if you have any feedback, please send us a text! Thank you!

Welcome to another episode of Vital Times.

In January 2026 the American Society of Anesthesiologists (ASA) and the Society for Pediatric Anesthesia (SPA) issued an updated joint communication regarding severe neurologic complications, including stroke and death, in healthy young adult (oldest reported so far is 36) and pediatric patients of Venezuelan ancestry following routine general anesthesia. There have been about 36 known or suspected cases worldwide although that number seems to be regularly increasing. The majority of cases have occurred in South American countries, with six reported in in the United States and eight in Europe. Genetic testing on a subset of the patients found a genetic mutation in mitochondrial DNA, known as the ND4 mutation. (for an interview with the physician and mother listen here https://www.instagram.com/reel/DUb4tYGjfdM/?utm_source=ig_web_copy_link .

In July 2025, anecdotal communications from South American anesthesiology societies described cases of patients having severe complications from general anesthesia. Despite incomplete and emerging clinical and scientific information, ASA and SPA felt the severity of the cases warrant an expert opinion communication to inform anesthesiologists and their patients.

Detailed family histories of patients who were recently affected revealed that all were of Venezuelan heritage and several had family members who also had adverse outcomes after an otherwise uneventful anesthetic. Four anesthesiologists at the leading edge of this newly discovered condition joined the show today to explain how it was discovered, what is known and what we can do about it. 

Dr. Jim Fehr is the past President of the Society for Pediatric Anesthesia, and the Division chief of Pediatric Anesthesia at Stanford Lucile Packard Children’s Hospital. He is one of the coauthors of the joint statement, a member of the Society for PEdiatri Anesthesia’s Wake Up Safe initiative and very involved with Patient Safety. 

Dr. Veronica Zoghbi is a Venezuelan pediatric anesthesiologist and Director of Pediatric Regional Anesthesia at the University of Miami in Miami, Florida.  South Florida and Miami have one of the highest concentrations of people from Venezuela in the USA. She and our other 2 guests are members of VAPOR (Venezuelan Anesthesiologist Perioperative Risk Reduction) 

Dr. Claudia Bruguera Torres is a pediatric anesthesiologist from Venezuela and Assistant Professor at Cincinnati Children's Hospital. 

Dr. Luis Rodriguez is a Venezuelan Pediatric Anesthesiologist from Miami FL, and currently serves as the Vice President for the Florida Society of Anesthesiologists

Finally, if complications occur in patients with the ND4 mutation, anesthesiologists should report the case to their institutions’ patient safety organization and the Anesthesia Incident Reporting System of the Anesthesia Quality Institute.