significant improvements in survival rates. Based on an interview with Dr. Gregory, this article describes the discovery of CPAP and reviews his career in advancing pediatric anesthesia and critical care medicine. [See video of Dr. Gregory]
Breaking the glass ceiling: an interview with Dr. Shirley Graves, a pioneering woman in medicine Pediatric Anesthesia Volume 24, Issue 4, April 2014, Pages: 440–445 Zulfiqar Ahmed, Christine L. Mai, Badrea Elder, Samuel Rodriguez and Myron Yaster
Shirley Graves M.D., D.Sc. (honorary) (1936), Professor Emeritus of Anesthesiology and Pediatrics at the University of Florida, was one of the most influential women in medicine in the 1960 and 1970s, a time when the medical profession was overwhelmingly male-dominated. In today’s society, it is hard to believe that only 50 years ago, women were scarce in the field of medicine. Yet Dr. Graves was a pioneer in the fields of pediatric anesthesia and pediatric critical care medicine. She identifies her development of the pediatric intensive care unit and her leadership in the Division of Pediatric Anesthesia at the University of Florida as her defining contributions. Through her journal articles, book chapters, national and international lectures, and leadership in the American Society of Anesthesiology and the Florida Society of Anesthesiology, she inspired a generation of men and women physicians to conquer the unthinkable and break through the glass ceiling. [See video of Dr. Shirley Graves]
History of pediatric anesthesia timeline Pediatric Anesthesia Volume 23, Issue 1, January 2013, Pages: 1–2 Christine L. Mai, Paul G. Firth and Myron Yaster This editorial comments on the History of Pediatric Anethesia Timeline article by Mai et al on pages 3–8 of this issue
The development of pediatric fluid resuscitation: an interview with Dr. Frederic A. ‘Fritz’ Berry Pediatric Anesthesia Volume 24, Issue 2, February 2014, Pages: 217–223 Christine L. Mai, Myron Yaster, Larry Chu, Zulfiqar Ahmed and Paul G. Firth Dr. Frederic A.
‘Fritz’ Berry (1935), Professor Emeritus of Anesthesiology and Pediatrics at the University of Virginia, has played a pioneering role in the development of pediatric anesthesiology through training generations of anesthesiologists. He identifies his early advocacy of balanced electrolyte solution for perioperative fluid resuscitation as his defining contribution. Based on his clinical experiences, he pushed to extend the advances in adult fluid resuscitation into pediatric practice. He imparted these and other insights to his colleagues although textbooks, book chapters, original journal publications, and decades of Refresher Course Lectures at the American Society of Anesthesiologists’ annual meetings. A model educator, clinician, and researcher, he shaped the careers of hundreds of physicians-in-training while advancing the field of pediatric anesthesiology. [See video of Dr. Fritz Berry]
The development of a specialty: an interview with Dr. Mark C. Rogers, a pioneering pediatric intensivist. Pediatric Anesthesia (Article first published online:Christine L. Mai, Paul G. Firth, Zulfiqar Ahmed, Samuel Rodriguez and Myron Yaster
Dr. Mark C. Rogers (1942–), Professor of Anesthesiology, Critical Care Medicine, and Pediatrics at the Johns Hopkins University, was recruited by the Department of Pediatrics at Johns Hopkins Hospital in 1977 to become the first director of its pediatric intensive care unit. After the dean of the medical school appointed him to chair the Department of Anesthesia in 1979, Rogers changed the course and culture of the department. He renamed it the Department of Anesthesiology and Critical Care Medicine, and developed a long-term strategy of excellence in clinical care, research, and education. However, throughout this period, he never lost his connection to pediatric intensive care. He has made numerous contributions to pediatric critical care medicine through research and his authoritative textbook, Rogers’ Textbook of Pediatric Intensive Care. He established a training programme that has produced a plethora of leaders, helped develop the pediatric critical care board examination, and initiated the first World Congress of Pediatric Intensive Care. Based on a series of interviews with Dr. Rogers, this article reviews his influential career and the impact he made on developing pediatric critical care as a specialty. [See video of Dr. Rogers]
Herbert Rackow and Ernest Salanitre: the emergence of pediatric anesthesia as a specialty in the United States. Pediatric Anesthesia (Article first published online: 4 MAR 2015) Robert H. Friesen
Herbert Rackow and Ernest Salanitre were pediatric anesthesiologists at Babies Hospital at the Columbia-Presbyterian Medical Center in New York whose work spanned three decades beginning in the early 1950s. Their pioneering research included studies of the uptake and elimination of inhalational anesthetics and of the risk of cardiac arrest in infants and children. They were actively involved in the development of pediatric anesthesia as a specialty, and their efforts contributed to inter-disciplinary collaboration and to the formation of the Section on Anesthesiology of the American Academy of Pediatrics. Their 1969 review article, ‘Modern Concepts in Pediatric Anesthesiology’, provides a fascinating view of pediatric anesthesia 50 years ago. In 1990, they were jointly awarded the Robert M. Smith award by the Section on Anesthesiology of the American Academy of Pediatrics.
