Anesthetic Related Perioperative Injury In Children
Target Investigator:
Mary C. Theroux, MD
Collaborators: Thomas L. Miller, Ph.D, Thomas Jefferson University
Andrew Costarino, Jr. M.D., Department of Anesthesia, Nemours
Mentors: Thomas H. Shaffer, MS.E., Ph.D., Nemours Biomedical Research
Robert Akins, Ph.D., Nemours Biomedical Research


We are studying anesthetic related Perioperative injuries focusing on:

  • Injury related to ventilation during thoracic surgeries
  • Injury related to per-existing conditions in children with cerebral palsy

Thoracic surgeries employ “One Lung Ventilation” in order to facilitate approach to the surgical site, by collapsing one of the two lungs. This leads to inflammatory and ischemia-reperfusion injury to both collapsed and the ventilated lungs. We have quantitated this injury related to the collapse as well as the re-expansion of the lung. We are currently examining interventions to minimize such injury. Similarly we have examined altered response to muscle relaxants in children with cerebral palsy and examined the correlation between the pre-existing neuromuscular status of children with cerebral palsy and the observed altered response. We are also examining perioperative occurrence of pancreatitis in children with cerebral palsy and designing interventions to minimize this post-operative complication.


Representative lung histology from piglets exposed to 3 hrs of one lung ventilation. Lungs that were collapsed (A) showed greater atelectasis following re-expansion and 30 minutes of bilateral ventilation, than lungs ventilated throughout the duration of the protocol (B).

Related Publications:

    Theroux, M.C., Oberman, K.G., Lahaye, J., Boyce, B., DuHadaway, D., Miller, F., Akins, R.E. Dysmorphic neuromuscular junctions associated with motor ability in cerebral palsy. Muscle Nerve 32:626-632, 2005.
    Theroux, M.C., Olivant, A., Lim, D., Bernardi, J.P., Costarino, A.T., Shaffer, T.H., Miller, T.L. Low dose methylprednisolone prophylaxis to reduce lung ventilation. Pediatr Anesth. 8:857-864, 2008.