• Ingen resultater fundet

The “Mother of pediatric cardiac anesthesia”: An interview with Dr Dolly D. Hansen, a pioneering woman in medicine

N/A
N/A
Info
Hent
Protected

Academic year: 2022

Del "The “Mother of pediatric cardiac anesthesia”: An interview with Dr Dolly D. Hansen, a pioneering woman in medicine"

Copied!
6
0
0

Indlæser.... (se fuldtekst nu)

Hele teksten

(1)

964  

|

© 2020 John Wiley & Sons Ltd wileyonlinelibrary.com/journal/pan Pediatric Anesthesia. 2020;30:964–969.

1 | INTRODUC TION

“Dr Gross (pediatric surgeon), our patient is bleeding and we need to give some blood now!”Dr Gross ignored the anesthesiologist, Dr Dolly D Hansen, and told her to just “give saline”. “I couldn't keep up with it,” she said, and told Dr Gross, “Just look at the floor…if we don't do something, we just as well can all go home.” Finally, Dr Gross looked at the floor and then looked at Dr Hansen, and said “give blood”. He reopened the chest and found the bleeders. Dr Gross never thanked her, but he knew Dr Hansen had saved his patient. Afterwards, he insisted that she provide anesthesia to all of his patients, cardiac or non-cardiac, and he never argued with her again.

This was the beginning of Dr Dolly Hansen's illustrious cardiac career.

Over a career spanning more than 30 years, Dr Hansen pioneered the modern practice of pediatric cardiac anesthesia and inspired and trained a generation of anesthesiologists, pediatricians, and surgeons. Often con- sidered the “mother of pediatric cardiac anesthesia,” this article, based on a series of interviews, highlights her career, the environment in which she came of age, and the impact she has had on our profession.

2 | BACKGROUND AND HISTORY

Dolly D. Hansen (1935-) was born and raised in Copenhagen, Denmark.

Her mother was an accountant and her father a machine engineer who

was killed when his ship was torpedoed by a Nazi submarine during World War II. Born prematurely and declared legally blind, probably due to retinopathy of prematurity, she did not want to go to kinder- garten. “I didn't like it, I didn't learn anything, and it's dull,” she recalls telling her mother. Indeed, the school called her mother and told her that “Dolly was quite ‘stupid’ and maybe it would be better if either she waited a year or went to a school for feeble-minded children.” Her mother told the teacher that she did not understand because Dolly could read the top of the newspapers and storefront names.” “Well, she cannot do what we tell her to do,” said her teacher. So Dolly was sent to a psychologist for an IQ test, and after the results came back they stopped telling her mother how “stupid” Dolly was. Nevertheless, despite getting eyeglasses and being moved forward in the classroom, she still had difficulty seeing what was written on the blackboard and managed to get through school largely by memorizing her assignments.

Life in Denmark during the German occupation was not easy with food rations and frequent bombing raids. She was raised by her mother and grandfather, who did everything they could to main- tain a normal life for her and her brother. Interestingly, her grand- father was often out for short boat rides during the war. After the war, she learned that he had played a major role in helping Jews in Copenhagen escape the Germans and their concentration camps by frequently taking them in his boat to safety in Sweden. Fortunately, he was never discovered by the Germans.

Received: 8 June 2020 

|

  Accepted: 9 June 2020 DOI: 10.1111/pan.13949

S P E C I A L I N T E R E S T A R T I C L E

The “Mother of pediatric cardiac anesthesia”: An interview with Dr Dolly D. Hansen, a pioneering woman in medicine

Kirsten C. Odegard  | Mark A. Rockoff

Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA

Correspondence

Kirsten C. Odegard, Cardiac Anesthesia Division, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.

Email: kirsten.odegard@childrens.harvard.

edu

Abstract

Dr Dolly D. Hansen (1935-), Associate Professor in the Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital and Harvard Medical School, devoted her life to improving the perioperative care of children with congenital heart disease. She applied her knowledge of cardiovascular and pulmonary physiology and the effects on anesthetic agents in children with and without heart disease into clinical practice and thereby greatly influenced the practice of pediatric anesthesia, cardiology, surgery, and critical care medicine. As an exceptional master clinician, leader, program builder, innovator, teacher, and academic role model, she shaped the careers of hundreds of fellows and young attendings, many of whom became leaders in the field.

