Overview

I am clinically involved at BCCH in the care of children with congenital heart disease as both a cardiac anesthesiologist and a critical care physician. I have a strong interest and significant training and experience in cardiovascular anesthesia and critical care. My primary focus is the study of anesthesia and critical care in children with congenital heart disease.

Publications

Intraoperative Extubation Post Arterial Switch Operation for Transposition of the Great Arteries With Intact Ventricular Septum: A One-Year, Single Center Experience
Seminars in Thoracic and Cardiovascular Surgery
Samuel, R. and Froese, N. and Betts, K. and Gandhi, S.
DOI: 10.1053/j.semtcvs.2020.06.038
2020

Special considerations in paediatric intensive care
Anaesthesia and Intensive Care Medicine
Peters, C.E. and Pitfield, A.F. and Froese, N.R.
DOI: 10.1016/j.mpaic.2017.07.007
2017

Special considerations in paediatric intensive care
Anaesthesia and Intensive Care Medicine
Pitfield, A.F. and Froese, N.R.
DOI: 10.1016/j.mpaic.2014.09.009
2014

Should early extubation be the goal for children after congenital cardiac surgery?
Journal of Thoracic and Cardiovascular Surgery
Harris, K.C. and Holowachuk, S. and Pitfield, S. and Sanatani, S. and Froese, N. and Potts, J.E. and Gandhi, S.K.
DOI: 10.1016/j.jtcvs.2014.06.093
2014

Infant repair of massive aortic aneurysm with prosthetic valved conduit
Annals of Thoracic Surgery
Hiebert, J.D. and Auld, B.C. and Sasaki, T. and Froese, N.R. and Ganshorn, M.K. and Casey, N.D. and Human, D.G. and Gandhi, S.K.
DOI: 10.1016/j.athoracsur.2012.12.054
2013

Transfusion-related acute lung injury in the Canadian paediatric population
Paediatrics and Child Health (Canada)
Gauvin, F. and Robillard, P. and Hume, H. and Grenier, D. and Whyte, R.K. and Webert, K.E. and Fergusson, D. and Lau, W. and Froese, N. and Delage, G.
DOI: 10.1093/pch/17.5.235
2012

Pulse oximeter plethysmograph variation and its relationship to the arterial waveform in mechanically ventilated children
Journal of Clinical Monitoring and Computing
Chandler, J.R. and Cooke, E. and Petersen, C. and Karlen, W. and Froese, N. and Lim, J. and Ansermino, J.M.
DOI: 10.1007/s10877-012-9347-z
2012

Equipment limitations of a multichannel infusion pump
Canadian Journal of Anesthesia
Froese, N. and McVicar, J. and Ansermino, M.
DOI: 10.1007/s12630-010-9399-9
2011

Pacemaker therapy of postoperative arrhythmias after pediatric cardiac surgery
Pediatric Critical Care Medicine
Skippen, P. and Sanatani, S. and Froese, N. and Gow, R.M.
DOI: 10.1097/PCC.0b013e3181ae5b8a
2010

Does troponin-I measurement predict low cardiac output syndrome following cardiac surgery in children?
Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine
Froese, N.R. and Sett, S.S. and Mock, T. and Krahn, G.E.
2009

Fibreoptic and Videoscopic Indirect Intubation Techniques for Intubation in Children
Pediatric Emergency Care
Levin, R. and Kissoon, N. and Froese, N.
DOI: 10.1097/PEC.0b013e3181aba8c1
2009

Special considerations in paediatric intensive care
Anaesthesia and Intensive Care Medicine
Froese, N.R.
DOI: 10.1016/j.mpaic.2009.06.004
2009

Diagnosis of postoperative arrhythmias following paediatric cardiac surgery
Anaesthesia and Intensive Care
Skippen, P.W. and Sanatani, S. and Gow, R.M. and Froese, N.
DOI: 10.1177/0310057x0903700506
2009

Iatrogenic hyponatremia in hospitalized children: Can it be avoided?
Paediatrics and Child Health
Skippen, P. and Adderley, R. and Bennett, M. and Cogswell, A. and Froese, N. and Seear, M. and Wensley, D.
DOI: 10.1093/pch/13.6.502
2008

Variation in blood pressure as a guide to volume loading in children following cardiopulmonary bypass
Journal of Clinical Monitoring and Computing
Tran, H. and Froese, N. and Dumont, G. and Lim, J. and Ansermino, J.M.
DOI: 10.1007/s10877-006-9051-y
2007

Measurement of cardiac output-transtracheal Doppler versus thermodilution
Canadian Journal of Anaesthesia
Froese, N. and Friesen, R.
DOI: 10.1007/BF03036977
1991

Research

Cardiac Preload Indicators in Children
The assessment of intravascular volume status in children is a difficult task guided by minimal scientific evidence. Administration of intravenous fluid to hemodynamically unstable and anesthetised children is a common therapeutic intervention. Much evidence exists of the danger of indiscriminate intravenous fluid loading. Dynamic preload indicators have been demonstrated in adults to represent a good indicator of volume status, but little evidence exists in children.

We aim to compare the ability of static preload indicators (central venous pressure and pulmonary capillary wedge pressure) with less invasive dynamic indicators (pulse pressure variation, plethysmograph variation) to predict the cardiac output response to a fluid bolus. The ultimate aim of this study is to help improve the safety of fluid administration for sick children.

Post Cardiac Surgery Blood Loss
When a child undergoes heart surgery, a heart lung machine is used to keep blood flowing while the child’s own heart is stopped. After surgery, a significant amount of the child’s own blood is left in this machine. In the case of small children, the relative amount of blood potentially lost to the child in this way is very large.

In older children, and those who have undergone less complicated surgery, this blood can all returned to the child. Giving the child back his or her own blood makes is less likely that the child will need a transfusion of donated blood.

However, in younger children, or in children who have undergone more complicated surgery, most or all of this blood is thrown away. This is because of worry that returning this blood may cause bleeding, and excessive bleeding is one of the most feared complications of heart surgery.

This project will explore a method whereby the red blood cells left in the heart lung machine can be returned to children without increasing the risk of bleeding. It will also carefully examine the exact causes of higher bleeding risk in children getting their own blood back so that in the future, all children can have their own blood returned at the end of surgery.