Related Experiment Video
Updated: Feb 11, 2026
Non-invasive Optical Imaging of the Lymphatic Vasculature of a Mouse
Published on: March 8, 2013
Lymphatic imaging and intervention in a pediatric population: Anesthetic considerations
David R Jobes1, Lauren A Brown1, Yoav Dori2
1Department of Anesthesiology and Critical Care, Division of Cardiothoracic Anesthesiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Insights
New lymphatic imaging and intervention techniques aid severe pediatric lymphatic disorders. General anesthesia for these procedures in high-risk children requires intensive care monitoring, with 25% experiencing complications.
Area of Science:
- Pediatric Anesthesiology
- Interventional Radiology
- Lymphatic Imaging and Intervention
Background:
- Severe pediatric lymphatic disorders often require advanced diagnostic and therapeutic interventions.
- These procedures necessitate general anesthesia due to immobility requirements for accurate catheter/needle placement and patient comfort.
- Managing medically complex pediatric patients under anesthesia presents significant logistical and medical challenges.
Purpose of the Study:
- To review the anesthetic management and outcomes of pediatric patients undergoing lymphatic imaging and intervention.
- To evaluate the safety and feasibility of these procedures in a specialized pediatric center.
- To identify complications and care escalation patterns in this high-risk population.
Main Methods:
- Retrospective review of a one-year cohort of pediatric patients undergoing lymphatic procedures.
- Data collected included patient demographics, comorbidities, anesthetic details, concurrent procedures, and intensive care unit (ICU) outcomes.
- All patients received general anesthesia with paralysis and controlled ventilation.
Main Results:
- 106 anesthetics were administered to 68 pediatric patients (4 days to 17 years).
- 98% of patients were American Society of Anesthesiologists (ASA) class 3 or 4, with 79.4% having significant comorbidities.
- 76% of procedures involved concurrent interventions; 25% of patients experienced complications within 24 hours of ICU admission.
Conclusions:
- Improved lymphatic access and Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography enable treatment for severe lymphatic disorders.
- Anesthetic management for these high-risk pediatric patients is complex, often involving multiple procedures.
- Intensive care observation is crucial for managing potential complications in the immediate postoperative period.
Abstract:
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures. We reviewed a one-year cohort of all pediatric patients in a newly created Center for Lymphatic Imaging and Intervention at a tertiary care children's hospital presenting for lymphatic procedures. The patients ranged in age from 4 days to 17 years and weighed from 2.5 to 92 kg. There were 106 anesthetics for 68 patients. Patients were functionally impaired (98% ASA 3 or 4) and included significant comorbidities (79.4%). Concurrent with lymphatic imaging and intervention additional procedures were frequently performed (76%). They included cardiac catheterization, bronchoscopy, endoscopy, and drain placement (thoracic or abdominal). Paralysis and controlled ventilation was used for all interventions. Reversal of paralysis and tracheal extubation occurred in all patients not previously managed by invasive respiratory support. All patients having an intervention were admitted to intensive care for observation where escalation of care or complications (fever, hypotension, bleeding, or stroke) occurred in 25% in the first 24 hours.
More Related Videos
Related Concept Videos
01:15Development of the Lymphatic System
The first lymph sacs to form are the paired jugular lymph sacs located at the junction of the internal jugular and subclavian veins. From these sacs, lymphatic capillary plexuses extend to the thorax, upper limbs, neck, and head, eventually forming lymphatic vessels. Each jugular lymph sac maintains a...
01:03Nursing Interventions I: Taxonomy of Nursing Interventions
A nursing intervention is a treatment or action based on scientific concepts and knowledge from the nursing, behavioral, and physical sciences. Identifying and prioritizing nursing interventions based on the desired outcome...
01:22Design Consideration
The factor of safety is another key...
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions
02:04Conservation of Small Populations
01:25What is Population Genetics?