SmartTots affiliate, the European Society of Anesthesiology, is recruiting individuals to serve on their Euro-SmartTots Task Force. Euro-SmartTots is designed to further SmartTots research and fundraising efforts in Europe. The ESA is seeking 6-8 qualified experts from their society.

Candidate Expectations:

1. Be committed to donate your time and enthusiastic about research in this area.
2. Have some research experience, either in experimental research or clinical research in this area.
3. Have access to a certain pediatric clinical case load.
4. Be prepared to generate third party financial resources.

Applications due December 1, 2011. Apply now.

The November issue of Anesthesia & Analgesia highlights current research related to pediatric anesthesia neurotoxicity and the SmartTots research effort. The issue includes four editorials, three research reports and a review article.

• Anesthetic Neurotoxicity: A Difficult Dragon to Slay
  Thomas J, Crosby G, Drummond JC, Todd M
• Early Childhood Exposure to Anesthesia and Risk of Developmental and Behavioral Disorders in a Sibling Birth Cohort
  Dimaggio C, Sun LS, Li G
• GABAergic Excitotoxicity Injury of the Immature Hippocampal Pyramidal Neurons' Exposure to Isoflurane
  Zhao YL, Xiang Q, Shi QY, Li SY, Tan L, Wang JT, Jin XG, Luo AL
• Neurotoxicity of Anesthetic Drugs in the Developing Brain
  Stratmann G
• Pediatric Anesthesia Neurotoxicity: An Overview of the 2011 SmartTots Panel
  Jevtovic-Todorovic V
• SmartTots: A Multidisciplinary Effort to Determine Anesthetic Safety in Young Children
  Ramsay JG, Rappaport BA
• The Role of Calcium Dysregulation in Anesthetic-Mediated Neurotoxicity
  Wei H
• The Toxic Effects of S(+)-Ketamine on Differentiating Neurons In Vitro as a Consequence of Suppressed Neuronal Ca2+ Oscillations
  Sinner B, Friedrich O, Zink W, Zausig Y, Graf BM

General anesthesia administered to the developing animal brain depresses much needed neuronal activity and communication resulting in long-lasting cognitive impairment, according to an article published in the August issue of Current Opinion in Anesthesiology. Author Dr. Vesna Jevtovic-Todorovic, SmartTots Scientific Advisory Board Member and Professor of Anesthesiology and Neuroscience at the University of Virginia Health System, claims proper brain development depends on undisturbed neuronal communications – a process modulated by anesthetic exposure in animals. Currently, insufficient data are available to either support or refute whether similar effects occur in children.

The most sensitive period of brain development in both animals and humans seems to occur during a peak of synaptogenesis – a period of substantial synapse formation responsible for building neuronal circuits capable of transmitting cellular signals. Studies in animal models over the past decade affirm that commonly used anesthetics, whether administered alone or in combination, can cause significant neuronal cell death and improper synapse formation.  According to Jevtovic-Todorovic, these effects are detrimental to brain development and function in both rodents and nonhuman primates. Read more

Dr. Mike Roizen, Chair of the SmartTots Executive Board, traveled to Bengaluru, India last week to present a key session dedicated to pediatric anesthesia neurotoxicity. Anesthesiologists from eight countries, including Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka, convened at the Bangalore International Exhibit Center Saturday to hear Dr. Roizen discuss recent outcomes and ongoing research efforts related to the safe use of anesthetics in young children.

Dr. Roizen highlighted findings from studies conducted by the United States Food and Drug Administration’s National Center for Toxicological Research (NCTR) and several Western universities with an emphasis on the evolving SmartTots research agenda. He referenced early rodent and recent monkey data – all of which demonstrate neurotoxicity as the result of anesthetic exposure during early brain development.

Read more about Dr. Roizen's trip to India

SmartTots issued its first Request for Applications today to solicit research proposals aimed at investigating whether anesthetics and sedatives impede the normal development of the human brain. Recent studies in animals show that exposure to commonly used anesthetics is neurotoxic, i.e., it causes significant neurodegenerative changes in the central nervous system and long-lasting behavioral impairments. Funded studies will investigate how relevant these results are to clinical practice.

