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Corresponding Author: (Same for reprint requests), Oluyinka Olutoye, MB, ChB, PhD, Division of Pediatric Surgery, Baylor College of Medicine, 6621 Fannin St, CC650.00, Houston, TX 77030-2399, Tel: (832) Fax: (832) 825-3141, oolutoye@bcm.tmc.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.Presented at the 39 th Annual Meeting of the Canadian Association of Pediatric Surgeons. Winner of the best basic science paper presentation (ANG). NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptIntroduction-GCSF is commonly employed for the treatment of chemotherapy-induced neutropenia. Despite high-dose intensive chemotherapy for advanced stage neuroblastoma, the survival rate remains poor. GCSF therapy is quite common in these children, thus we questioned its effect on neuroblastoma cells. We hypothesized that exogenous GCSF stimulates the proliferation and invasive character of neuroblastoma cells.

As the field of pediatric ambulatory anesthesia expands, anesthesiologists can anticipate encountering an increasing number of patients with expected and unexpected difficult airways. This unique setting and patient population both present challenges in making a decision whether and how to safely proceed in the case of a child with a difficult airway. A host of patient, provider, procedure, and facility-specific factors should be considered. Providers should understand the differences between the pediatric and adult airway, recognize common features and syndromes associated with difficult airways, and be comfortable with different airway equipment and techniques available in the ambulatory setting. Early anticipation, a comprehensive patient assessment, and a clear decision-making algorithm with multiple airway management plans are all critical in safely and effectively managing these patients. These issues and recommendations will be discussed in this comprehensive narrative review.

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