{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:19:46Z","timestamp":1762521586518,"version":"3.40.4"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,5,16]],"date-time":"2013-05-16T00:00:00Z","timestamp":1368662400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:label\/><jats:p>Dr. John J. \u2018Jack\u2019 Downes (1930\u2013), the anesthesiologist\u2010in\u2010chief at The Children's Hospital of Philadelphia (1972\u20131996), has made numerous contributions to pediatric anesthesia and critical care medicine through a broad spectrum of research on chronic respiratory failure, status asthmaticus, postoperative risks of apnea in premature infants, and home\u2010assisted mechanical ventilation. However, his defining moment was in January 1967, when The Children's Hospital of Philadelphia inaugurated its pediatric intensive care unit\u2014the first of its kind in North America. During his tenure, he and his colleagues trained an entire generation of pediatric anesthesiologists and intensivists and set a standard of care and professionalism that continues to the present day. Based on an interview with Dr. Downes, this article reviews a career that advanced pediatric anesthesia and critical care medicine and describes the development of that first pediatric intensive care unit at The Children's Hospital of Philadelphia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.12186","type":"journal-article","created":{"date-parts":[[2013,5,16]],"date-time":"2013-05-16T14:28:40Z","timestamp":1368714520000},"page":"655-664","source":"Crossref","is-referenced-by-count":9,"title":["The development of Pediatric Critical Care Medicine at The Children's Hospital of Philadelphia: an interview with Dr. John J. \u2018Jack\u2019 Downes"],"prefix":"10.1111","volume":"23","author":[{"given":"Christine L.","family":"Mai","sequence":"first","affiliation":[{"name":"Departments of Anesthesia, Critical Care Medicine &amp; Pain Medicine Massachusetts General Hospital Harvard Medical School Boston MA USA"},{"name":"Departments of Anesthesiology, Critical Care Medicine, and Pediatrics The Johns Hopkins University Baltimore MD USA"},{"name":"Department of Anesthesia Massachusetts Eye and Ear Infirmary Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark S.","family":"Schreiner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care The Children's Hospital of Philadelphia Perelman School of Medicine at the University of Pennsylvania Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul G.","family":"Firth","sequence":"additional","affiliation":[{"name":"Departments of Anesthesia, Critical Care Medicine &amp; Pain Medicine Massachusetts General Hospital Harvard Medical School Boston MA USA"},{"name":"Department of Anesthesia Massachusetts Eye and Ear Infirmary Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myron","family":"Yaster","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology, Critical Care Medicine, and Pediatrics The Johns Hopkins University Baltimore MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,5,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1986.03370110098030"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/pan.12075"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197106172842401"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-197303000-00001"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)32709-2"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1972.02110090097011"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-197102000-00002"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-8707(68)90020-8"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1542\/peds.42.2.238","article-title":"Arterial blood gas and acid\u2010base disorders in infants and children with status asthmaticus","volume":"42","author":"Downes JJ","year":"1968","journal-title":"Pediatrics"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-196805000-00008"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1966.tb01091.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)33905-0"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-197508000-00009"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1987.03400230058032"},{"key":"e_1_2_9_16_1","first-page":"16","article-title":"A statewide program for home care of children with chronic respiratory failure","volume":"26","author":"Downes JJ","year":"2007","journal-title":"Caring"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1099-0496(199601)21:1<52::AID-PPUL9>3.0.CO;2-S"},{"key":"e_1_2_9_18_1","unstructured":"DownesJJ WoodDW.Mechanical ventilation in the management of status asthmaticus in children. Science and Practice in Anesthesia: The Bicentennial Conference University of Pennsylvania School of Medicine JB Lippincott Co Philadelphia 1965 141."},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1967.00760040212015"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/S0022-3565(25)27812-0","article-title":"Magnitude and duration or respiratory depression due to fentanyl and meperidine in man","volume":"158","author":"Downes JJ","year":"1967","journal-title":"J Pharm Exper Therap"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.42.226.659"},{"key":"e_1_2_9_22_1","first-page":"570","article-title":"The organization and function of an intensive care unit in a children's hospital","volume":"46","author":"Bachman L","year":"1967","journal-title":"Anesth Analg"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)38688-6"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-0704(18)30264-1"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2012.03828.x"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpan.12186","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pan.12186","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T10:23:02Z","timestamp":1746008582000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pan.12186"}},"subtitle":[],"editor":[{"given":"Timeline","family":"Podcasts","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2013,5,16]]},"references-count":24,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2013,7]]}},"alternative-id":["10.1111\/pan.12186"],"URL":"https:\/\/doi.org\/10.1111\/pan.12186","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"type":"print","value":"1155-5645"},{"type":"electronic","value":"1460-9592"}],"subject":[],"published":{"date-parts":[[2013,5,16]]}}}