“We are eager to fund some investigations and start producing the evidence needed to inform clinical practice,” said Dr. Alex Evers, SmartTots Scientific Advisory Board Co-Chair. “We need to understand whether we do in fact have an issue, and if so, define the mechanisms causing that issue before we attempt to identify and implement a solution.”

Proposed investigations will be reviewed by the SmartTots Scientific Advisory Board, a multidisciplinary team of experts appointed to evaluate the scientific merit of SmartTots funded research projects. The Scientific Advisory Board will fund projects based on their relevance and probability of success.  All generated data will be placed in the public domain.

View the full RFA and submit a proposal.

Infants and very young children who are exposed to anesthesia may experience higher rates of learning disabilities and cognitive difficulties than children who are not exposed to anesthesia, according to research and emerging data presented during the SmartTots: Pediatric Anesthesia Neurotoxicity panel at the International Anesthesia Research Society annual meeting in Vancouver, B.C.

"We want to impress upon people that there is a very reliable link between the animal and human data that is rapidly emerging," said panel moderator Dr. Vesna Jevtovic-Todorovic, M.D., Ph.D., M.B.A., Professor of Anesthesiology and Neuroscience at the University of Virginia Health System and SmartTots Scientific Advisory Board member.

The IARS Board of Trustees announced a $200,000 contribution to SmartTots at the 2011 Annual Meeting, launching the safety initiative’s first fundraising campaign. In addition, each member of the IARS Board of Trustees demonstrated their commitment to SmartTots by contributing individual donations. At the commencement of the SmartTots Panel Monday, Dr. Mike Roizen, Chair of the SmartTots Executive Board, challenged the panel participants and all anesthesia professionals to mirror the IARS Board of Trustees’ dedication with 100% support of SmartTots. Dr. Roizen announced he will personally contribute $1 for every $2 donated to SmartTots, up to $50,000 annually. All SmartTots donations are allocated to research. SmartTots will release a request for research proposals June 15, 2011.

SAFEKIDS, the public-private partnership between the IARS and U.S. Food and Drug Administration is now SmartTots (Strategies for Mitigating Anesthesia Related neuro-Toxicity in Tots).  The new name more accurately reflects the goals of the partnership and the research studies it will support.  The mission of the partnership remains intact.

The SmartTots Scientific Advisory Board (SAB) is comprised of individuals from multiple specialties and areas of expertise relevant to SmartTots.  The SAB is responsible for assessing the scientific merit and potential impact of research proposals submitted under SmartTots, as well as overseeing the implementation and progress of funded projects.  

View our newly appointed Scientific Advisory Board

More than 250 attendees of the 2010 IARS Annual Meeting participated in the SAFEKIDS International Science Symposium on Saturday, March 20. Speakers included:

• Emery Brown, MD, PhD, from the MIT-Harvard Division of Health Sciences and Technology
• Andrew Davidson, MDDS, MD, FANZCA from the Royal Children’s Hospital Melbourne
• William Slikker, Jr., PhD, Director, National Center for Toxicological Research at the FDA
• John Olney, MD, Washington University in St. Louis
• Peter J. Davis, MD, University of Pittsburgh School of Medicine.

The Poster Discussion highlighted late-breaking abstracts by:

• Dr. Joss Thomas, MD, MPH, from the University of Iowa Hospitals & Clinics
• Ansgar Brambrink, MD, PhD from Oregon Health and Science University
• L.M. Steele from the University of Washington

SAFEKIDS, a public-private partnership between the U.S. Food and Drug Administration and the IARS, was launched as a long-term collaborative effort to address major gaps in scientific and clinical knowledge regarding safety for the millions of infants and children who undergo anesthesia and sedation each year. Projects conducted under the auspices of SAFEKIDS will investigate diverse aspects of existing anesthetics and their administration as well as patient outcome. Ultimately, these projects will enhance the safety of current anesthetics and drive the development of new drugs. The SAFEKIDS Executive Board has announced a $30 million fundraising effort to support this research; Dr. Roizen will lead the fundraising activities.