K E Y W O R D S

cardiac anesthesia, congenital heart defects, history

(2)

3 |  E ARLY YE ARS

Dr Hansen was one of 20 women graduating from the University of Copenhagen in 1961 with a medical degree. After graduation, her first assignment was a three-month position in anesthesia. On one of her first days on call, she responded to a cardiac arrest on the ward;

Dr Hansen did not know how to intubate or resuscitate the patient and had to call for help. Fortunately, the patient survived thanks to a nurse anesthetist also on call. She never forgot this and decided that anesthesia was the field she wanted to specialize in. After her internship, she got a job in anesthesia at Frederiksberg Hospital, one of the largest in Copenhagen. Dr Hansen was the first female resident there, and she stated, “No one really bothered me. At first they treated me like a maid, nicely I might say, but when the other male attendings realized I knew what I was doing, they accepted me and respected me.” Never did she feel neglected, bullied, or sexu- ally discriminated against, despite this being the late 1950s and early 1960s, demonstrating the strong character she always has had.

After 2 years of residency, she relocated to the University Hospital in Copenhagen for a third, extra year of anesthesia training. She did more and more pediatric anesthesia cases, initially by chance since the other attendings did not like caring for children. However, Dr Hansen realized she liked this work, was good at it, and enjoyed talk- ing and playing with the children.

During this time in Denmark, surgeons had started to do a few cardiac procedures in adult patients, mostly valve replacements and some valvotomies. The reason was that Copenhagen University Hospital had a fairly large population coming from Greenland where patients frequently presented with severe mitral disease follow- ing rheumatic fever which commonly occurred during World War II. There were no intensive care units at this time in Denmark and therefore some of the cardiac patients were extubated in the op- erating room and others went to a regular ward intubated, since the hospital had primitive ventilators which were still operational after the polio epidemics in the 1950s. Dr Hansen also suffered from polio as a child, but luckily never needed respiratory support.

However, she had a limp ever since. When asked how she kept pa- tients anesthetized while intubated, she shrugged her shoulders and said they were simply given some morphine and barbiturates.

Despite this, she does not remember patients complaining about re- call. Eventually in the late 1960s, they started doing pediatric cardiac surgery in Copenhagen, first shunts and later atrial and ventricular septal defect closures. Dr Hansen was assigned to most of these cases. Morbidity and mortality of these first pediatric cardiac cases in Copenhagen were high, and often patients could not come off the cardiopulmonary bypass (CPB) machine. The reason was unknown, but Dr Hansen wonders whether it was due to residual or uncor- rected lesions. She also readily admits that anesthesiologists did not help a whole lot “because at that time we did not know anything about the pulmonary vascular system and the systemic vascular sys- tem and their influence on different congenital heart lesions. It was only when we started to go to the cardiac catheterization labora- tory (years later) at Boston Children's Hospital (BCH) that we started

to understand vascular resistance and its importance for different congenital cardiac lesions, which made a significant change in the management of these patients.” Unfortunately, and not infrequently, many infants died on the operating table, and there was nothing that could be done because there was no extracorporeal membrane oxy- genation (ECMO) at that time.

4  | BOSTON CHILDREN ' S HOSPITAL

Despite having many patients suffer dismal outcome, Dr Hansen was intrigued by the pathophysiology of CHD and she wanted to learn more and be a part of the development of this new, very fascinat- ing, and difficult specialty. She fiercely wanted to help these children survive into adulthood. She therefore contacted Dr Robert M. Smith, Chief Anesthesiologist at BCH, and was accepted for a 1-year fellow- ship in pediatric anesthesia in 1971. Dr Hansen had high expecta- tions for this upcoming year. At the time, “the Father of Pediatric Cardiac Surgery,” Dr Robert Gross, was Chief of Surgery at BCH. He was also the first surgeon to ligate a patent ductus arteriosus (PDA) in 1938 initiating the field of pediatric cardiac surgery. However, Dr Gross was soon to retire, and BCH was looking for a new cardiac Surgeon-in-Chief. The search was difficult because the hospital did not have the best reputation for cardiac surgery at the time with major advances primarily coming from hospitals in Minnesota and Baltimore. Nevertheless, Dr William F. Bernhard, the first Director of BCH’s Cardiovascular Research Laboratory, continued to operate on small cyanotic children inside a hyperbaric chamber. (The same hy- perbaric chamber was used in an attempt to save the life of President John F. Kennedy's premature son in 1963, though the baby died on day 2 of life). The thought was that the hyperbaric chamber with its ability to provide increased oxygen would be helpful for cyanotic lesions.

