Two cases of Ex utero intrapartum treatment (EXIT) in UP-PGH

The survival rate and prognosis for neonates with airway obstruction is poor if not managed immediately after delivery. Ex utero intrapartum treatment (EXIT) is indicated for cases in which airway obstruction is anticipated. The procedure establishes the fetal airway prior to complete delivery while maintaining an intact uteroplacental circulation. Maintaining uteroplacental circulation, ensuring uterine relaxation, and temporizing placental detachment during the EXIT procedure are achieved by administering a higher dose of inhalation anesthetic and intravenous nitroglycerine. However, this can lead to maternal hypotension and compromised feto-placental perfusion, reduced fatal cardiac output and acidosis. It is therefore essential that these be managed using vasopressors and inotropes. This paper reports the first institutional experience with the EXIT procedure in the Philippines, presenting two cases of neonates with large cystic hygroma. One case was performed as an elective procedure, the other as emergency treatment.

An evaluation of the structural components of the residency training program of the Department of Anesthesiology, UP-PGH

BACKGROUND:The residency training program in Anesthesiology of UP-PGH is the pioneer and biggest training program in the country. However, since its inception, the training program has not undergone any form of comprehensive evaluation. OBJECTIVE: The main objective of the study is to assess the different structural components of the training program and come up with recommendations on how to further improve it. METHODS: This is a descriptive study, utilizing both qualitative and quantitative research methods. Several validated survey instruments were used. RESULTS: The academic and neuro-psychiatric profiles of the residents were within the purview of mediocrity, while their socio-demographic profile was basically unremarkable. Their overall Quality of Life and Working Condition were both satisfactory. Although their Work Load was heavy and stressful, their Motivational Level was above par. Their performance from their trainers' perspective was generally satisfactory but needs improvement in the basic and theoretical knowledge. On the other hand, the trainees rated their trainers' performance from Good to Outstanding. The trainers' academic profile was excellent. Problems, weaknesses and strengths inherent to the program were also identified. CONCLUSION: To improve the training program, the quality of the residents must also necessarily be improved. A reduction in work load by increasing the number of residents as well as providing a more conducive learning environment are both recommended. The trainers'/mentors' teaching performance have been exemplary and needs to be maintained.