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NOvA, the NuMI Off-Axis νe Appearance experiment, uses an established muon neutrino, or antineutrino, beam from Fermilab to study neutrino oscillations. NOvA is composed of two functionally equivalent liquid scintillator detectors; the near detector is located at Fermilab and the far detector 810 km away in Ash River, Minnesota. The νe appearance measurement relies on accurate electromagnetic energy reconstruction, which is dependent on the energy scale calibration of the detector. Studying the π0 → γγ decay, where the invariant π0 mass is directly correlated to the energy scale, we can directly “peak” at the electromagnetic energy calibration. Our sample is mainly composed of neutral pions produced through neutral current coherent neutrino scattering in the NOvA Near Detector. In this poster, we discuss the particle identification tools used to produce our sample and the latest results of the π0 invariant mass peak reconstruction.

Ultrasound technology is available in many pediatric perioperative settings. There is an increasing number of ultrasound applications for anesthesiologists which may enhance clinical performance, procedural safety, and patient outcomes. This review highlights the literature and experience supporting focused ultrasound applications in the pediatric perioperative setting across varied disciplines including anesthesiology. The review also suggests strategies for building educational and infrastructural systems to translate this technology into clinical practice.

PURPOSE OF REVIEW The current review focuses on the new development of adult congenital heart disease (ACHD) patients in the areas of imaging, percutaneous interventions, ventricular assist devices and transplantation. RECENT FINDINGS Since the last ACHD publication in the journal, several advances have been made in the evaluation and treatment of these patients. As CHD patients' longevity increases pregnancy, comorbities and acquired heart disease become a concern. Recent data show that the incidence of complications in low-risk CHD is not higher that the regular population. In addition, breakthrough research in percutaneous valve implantation has been published showing good outcomes but needing intensive care recovery in a significant number of patients. In the ACHD heart failure population, assist device and transplant fields mounting evidence shows that these therapies should not be the last resort since low-risk ACHD patient may have similar outcomes to those with acquired heart disease. Finally risk stratification is important in ACHD to define better ways to recover from surgery and anesthesia. SUMMARY The field of anesthesia for ACHD is growing with new indications for diagnostic, interventional and surgical procedures. Tailoring cardiac and noncardiac care to the different risk profile in ACHD patients will be defined in the next few years. VIDEO ABSTRACT Motta summary clip: http://links.lww.com/COAN/A65.

Anaphylactic reaction to gelatin-containing hemostatic agents has been reported in the orthopedic literature, most commonly during scoliosis repair in adolescents. However, the risk, differential diagnosis, and management of anaphylaxis in patients with complex congenital heart disease undergoing noncardiac procedures have not been previously reported. We describe the case of an adolescent with a history of repaired truncus arteriosus undergoing posterior spinal fusion who developed sudden and profound hypotension that was ultimately confirmed to be an anaphylactic reaction to Surgiflo. Echocardiography was used to aid in diagnosis and management of the cardiovascular effects of anaphylaxis in this patient with residual cardiac pathophysiology.

The complex resonance frequency of a vibrating edge supported plate fabricated by the methods of MicroElectroMechanical Systems (MEMS) has been described by Goodwin et al. (J. Chem. Eng. Data 2006, 51, 190−208) and can be used to determine the density and viscosity of fluids. Working equations are required to relate the measured and desired quantities. In this article, two decoupled equations are used: one for density, the other for viscosity. For density, two expressions were evaluated. The first has been reported by Harrison et al. (Proc. SPIE 2006, 6111, 61110D) and contains three adjustable parameters, while the second is a purely empirical expression with two coefficients. For viscosity, the expression reported by Goodwin et al. (J. Chem. Eng. Data 2006, 51, 190−208) was used. The complex resonance frequency was measured for nitrogen, methylbenzene, water, 1-propene,1,1,2,3,3,3-hexafluoro-oxidized-polymd, polydimethylsiloxane, and four certified reference materials at temperatures between (313 and 37...

Objective The purpose of this study was to review the early postoperative course of stage 1 Norwood with Blalock-Taussig shunt (BTS) or right ventricle-to-pulmonary artery conduit (RVPA) and to identify early predictors of failure.