The hyperbaric chamber was a huge iron “capsule” with two chambers, the first being a room where the patient and staff were initially pressurized. (Figure 1) A dive master would pressurize the chamber slowly to 3 atmospheres (approximately equivalent to a 66 foot scuba dive). Thereafter, the team would go into the next cham- ber which was the pressurized operating room, fully equipped as any operating room. After about 30 minutes to allow tissue oxygenation to increase, the operation was begun. Some neonates arrived intu- bated, but most were anesthetized in the chamber. After surgery, the patient, surgeon, anesthesiologist, and nurse had to remain in the chamber for time to allow nitrogen to dissolve. Doing cases in the hyperbaric chamber, according to Dr Hansen, was almost like a punishment; she knew if anything happened during the procedure, there was no way anyone could come and help. The hyperbaric chamber was only used until the new Cardiac Surgeon-in-Chief, Dr Aldo Castaneda, was appointed in 1972.

Dr Hansen did approximately 200 cases with Dr Castaneda in his first year at BCH. Dr Castaneda revolutionized the care of chil- dren with CHD and enhanced the spirit of innovation at the hospi- tal. Instead of doing palliating repairs with placement of shunts and

(3)

pulmonary bands, Dr Castaneda introduced complete repairs in in- fancy. He also introduced deep hypothermia and circulatory arrest with surface cooling and cooling on bypass. Due to her expertise, Dr Hansen became his favorite anesthesiologist; he respected her im- mediately. She recalled two days before Christmas and shortly after Dr Castaneda arrived that he told her: “There is a small neonate with a large VSD in severe heart failure that I want to repair, on Boxing Day (the day after Christmas), and we are using deep hypothermic cardiac arrest.” “You are doing what?” was her response, and she asked what he expected from her. He said he would see whether he could find some literature, but all he could come up with were some papers in Japanese, which only described the surgical tech- nique, with no mention of anesthesia. Given the lack of information for guidance, Dr Hansen had to quickly determine what would be the best approach. The first cases were done with oxygen, nitrous oxide, curare, ketamine, and small dosages of morphine. This was the beginning of an era when most neonates and infants undergo- ing complete repair were done under deep hypothermic circulatory arrest (DHCA). In initial years, the patients often developed jerky movements of the face and tongue (choreoathetosis) and transient seizures during the postoperative period. According to Dr Hansen, clues to neurological damage following open-heart surgery were “ig- nored” during the first decade and not actually studied until Dr Jane Newburger, a cardiologist at BCH, followed a group of infants with transposition of the great arteries (TGA) who underwent an arterial switch operation (ASO) in the early 1990s using DHCA.

Dr Bill Norwood from Brigham and Women's Hospital joined Dr Castaneda in 1976, first as Chief Fellow and then as a surgical at- tending. Dr Norwood, according to Dr Hanssen, was a very good surgeon with good hands, extremely forward-thinking and innova- tive. One day, he came up to her and said, “We are finally going to try to repair an infant with hypoplastic left heart syndrome (HLHS), and the first infant will be repaired tomorrow.” She had not even heard of HLHS, because this was a universally fatal disease for which there was no effective medical or surgical treatment. Dr Norwood was not as patient as Dr Castaneda, so he said he needed to submerge the baby in ice water to make the cooling go faster, repair thereafter

