News and Events
SmartTots: Building Community and Advocating for Important Research
SmartTots pediatric anesthetic neurotoxicity thought leaders discuss the current status of the field and provide insights into the future of the research. View on YouTube.
Pediatric Anesthetic Neurotoxicity: Finding Ways to Move Forward
Pediatric anesthetic neurotoxicity investigators discuss the state of the research and identify compelling ways to move the field forward. View on YouTube.
Pediatric Anesthetic Neurotoxicity: Designing the Proper Study
Pediatric anesthetic neurotoxicity thought leaders ponder the feasibility of designing and conducting studies that successfully isolate the effects of anesthetics from the effects of the procedure or patient’s underlying condition. View on YouTube.
Pediatric Anesthetic Neurotoxicity: The Pre-Clinical Journey
Pediatric anesthetic neurotoxicity researchers discuss how pre-clinical studies are providing insight into the mechanisms of neurotoxicity, and the impact on the future of clinical studies. View on YouTube.
Panda Symposium
SmartTots – Perspectives from the Front Lines
Millions of children undergo surgery annually. Recent studies suggest there may be reason for concern. This video, featuring Dr. Dean Andropoulos, Dr. Peter Davis, and Dr. Caleb Ing, provides a summary as to why research is needed and the type that is needed.
SmartTots and the Power of Scientific Public–Private Partnerships with the US Food and Drug Administration
As early as 1999, research began showing that general anesthetic drugs, once assumed to have no lasting effects after elimination from the body, may potentially impact brain development, prompting concerns about their safety in infants and young children. In response,...
Exposure to Operative Anesthesia in Childhood and Subsequent Neurobehavioral Diagnoses: A Natural Experiment Using Appendectomy
Using a Medicaid database from 2001 – 2018, researchers undertake an observational study that takes advantage of a natural experiment associated with appendicitis to determine whether anesthesia and surgery in childhood were specifically associated with subsequent neurobehavioral outcomes.
Long-term outcomes of early exposure to repeated general anaesthesia in children with cystic fibrosis (CF-GAIN): a multicentre, open-label, randomised controlled phase 4 trial. Claire Elizabeth Wainwright, et al. June 2024
Data gathered from the original Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) trial provided a unique, optimal opportunity to examine the long-term effects of multiple exposures to general anaesthesia in a randomised controlled trial setting.
Columbia University Physician Scientist and SmartTots Investigator, Caleb Ing, MD, publishes new findings regarding prenatal exposure to general anesthesia and subsequent risk to the child.
The association between prenatal exposure to general anaesthesia for maternal surgery during pregnancy and subsequent risk of disruptive or internalising behavioural disorder diagnosis in the child has not been well-defined.
Columbia researchers, led by Caleb Ing, MD, undertook the task to better define the association by linking a nationwide sample of pregnant women to their liveborn infants using the Medicaid Analytic eXtract (MAX, 1999e2013). Multivariate matching was used to match each child prenatally exposed to general anaesthesia owing to maternal appendectomy or cholecystectomy during pregnancy with five unexposed children. The primary outcome was diagnosis of a disruptive or internalising behavioural disorder in children. Secondary outcomes included diagnoses for a range of other neuropsychiatric disorders.
34,271 prenatally exposed children were matched with 171,355 unexposed children in the database. Prenatally exposed children were more likely than unexposed children to receive a diagnosis of a disruptive or internalizing behavioural disorder (hazard ratio [HR], 1.31; 95% confidence interval [CI], 1.23e1.40). For secondary outcomes, increased hazards of disruptive (HR, 1.32; 95% CI, 1.24e1.41) and internalising (HR, 1.36; 95% CI, 1.20e1.53) behavioural disorders were identified, and also increased hazards of attention-deficit/hyperactivity disorder (HR, 1.32; 95% CI, 1.22e1.43), behavioural disorders (HR, 1.28; 95% CI, 1.14e1.42), developmental speech or language disorders (HR, 1.16; 95% CI, 1.05e1.28), and autism (HR, 1.31; 95% CI, 1.05e1.64).
Researchers found that prenatal exposure to general anaesthesia is associated with a 31% increased risk for a subsequent diagnosis of a disruptive or internalising behavioural disorder in children. However, caution is advised when making any clinical decisions regarding care of pregnant women, as avoidance of necessary surgery during pregnancy can have detrimental effects on mothers and their children.