This article studies the fluid reaction on a vibrating disc immersed in a viscous fluid. The fluid is considered incompressible and Newtonian. The disc which is of negligible thickness vibrates harmonically in the direction perpendicular to its surface with an amplitude much smaller than the radius of the disc, in such a way that the non-linear terms can be neglected. The flow is axisymmetric and the velocity tends to zero away from the disc. Different approaches to this problem are presented. The first method consists in solving numerically an integral equation obtained from the Navier–Stokes equation. The second method calculates in an analytic fashion the asymptotic series for the pressure differential across the plate for large values of the dimensionless parameter β , equal to the frequency times the radius squared divided by the kinematic viscosity. The limit when β tends to zero is also studied. The analytical expressions give more reliable results when approaching the limits β large and β small than the numerical solution.

In the petroleum industry, measurements of the density and viscosity of petroleum reservoir fluids are required to determine the value of the produced fluid and production strategy. These thermophysical properties are also useful for the design of separators and process equipment and to control production processes. To measure the density and viscosity of petroleum fluids requires a transducer that can operate up to reservoir conditions and, to guide value and exploitation calculations with sufficient rigor, provide results with an accuracy of about ± 1 % in density and ± 10 % in viscosity. Necessarily, these specifications place robustness as a superior priority to accuracy for the design. In this paper, we describe a Micro Electrical Mechanical System (MEMS) that is capable of providing both density and viscosity of fluids in which it is immersed at the desired operating conditions. This transducer is based on a vibrating plate, with dimensions of about 1 mm and mass of about 0.12 mg, clamped along one ...

This case discusses pharmacodynamic drug–drug interactions between magnesium sulfate and intravenous anesthetics and between magnesium sulfate and vecuronium. Additional information regarding the use of magnesium for perioperative patients is presented.

Objective The aim of this study was to evaluate the addition of paravertebral blockade to general anesthesia in patients undergoing robotic mitral valve repair. Design A randomized, prospective trial. Setting A single tertiary referral academic medical center. Participants 60 patients undergoing robotic mitral valve surgery. Interventions Patients were randomized to receive 4-level paravertebral blockade with 0.5% bupivicaine before induction of general anesthesia. All patients were given a fentanyl patient-controlled analgesia upon arrival to the intensive care unit, and visual analog scale pain scores were queried for 24 hours. On postoperative day 2, patients were given an anesthesia satisfaction survey. Measurements and Main Results After obtaining institutional review board approval, surgical and anesthetic data were recorded perioperatively and compared between groups. Compared to general anesthesia alone, patients receiving paravertebral blockade and general anesthesia reported significantly less postoperative pain and required fewer narcotics intraoperatively and postoperatively. Patients receiving paravertebral blockade also reported significantly higher satisfaction with anesthesia. Successful extubation in the operating room at the conclusion of surgery was 90% and similar in both groups. Hospital length of stay also was similar. No adverse reactions were reported. Conclusions The addition of paravertebral blockade to general anesthesia appears safe and can reduce postoperative pain and narcotic usage in patients undergoing minimally invasive cardiac surgery. These findings were similar to previous studies of patients undergoing thoracic procedures. Paravertebral blockade alone likely does not reduce hospital length of stay. This may be more closely related to early extubation, which is possible with or without paravertebral blockade.

Extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) is the implementation of the cardiopulmonary bypass machine for prolonged periods of time to sustain systemic perfusion and gas exchange. The support is preferred for patients with potentially treatable pulmonary or cardiac disease. Currently, it is the most common method of mechanical circulatory support for pediatric patients. The development and improvement of this technology has allowed ECMO to progress from a salvage therapy to a commonly used treatment allowing time for cardiopulmonary recovery. Many centers have continually available rapidly deployed ECMO teams for the rapid resuscitation of patients. Some of the advantages of ECMO include rapid setup, provides both respiratory and cardiac support, reliable support with known outcomes, and a now vast clinical experience.

OBJECTIVE In this report, we describe our experience with the use of dexmedetomidine in spontaneously breathing as well as in mechanically ventilated patients, after congenital cardiac and thoracic surgery. DESIGN Retrospective case series. SETTING University hospital, pediatric cardiac intensive care unit. PATIENTS Thirty-three spontaneously breathing and five mechanically ventilated patients who received dexmedetomidine after cardiothoracic surgery. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Thirty-eight patients, age 8 +/- 1.1 yrs old and weight 29 +/- 3.8 kg, were included. Seven patients (18%) were