using DHCA, and warm on CPB, and then he departed. Dr Hansen was left to figure out how to do this. For the procedure, she used a green, dishwashing bucket (Figures 2 and 3) she bought at a local store. The patient came to the operating room intubated with one IV in place where prostaglandins were running and was anesthetized with morphine, halothane, and pancuronium. An arterial line and an- other IV catheter were inserted before the patient was put in a plas- tic bag and then submerged in the green bucket which was filled with ice (Figure 3). Cooling continued until the patient's core temperature was approximately 20°C. Thereafter, the baby was taken out of the bucket and plastic bag, dried off, and put on the table for surgery to start. This first HLHS was done in 1983, the start of yet another new era in the surgical correction of CHD. However, it was initially a work-in-progress. Dr Hansen described that “there were several modifications to the pulmonary shunt and a new twist for every pro- cedure done at this time, never knowing what the surgical plan was.”

Norwood started with a right ventricle to pulmonary artery (RV-PA) shunt, similar to the Sano procedure done today. Some of the shunts caused too much pulmonary blood flow and others resulted in too little. It took about two years before the “real” Norwood procedure was developed, with a modified Blalock-Taussig shunt.1 The ice bucket was used for a few years until Norwood also started to do cooling with the CPB machine. On several occasions, he came into the operating room, pouring regular table salt into the ice water to decrease the freezing point of the water. According to Dr Hansen,

“mortality was surprisingly low after the initial period of trial-and-er- ror even before ECMO.” She believes the reason might have been

“because the shunts were often very small, restricting pulmonary blood flow, and the combination with high pulmonary vascular resis- tance (PVR) was good for many patients.”

Not uncommonly though, infants developed ventricular fibrillation (VF) upon sternotomy. This was mainly due to mechanical stimulation but was often intractable, and CPB had to be initiated emergently.

Around this time, the synthetic opioid, fentanyl, was introduced to the market. The combination of high-dose fentanyl and 100% oxygen was supposed to decrease the stress response in pediatric cardiac patients F I G U R E 1  Hyperbaric Chamber at Boston Children's Hospital

1972 [Colour figure can be viewed at wileyonlinelibrary.com]

F I G U R E 2  A neonate with Hypoplastic Left Heart Syndrome, submerged in ice before surgery 1983 [Colour figure can be viewed at wileyonlinelibrary.com]

(4)

as had been demonstrated successfully in adult cardiac surgery. The anesthetic technique up until then at BCH had been a combination of morphine, halothane, and a blend of nitrous oxide and oxygen. After the transition to high-dose fentanyl and 100% O2, the outcome was worse! Dr Hansen, along with Drs. Paul Hickey and Sunny Anand, had published several papers demonstrating the benefit of high-dose nar- cotics on the stress response2-6 so it was unclear why patients were doing worse. Dr Hansen started to do some research and noted that the biggest change was the use of 100% oxygen. She postulated that 100% oxygen might decrease PVR which again caused a decrease in cardiac output. She discussed this with cardiologist, Dr Peter Lang, who experimented in the catheterization laboratory with different oxygen concentrations and discovered that PVR was very responsive to oxygen. Going back to the operating room and adding room air to the circuit instead of 100% oxygen made a tremendous difference.4

As Dr Hansen said, “This discovery and change of practice is really what I am most proud of in my career, because it really changed the outcome for these children.” (Figure 4).

Innovations and advancements continued with the first success- ful application of the ASO for D-TGA in the mid-1980s replacing the Mustard and Senning procedures at BCH led by Dr Norwood. The ASO eliminated the risk for obstruction of the pulmonary and sys- temic venous return, and made the left ventricle instead of the right ventricle the systemic chamber as with the Mustard and the Senning operations. The outcome was excellent with less than 1% mortality.

Cardiologist Newburger and colleagues followed this uniform group of patients with D-TGA over years in what became known as the Boston Cardiac Arrest study.7-10

Dr Hansen was also part of the first bidirectional Glenn (BDG) operations, Fontan operations, and many innovative interventions in the catheterization laboratory. She was an integral member of the cardiac surgical team, which would round with the Chief Surgical Fellows every morning at 6:00 AM, round on postoperative patients, and help make plans for upcoming surgeries. Since Dr Hansen had

“seen it all,” it was not uncommon if a young surgeon having difficul- ties coming off CPB, to ask for her advice.

