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Pediatric cardiac surgery

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https://www.readbyqxmd.com/read/28350561/reducing-pediatric-sternal-wound-infections-a-quality-improvement-project
#1
Claudia Delgado-Corcoran, Charlotte S Van Dorn, Charles Pribble, Emily A Thorell, Andrew T Pavia, Camille Ward, Randall Smout, Susan L Bratton, Phillip T Burch
OBJECTIVES: To evaluate whether a quality improvement intervention reduces sternal wound infection rates in children after cardiac surgery. DESIGN: This is a pre- and postintervention quality improvement study. SETTING: A 16-bed cardiac ICU in a university-affiliated pediatric tertiary care children's hospital. PATIENTS: All patients undergoing cardiac surgery via median sternotomy from January 2010 to December 2014 are included...
March 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28341498/natural-history-of-iatrogenic-pediatric-femoral-artery-injury
#2
Elizabeth A Andraska, Tatum Jackson, Huiting Chen, Katherine A Gallagher, Jonathan L Eliason, Dawn M Coleman
INTRODUCTION: Iatrogenic femoral artery trauma complicates the course of critically-ill neonates and children. Complications from persistent arterial occlusion include claudication and limb length discrepancies. Data supporting risk factors for such and need for revascularization are lacking. METHODS: Review of a prospectively maintained database at a tertiary institution of iatrogenic pediatric femoral artery injuries incurred between 2013-2014 was performed. Additional injuries were identified by review of pediatric arterial duplex performed between 2008-2013...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28338185/a-structured-blood-conservation-program-in-pediatric-cardiac-surgery
#3
A B Budak, K McCusker, S Gunaydin
OBJECTIVE: The limitation of alternative transfusion practices in infants increases the benefits of blood conservation. We analyzed the efficacy of a structured program to reduce transfusions and transfusion-associated complications in cardiac surgery PATIENTS AND METHODS: Our pediatric surgery database was reviewed retrospectively, comparing outcomes from two different time periods, after the implementation of an effective blood conservation program beginning in March 2014. A total of 214 infants (8...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28329452/effect-of-prime-blood-storage-duration-on-clinical-outcome-after-pediatric-cardiac-surgery
#4
Arvind Kumar Bishnoi, Pankaj Garg, Kartik Patel, Parth Solanki, Jigar Surti, Atul Solanki, Komal Shah, Sanjay Patel
BACKGROUND: In this study, we tested the hypothesis that in pediatric patients undergoing cardiac surgery using cardiopulmonary bypass (CPB) with blood prime, the storage duration of the packed red blood cells (PRBCs) used in prime led to differences in postoperative complications and metabolic profiles of the patients. METHODS: For this prospective observational study we included 400 pediatric patients undergoing cardiac operations using CPB and requiring PRBCs prime...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28328555/association-of-pediatric-cardiac-surgical-volume-and-mortality-after-cardiac-ecmo
#5
Cindy S Barrett, Titus T Chan, Jacob Wilkes, Susan L Bratton, Ravi R Thiagarajan
Centers with higher surgical and ECMO volume have improved survival for children undergoing pediatric cardiac surgery and ECMO respectively. We examined the relationship between both cardiac surgical and cardiac ECMO volumes, with survival. Using data from the Pediatric Health Information System, we reviewed patients who underwent ECMO during the hospitalization for cardiac surgery or heart transplantation from January 2003- June 2014. Among 106,967 patients in 43 centers undergoing a Risk Adjustment for Congenital Heart Surgery-1 (RACHS) 1-6 procedure (n =104,951) and/or cardiac transplantation (n=2016), 2...
March 20, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28325567/microvascular-surgery-in-the-congenital-cardiac-patient-a-case-series-exploring-feasibility-and-practical-applications
#6
John A LoGiudice, Karri Adamson, Nancy Ghanayem, Ronald K Woods, Michael E Mitchell
BACKGROUND: Pediatric congenital heart disease patients are at risk for vascular injuries during surgical procedures or when the arterial system is accessed for monitoring or diagnostic studies. Our treatment of emergent situations in this patient population using microvascular techniques shows the feasibility of such techniques. METHODS: A retrospective chart review of patients aged 0-18 years with congenital heart disease identified six patients who underwent microvascular surgery by the senior surgeon from June 2007 to May 2015...
