a recent issue of Critical Care, Bojan and colleagues [1] reported their experience with early initiation of high-frequency oscillatory ventilation (HFOV) in pediatric cardiac surgery that demonstrated shorter mechanical ventilation times and intensive care stays. Acute lung injury is common in adult patients undergoing surgery, yet there is scant reporting of the intraoperative utility of HFOV...

In this report we describe difficult ventilation during anesthesia as well as in the pediatric intensive care unit in a pediatric patient with pulmonary fibrosis. We discuss how an initial diagnosis of acute spontaneous pneumothorax, a correctable problem, misdirected perioperative planning and anesthetic management of a patient with severe pulmonary fibrosis.

71 The earliest description of what is now known as the acute respiratory distress syndrome 72 (ARDS) was a highly lethal double pneumonia. Ashbaugh and colleagues correctly identified the 73 disease as ARDS in a paper published in the Lancet in 1967. Their initial study, showing the 74 positive impact of mechanical ventilation with positive end-expiratory pressure (PEEP) on ARDS 75 mortality, ...