5  | SUMMARY

Dr Dolly Hansen (Figures 5, 6 and 7) is a pioneer in pediatric cardiac anesthesia and was an integral part of most of the innovations and advancements in the field of congenital cardiac surgery since its in- ception. Dr Hansen is also one of the first female pediatric cardiac anesthesiologists who opened the door for many others to follow in her footsteps. Dr Hansen however set a very high bar for everyone, considered by some as unreachable.

F I G U R E 3  A neonate with Hypoplastic Left Heart Syndrome, ready for surgery after being cooled in ice [Colour figure can be viewed at wileyonlinelibrary.com]

F I G U R E 4  From A&A 1986:65:127-32

(5)

Dr Hansen retired in 2001 after 30 years at BCH and returned to her native Denmark. When asked why she retired, she said it was time, her eyesight was starting to fail, and she did not want to make any mistakes. She essentially devoted her life to children with CHD and to BCH, and when asked whether she would do it again, she said, “Definitely”! Always very modest, she just did what she liked and was blessed to be at the right place at the right time to be able to help move the field forward, both with her research and clinical work. Dr Hansen applied her knowledge of the physiology of CHD and the effects on anesthetic agents into practice and communi- cated these innovations with her peers and surgeons, knowledge we take for granted and still use today. Her insight, devotion, and

keen interests have had a major role in improving the outcome for countless children with CHD. She has been a model clinician-sci- entist, helping shape the careers of hundreds of fellows and young attendings.

Dr Dolly Hansen, the “Mother of Pediatric Cardiac Anesthesia,”

has played a major role in moving the whole field of pediatric cardiac anesthesia forward, and for that we should all be grateful!.1-6,11-34

ACKNOWLEDG MENT

Special thanks to Dr. Paul Hickey who always stood by her side, and Drs. Myron Yaster, Christine Mai, and Jesse Barnes for helping with the manuscript.

After Dr Dolly D. Hansen retired, a chair in pediatric cardiac an- esthesia was established in her name at BCH.

ORCID

Kirsten C. Odegard https://orcid.org/0000-0002-8996-1005

R E FE R E N C E S

1. Norwood WI, Lang P, Hansen DD. Physiologic repair of aor- tic atresia-hypoplastic left heart syndrome. N Engl J Med.

1983;308(1):23-26.

2. Hickey PR, Hansen DD, Wessel DL, Lang P, Jonas RA, Elixson EM.

Blunting of stress responses in the pulmonary circulation of infants by fentanyl. Anesth Analg. 1985;64(12):1137-1142.

3. Hickey PR, Hansen DD. Fentanyl- and sufentanil-oxygen-pan- curonium anesthesia for cardiac surgery in infants. Anesth Analg.

1984;63(2):117-124.

4. Hansen DD, Hickey PR. Anesthesia for hypoplastic left heart syn- drome: use of high-dose fentanyl in 30 neonates. Anesth Analg.

1986;65(2):127-132.

5. Hickey PR, Hansen DD. High-dose fentanyl reduces intraoperative ventricular fibrillation in neonates with hypoplastic left heart syn- drome. J Clin Anesth. 1991;3(4):295-300.

F I G U R E 5  Dr Dolly D. Hansen in the 1970s [Colour figure can be viewed at wileyonlinelibrary.com]

F I G U R E 6  Portrait of Dr Hansen in the Department of Anesthesiology, Critical Care and Pain Medicine at Boston Children's Hospital [Colour figure can be viewed at wileyonlinelibrary.com]

F I G U R E 7  Dr Dolly Hansen was a recipient of the Robert M.

Smith Award given annually by the AAP Section on Anesthesiology and Pain Medicine to a distinguished contributor to the field. Dr Hansen was presented this award by Dr Robert Smith, her mentor, at the annual SPA/AAP meeting in 2002 [Colour figure can be viewed at wileyonlinelibrary.com]

(6)

6. Anand KJ, Hansen DD, Hickey PR. Hormonal-metabolic stress re- sponses in neonates undergoing cardiac surgery. Anesthesiology.

1990;73(4):661-670.

7. Newburger JW, Silbert AR, Buckley LP, Fyler DC. Cognitive func- tion and age at repair of transposition of the great arteries in chil- dren. N Engla J Med. 1984;310(23):1495-1499.