February 17, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#7
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28318514/incorporating-comorbidity-within-risk-adjustment-for-uk-pediatric-cardiac-surgery
#8
Katherine L Brown, Libby Rogers, David J Barron, Victor Tsang, David Anderson, Shane Tibby, Thomas Witter, John Stickley, Sonya Crowe, Kate English, Rodney C Franklin, Christina Pagel
BACKGROUND: When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity. METHODS: The National Congenital Heart Disease Audit data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non-procedure-based risk factors within a risk adjustment model for 30-day mortality...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28318513/improving-risk-adjustment-for-mortality-after-pediatric-cardiac-surgery-the-uk-prais2-model
#9
Libby Rogers, Katherine L Brown, Rodney C Franklin, Gareth Ambler, David Anderson, David J Barron, Sonya Crowe, Kate English, John Stickley, Shane Tibby, Victor Tsang, Martin Utley, Thomas Witter, Christina Pagel
BACKGROUND: Partial Risk Adjustment in Surgery (PRAiS), a risk model for 30-day mortality after children's heart surgery, has been used by the UK National Congenital Heart Disease Audit to report expected risk-adjusted survival since 2013. This study aimed to improve the model by incorporating additional comorbidity and diagnostic information. METHODS: The model development dataset was all procedures performed between 2009 and 2014 in all UK and Ireland congenital cardiac centers...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28314534/total-cavopulmonary-connection-with-a-new-bioabsorbable-vascular-graft-first-clinical-experience
#10
Leo A Bockeria, Oleg Svanidze, Alex Kim, Konstantin Shatalov, Vladimir Makarenko, Martijn Cox, Thierry Carrel
OBJECTIVES: To assess safety and clinical performance of a novel bioabsorbable vascular graft in pediatric patients with univentricular cardiac malformation who received surgical correction via an extracardiac cavopulmonary conduit. METHODS: The implanted graft material is designed to attract patient's own cells and proteins, which trigger a cascade of physiological events leading to endogenous tissue restoration. As the graft resorbs progressively after implantation, components of native tissue including collagen, endothelial lining, and capillary blood vessels develop and organize into a natural tissue...
February 7, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28303771/epidemiology-and-outcome-of-acute-kidney-injury-in-children-a-single-center-study
#11
Werner Keenswijk, Jill Vanmassenhove, Ann Raes, Evelyn Dhont, Johan VandeWalle
BACKGROUND: Information on the epidemiology of Acute Kidney Injury (AKI) in children is scarce. We performed a single center retrospective cohort study to analyze the incidence of AKI, the male/female ratio, the underlying etiology, and age at presentation. We also aimed to assess outcome measured by mortality, duration of PICU stay, and development of Chronic Kidney Disease (CKD). METHODS: Records were searched for children presenting with or developing AKI between 1st January 2008 and 1st January 2015...
March 17, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28300357/pilot-randomized-controlled-trial-on-early-and-late-remote-ischemic-preconditioning-prior-to-complex-cardiac-surgery-in-young-infants
#12
Gonzalo Garcia Guerra, Ari R Joffe, Rob Seal, Ernest Phillipos, Maggie Wong, Elham Khodayari Moez, Irina A Dinu, Jonathan P Duff, David Ross, Ivan Rebeyka, Charlene M T Robertson
BACKGROUND: Remote ischemic preconditioning involves providing a brief ischemia-reperfusion event to a tissue to create subsequent protection from a more severe ischemia-reperfusion event to a different tissue/organ. The few pediatric remote ischemic preconditioning studies in the literature show conflicting results. AIM: We conducted a pilot randomized controlled trial to determine the feasibility of conducting a larger trial and to gather provisional data on the effect of early and late remote ischemic preconditioning on outcomes of infants after surgery for congenital heart disease...