The development of pediatric anesthesiology and critical care medicine at the Cincinnati Children’s Hospital: an interview with Dr. Theodore Striker.Pediatric Anesthesia (Article first published online: 18 MAY 2015) Zulfiqar Ahmed, Paul J. Samuels, Christine L. Mai, Samuel Rodriguez, Ahmed Raza Iftikhar and Myron Yaster
Dr. Theodore W. ‘Ted’ Striker (1936–), Professor of Anesthesiology and Pediatrics at the University of Cincinnati, has played a pioneering role in the development of pediatric anesthesiology in the United States. As a model educator, clinician, and administrator, he shaped the careers of hundreds of physicians-in-training and imbued them with his core values of honesty, integrity, and responsibility.
Pediatric transport medicine and the dawn of the pediatric anesthesiology and critical care medicine subspecialty: an interview with pioneer Dr. Alvin Hackel. Christine L. Mai, Zulfiqar Ahmed, Aubrey Maze, Fatima Noorulla, Myron Yaster (Article first published online: 19 MAR 2016)
Dr. Alvin ‘Al’ Hackel (1932-) Professor Emeritus of Anesthesiology, Perioperative and Pain Medicine, and Pediatrics at the Stanford University School of Medicine, has been an influential pioneer in shaping the scope and practice of pediatric anesthesia. His leadership helped to formally define the subspecialty of pediatric anesthesiology (‘who is a pediatric anesthesiologist?’) and the importance of specialization and regionalization of expertise in both patient transport and perioperative care. His enduring impact on pediatric anesthesia and critical care practice was recognized in 2006 by the American Academy of Pediatrics when it bestowed upon him the profession’s highest lifetime achievement award, the Robert M. Smith Award. Of his many contributions, Dr. Hackel identifies his early involvement in the development of pediatric transport medicine as well as the subspecialty of pediatric anesthesiology as his defining contribution. Based on a series of interviews held with Dr. Hackel between 2009 and 2014, this article reviews the early development of transportation medicine and the remarkable career of a pioneering pediatric anesthesiologist.
Fifty years of the American Academy of Pediatrics Section on Anesthesiology: a history of our specialty. Rita Agarwal, , Jennifer Riefe, Constance S. Houck. (first published online Pediatric Anesthesia 23 March 2017)
The American Academy of Pediatrics Section on Anesthesiology and Pain Medicine celebrated its 50th Anniversary in 2015. The Section was one of the first and only subspecialty organizations in anesthesiology at the time. This special article will focus on the contributions of the Section to the practice of pediatric anesthesiology in the areas of advocacy, education and member contributions. In 1986, the Section created the Robert M. Smith Award to honor those members who had made significant advances in the practice of pediatric anesthesiology. It is named after one of the Section founders, an influential educator, inventor, and researcher in our field. We will focus the latter part of the article on the Robert M. Smith award winners to illustrate the contributions of the Section and its members to the development of the field of pediatric anesthesiology.
Outstanding contribution to pediatric anesthesiology: An interview with Dr. Robert H. Friesen Mark D. Twite, Richard J. Ing, Christopher S. Nichols, Myron Yaster. (
Dr. Robert H. Friesen, (1946–) Professor of Anesthesiology, Children’s Hospital Colorado, University of Colorado, Anschutz Medical Campus, has played a pivotal and pioneering role in the development of pediatric and congenital cardiac anesthesiology. His transformative research included the study of the hemodynamic effects of inhalational and intravenous anesthetic agents in the newborn and the effects of anesthetic agents on pulmonary vascular resistance in patients with pulmonary hypertension. As a model clinician-scientist, educator, and administrator, he changed the practice of pediatric anesthesia and shaped the careers of hundreds of physicians-in-training, imbuing them with his core values of honesty, integrity, and responsibility. Based on a series of interviews with Dr. Friesen, this article reviews a career that advanced pediatric and congenital cardiac anesthesia during the formative years of the specialties. (see Accompanying video)