8. McGrath E, Wypij D, Rappaport LA, Newburger JW, Bellinger DC.

Prediction of IQ and achievement at age 8 years from neurodevel- opmental status at age 1 year in children with D-transposition of the great arteries. Pediatrics. 2004;114(5):e572-e576.

9. Bellinger DC, Wypij D, duPlessis AJ, et al. Neurodevelopmental sta- tus at eight years in children with dextro-transposition of the great arteries: the Boston Circulatory Arrest Trial. J Thorac cardiovasc Surg. 2003;126(5):1385-1396.

10. Bellinger DC, Rappaport LA, Wypij D, Wernovsky G, Newburger JW. Patterns of developmental dysfunction after surgery during infancy to correct transposition of the great arteries. J Dev Behav Pediatr. 1997;18(2):75-83.

11. Neuman GG, Hansen DD. The anaesthetic management of preterm infants undergoing ligation of patent ductus arteriosus. Can Anaesth Soc J. 1980;27(3):248-253.

12. Hansen DD, Fernandes A, Skovsted P, Berry P. Cyclopropane anaes- thesia for renal transplantation. Report of 100 cases. Br J Anaesth.

1972;44(6):584-589.

13. Hickey PR, Hansen DD, Wessel DL, Lang P, Jonas RA. Pulmonary and systemic hemodynamic responses to fentanyl in infants. Anesth Analg. 1985;64(5):483-486.

14. Hickey PR, Hansen DD, Strafford M, Thompson JE, Jonas RE, Mayer JE. Pulmonary and systemic hemodynamic effects of nitrous oxide in infants with normal and elevated pulmonary vascular resistance.

Anesthesiology. 1986;65(4):374-378.

15. Hickey PR, Hansen DD, Norwood WI, Castaneda AR. Anesthetic complications in surgery for congenital heart disease. Anesth Analg.

1984;63(7):657-664.

16. Hickey PR, Hansen DD, Cramolini GM, Vincent RN, Lang P.

Pulmonary and systemic hemodynamic responses to ketamine in infants with normal and elevated pulmonary vascular resistance.

Anesthesiology. 1985;62(3):287-293.

17. Donahue PJ, Hansen DD, Mayer JE. A new complication of left atrial catheters. J Cardiothorac Anesth. 1989;3(6):757-759.

18. Hansen DD, Haberkern CM, Jonas RA, Davis PJ, McGowan FX.

Case 1--1991. Tracheal stenosis in an infant with Down's syndrome and complex congenital heart defect. J Cardiothorac Vasc Anesth.

1991;5(1):81-85.

19. Odegard KC, Schure A, Saiki Y, Hansen DD, Jonas RA, Laussen PC. Anesthetic considerations during caval inflow occlusion in children with congenital heart disease. J Cardiothorac Vasc Anesth.

2004;18(2):144-147.

20. Odegard KC, McGowan FX Jr, DiNardo JA, et al. Coagulation ab- normalities in patients with single-ventricle physiology precede the Fontan procedure. J Thorac Cardiovasc Surg. 2002;123(3):459-465.

21. Odegard KC, Laussen PC, Zurakowski D, Hornykewycz SJ, Laussen JC, Hansen DD. Distribution of ABO phenotypes in patients with congenital cardiac defects. Cardiol Young. 2008;18(3):307-310.

22. Lavoie J, Walsh EP, Burrows FA, Laussen P, Lulu JA, Hansen DD.

Effects of propofol or isoflurane anesthesia on cardiac conduction in children undergoing radiofrequency catheter ablation for tachy- dysrhythmias. Anesthesiology. 1995;82(4):884-887.

23. Lavoie J, Burrows FA, Hansen DD. Video-assisted thoracoscopic surgery for the treatment of congenital cardiac defects in the pedi- atric population. Anest Analg. 1996;82(3):563-567.

24. Laussen PC, Hansen DD, Perry SB, et al. Transcatheter closure of ventricular septal defects: hemodynamic instability and anesthetic management. Anesth Analg. 1995;80(6):1076-1082.