April 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28298664/the-impact-of-roller-pump-vs-centrifugal-pump-on-homologous-blood-transfusion-in-pediatric-cardiac-surgery
#13
Bharat Datt, Moui B Nguyen, Gary Plancher, Mark Ruzmetov, Michael O'Brien, Alicia Kube, Hamish M Munro, Kamal K Pourmoghadam, William M DeCampli
Centrifugal pumps are considered to be less destructive to blood elements (1) when compared to roller pumps. However, their large prime volumes render them unsuitable as arterial pumps in heart lung machine (HLM) circuitry for children. In November of 2014, the circuit at Arnold Palmer Hospital, a Biomedicus BP-50 with kinetic assist venous drainage (KAVD) and 1/4″ tubing was converted to a roller pump in the arterial position with gravity drainage. Vacuum-assisted venous drainage (VAVD) was mounted on the HLM as a backup, but not used...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#14
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
March 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28291093/racial-and-ethnic-variation-in-pediatric-cardiac-extracorporeal-life-support-survival
#15
Titus Chan, Jane Di Gennaro, Reid W D Farris, Monique Radman, David Michael McMullan
OBJECTIVES: Previous studies have suggested an association between nonwhite race and poor outcomes in small subsets of cardiac surgery patients who require extracorporeal life support. This study aims to examine the association of race/ethnicity with mortality in pediatric patients who receive extracorporeal life support for cardiac support. DESIGN: Retrospective analysis of registry data. SETTING: Prospectively collected multi-institutional registry data...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28266954/diagnostic-value-of-procalcitonin-on-early-postoperative-infection-after-pediatric-cardiac-surgery
#16
Xia Li, Xu Wang, Shoujun Li, Jun Yan, Dan Li
OBJECTIVES: Assess the diagnostic value of serial monitoring of procalcitonin levels on early postoperative infection after pediatric cardiac surgery with cardiopulmonary bypass. DESIGN: Prospective, observational study. SETTING: A pediatric cardiac surgical ICU (PICU) and pediatric cardiac surgery department at Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College. PATIENTS: Patients were 3 years old and below, underwent cardiac surgery involving cardiopulmonary bypass, the Aristotle Comprehensive Complexity score was 8 or higher and free from active preoperative infection or inflammatory disease...
March 6, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28265211/modified-cone-reconstruction-of-the-tricuspid-valve-for-ebstein-anomaly-as-performed-in-siberia
#17
Evgeny V Krivoshchekov, Jaeger P Ackerman, Olga S Yanulevich, Alexander A Sokolov, Nadezhda V Ershova, Joseph A Dearani, Frank Cetta
The cone reconstruction technique, first described by da Silva and modified by Dearani and by others, has become the repair method of choice in patients with Ebstein anomaly of the tricuspid valve. This report details the outcome of the modified cone reconstruction technique in 6 children who underwent surgical correction of Ebstein anomaly at the Tomsk Institute of Cardiology in Siberia. From 2012 through 2015, 4 boys and 2 girls (age range, 11 mo-12 yr) underwent surgery to correct Ebstein anomaly. All had presented with cyanosis, exertional dyspnea, fatigue, or new-onset atrial arrhythmia, and none had undergone previous cardiac surgery...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28259455/variation-in-extubation-failure-rates-after-neonatal-congenital-heart-surgery-across-pediatric-cardiac-critical-care-consortium-hospitals
#18
Brian D Benneyworth, Christopher W Mastropietro, Eric M Graham, Darren Klugman, John M Costello, Wenying Zhang, Michael Gaies
OBJECTIVE: In a multicenter cohort of neonates recovering from cardiac surgery, we sought to describe the epidemiology of extubation failure and its variability across centers, identify risk factors, and determine its impact on outcomes. METHODS: We analyzed prospectively collected clinical registry data on all neonates undergoing cardiac surgery in the Pediatric Cardiac Critical Care Consortium database from October 2013 to July 2015. Extubation failure was defined as reintubation less than 72 hours after the first planned extubation...
February 4, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28259368/practices-and-attitudes-of-canadian-cardiologists-caring-for-patients-with-trisomy-18
#19
Aisling A Young, Christy Simpson, Andrew E Warren
Trisomy 18 (T18) is a genetic disorder with cardiac lesions in up to 90% of patients. Cardiac surgery is not frequently offered because of the overall poor prognosis, although this has recently been challenged. Our study aimed to explore the practices and attitudes of Canadian pediatric cardiologists managing T18 patients. We administered a survey to pediatric cardiologists attending the Canadian Cardiovascular Congress, Canadian Pediatric Cardiology Association Business Meeting. There were 30 respondents. Most (67%) supported comfort care for affected patients with a heart lesion...
November 17, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28249863/maternal-stress-and-anxiety-in-the-pediatric-cardiac-intensive-care-unit
#20
Amy Jo Lisanti, Lois Ryan Allen, Lynn Kelly, Barbara Medoff-Cooper
BACKGROUND: Mothers whose infants are born with complex congenital heart disease (CCHD) experience stress during their infant's hospitalization in a pediatric cardiac intensive care unit (PCICU). OBJECTIVES: This study addressed 2 research questions: (1) What are the parental stressors for mothers whose infants with CCHD are in the PCICU? And (2) What are the relationships of trait anxiety and 3 parental stressors to the parental stress response of state anxiety in mothers whose infants with CCHD are in the PCICU? METHODS: This descriptive correlational study included 62 biological mothers of infants admitted to a PCICU within 1 month of birth who had undergone cardiac surgery for CCHD...
March 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
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