25. Kussman BD, Gruber EM, Zurakowski D, Hansen DD, Sullivan LJ, Laussen PC. Bispectral index monitoring during infant cardiac sur- gery: relationship of BIS to the stress response and plasma fentanyl levels. Paediatr Anesth. 2001;11(6):663-669.

26. Kussman BD, Devavaram P, Hansen DD, et al. Anesthetic im- plications of primary cardiac tumors in infants and children. J Cardiothorac Vasc Anesth. 2002;16(5):582-586.

27. Jonas RA, Hansen DD, Cook N, Wessel D. Anatomic subtype and survival after reconstructive operation for hypoplastic left heart syndrome. J Thorac Cardiovasc Surg. 1994;107(4):1121-1128; dis- cussion 1127–1128.

28. Javorski JJ, Hansen DD, Laussen PC, Fox ML, Lavoie J, Burrows FA. Paediatric cardiac catheterization: innovations. Can J Anaesth.

1995;42(4):310-329.

29. Hickey PR, Wessel DL, Streitz SL, et al. Transcatheter closure of atrial septal defects: hemodynamic complications and anesthetic management. Anesth Analg. 1992;74(1):44-50.

30. Gruber EM, Shukla AC, Reid RW, Hickey PR, Hansen DD. Synthetic antifibrinolytics are not associated with an increased incidence of baffle fenestration closure after the modified Fontan procedure. J Cardiothorac Vasc Anesth. 2000;14(3):257-259.

31. Gruber EM, Laussen PC, Casta A, et al. Stress response in infants undergoing cardiac surgery: a randomized study of fentanyl bolus, fentanyl infusion, and fentanyl-midazolam infusion. Anesth Analg.

2001;92(4):882-890.

32. Gruber EM, Jonas RA, Newburger JW, Zurakowski D, Hansen DD, Laussen PC. The effect of hematocrit on cerebral blood flow veloc- ity in neonates and infants undergoing deep hypothermic cardio- pulmonary bypass. Anest Analg. 1999;89(2):322-327.

33. Fox ML, Burrows FA, Reid RW, Hickey PR, Laussen PC, Hansen DD.

The influence of cardiopulmonary bypass on ionized magnesium in neonates, infants, and children undergoing repair of congenital heart lesions. Anesth Analg. 1997;84(3):497-500.

34. Casta A, Gruber EM, Laussen PC, et al. Parameters associated with perioperative baffle fenestration closure in the Fontan operation. J Cardiothorac Vasc Anesth. 2000;14(5):553-556.

How to cite this article: Odegard KC, Rockoff MA. The

“Mother of pediatric cardiac anesthesia”: An interview with Dr Dolly D. Hansen, a pioneering woman in medicine. Pediatr Anesth. 2020;30:964–969. https://doi.org/10.1111/pan.13949

Referencer

RELATEREDE DOKUMENTER

Challenges in Pre-Hospital Care I (Organized in cooperation with the SSAI training program of Critical Emergency Medicine and the Norwegian Air Ambulance Foundation).. The value

Background: The objective of the Scandinavian Society of Anaes- thesiology and Intensive Care Medicine (SSAI) task force on mechanical ventilation in adults with the acute

Background: The objective of the Scandinavian Society of Anaes- thesiology and Intensive Care Medicine (SSAI) task force on fluid and drug therapy in adults with acute

1 Department of Cardiology, Aarhus University Hospital, and Department of Clinical Medicine, Aarhus University, Denmark, 2 Division of Cardiovascular and Diabetes

During the 1970s, Danish mass media recurrently portrayed mass housing estates as signifiers of social problems in the otherwise increasingl affluent anish

Dept of Anesthesiology, Clinic of Surgery, Vestfold Hospital Trust & Dept of Anesthesia and Intensive Care Medicine, Oslo University Hospital. • Francisco Almeida Lobo,

Pall Karlsson, Associate professor, PhD., Danish Pain Research Centre; Core Centre for Molecular Morphology, Section for Stereology & Microscopy, Department of Clinical

Pall Karlsson, Associate professor, PhD., Danish Pain Research Centre; Core Centre for Molecular Morphology, Section for Stereology & Microscopy, Department of Clinical