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Pediatric cardiac surgery

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https://www.readbyqxmd.com/read/28622280/elevated-central-venous-to-arterial-co2-difference-is-not-associated-with-poor-clinical-outcomes-after-cardiac-surgery-with-cardiopulmonary-bypass-in-children
#1
Takaaki Akamatsu, Yu Inata, Kazuya Tachibana, Takeshi Hatachi, Muneyuki Takeuchi
OBJECTIVE: To investigate whether elevated central venous to arterial CO2 difference is associated with delayed extubation and prolonged ICU stay in children after cardiac surgery with cardiopulmonary bypass. DESIGN: Retrospective review of medical records. SETTING: PICU in a tertiary children's hospital. PATIENTS: Pediatric patients younger than 18 years old who underwent cardiac surgery with cardiopulmonary bypass between January 2014 and December 2014...
June 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28617685/adult-congenital-heart-disease-magnitude-of-the-problem
#2
Akanksha N Thakkar, Ponraj Chinnadurai, C Huie Lin
PURPOSE OF REVIEW: To define the magnitude of problems faced by patients with adult congenital heart disease (ACHD) and to identify unmet needs for this population. RECENT FINDINGS: The ACHD population is estimated to include more than 1 million people in the United States and continues to grow at a steady rate. Owing to the decline in early mortality in this group, modern medicine is now faced by the long-term complications associated with congenital heart disease such as chronic heart failure, increased endocarditis risk, elevated burden of arrhythmias, pulmonary hypertension, valvular dysfunction, and pregnancy...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28611229/variation-in-definition-of-prolonged-mechanical-ventilation
#3
Louise Rose, Michael McGinlay, Reshma Amin, Karen Ea Burns, Bronwen Connolly, Nicholas Hart, Philippe Jouvet, Sherri Katz, David Leasa, Cathy Mawdsley, Danny F McAuley, Marcus J Schultz, Bronagh Blackwood
Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28604574/use-of-extracorporeal-membrane-oxygenation-and-mortality-in-pediatric-cardiac-surgery-patients-with-genetic-conditions-a-multicenter-analysis
#4
Jamie M Furlong-Dillard, Venugopal Amula, David K Bailly, Steven B Bleyl, Jacob Wilkes, Susan L Bratton
OBJECTIVE: Congenital heart disease is commonly a manifestation of genetic conditions. Surgery and/or extracorporeal membrane oxygenation were withheld in the past from some patients with genetic conditions. We hypothesized that surgical care of children with genetic conditions has increased over the last decade, but their cardiac extracorporeal membrane oxygenation use remains lower and mortality greater. DESIGN: Retrospective cohort study. SETTING: Patients admitted to the Pediatric Health Information System database 18 years old or younger with cardiac surgery during 2003-2014...
June 9, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28603625/physiological-impact-of-high-flow-nasal-cannula-therapy-on-postextubation-acute-respiratory-failure-after-pediatric-cardiac-surgery-a-prospective-observational-study
#5
Naohiro Shioji, Tatsuo Iwasaki, Tomoyuki Kanazawa, Kazuyoshi Shimizu, Tomohiko Suemori, Kentaro Sugimoto, Yasutoshi Kuroe, Hiroshi Morimatsu
BACKGROUND: Reintubation after pediatric cardiac surgery is associated with a high rate of mortality. Therefore, adequate respiratory support for postextubation acute respiratory failure (ARF) is important. However, little is known about the physiological impact of high-flow nasal cannula (HFNC) therapy on ARF after pediatric cardiac surgery. Our working hypothesis was that HFNC therapy for postextubation ARF after pediatric cardiac surgery improves hemodynamic and respiratory parameters...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28598945/long-term-outcomes-of-pediatric-cardiac-patients-supported-by-extracorporeal-membrane-oxygenation
#6
Matthew D Elias, Barbara-Jo Achuff, Richard F Ittenbach, Chitra Ravishankar, Thomas L Spray, Stephanie Fuller, Lisa M Montenegro, J William Gaynor, Matthew J O'Connor
OBJECTIVE: Extracorporeal membrane oxygenation is an important form of short-term mechanical support in children with cardiac disease, but information on long-term outcomes and quality of life is limited. The primary objective of this study was to determine the long-term outcomes of children previously supported by extracorporeal membrane oxygenation for cardiac etiologies. DESIGN: A retrospective analysis was performed on patients with cardiac disease managed with extracorporeal membrane oxygenation between January 1, 1995, and December 31, 2012, at the Children's Hospital of Philadelphia...
June 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28598588/nutritional-outcomes-in-infants-with-food-allergy-after-cardiac-surgery
#7
Wen-Yi Luo, Zhuo-Ming Xu, Li Hong, Qian-Yue Wu, Yue-Yue Zhang
BACKGROUND: Food allergy is a rapidly growing public health concern because of its increasing prevalence, as well as life-threatening potential. There is limited knowledge on the nutritional status for the pediatric congenital heart disease (CHD) patients with food allergy. OBJECTIVE: This study investigated both clinical and nutritional outcomes according to the CHD infants with food allergy. METHODS: Forty CHD infants with food allergy and 39 controls were recruited in Shanghai, China...
June 9, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28597463/hemostasis-in-pediatric-cardiac-surgery
#8
Hanne Berg Ravn
No abstract text is available yet for this article.
June 8, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28583371/bacterial-infections-after-pediatric-heart-transplantation-epidemiology-risk-factors-and-outcomes
#9
Christina A Rostad, Karla Wehrheim, James K Kirklin, David Naftel, Elizabeth Pruitt, Timothy M Hoffman, Thomas L'Ecuyer, Katie Berkowitz, William T Mahle, Janet N Scheel
BACKGROUND: Bacterial infections represent a major cause of morbidity and mortality in heart transplant recipients. However, data describing the epidemiology and outcomes of these infections in children are limited. METHODS: We analyzed the Pediatric Heart Transplant Study database of patients transplanted between 1993 and 2014 to determine the etiologies, risk factors and outcomes of children with bacterial infections post-heart transplantation. RESULTS: Of 4,458 primary transplants in the database, there were 4,815 infections that required hospitalization or intravenous therapy, 2,047 (42...
May 11, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28580658/improvement-in-perioperative-care-in-pediatric-cardiac-surgery-by-shifting-the-primary-focus-of-treatment-from-cardiac-output-to-perfusion-pressure-are-beta-stimulants-still-needed
#10
Amir-Reza Hosseinpour, Mathieu van Steenberghe, Marc-André Bernath, Stefano Di Bernardo, Marie-Hélène Pérez, David Longchamp, Mirko Dolci, Yann Boegli, Nicole Sekarski, Javier Orrit, Michel Hurni, René Prêtre, Jacques Cotting
OBJECTIVE: An important aspect of perioperative care in pediatric cardiac surgery is maintenance of optimal hemodynamic status using vasoactive/inotropic agents. Conventionally, this has focused on maintenance of cardiac output rather than perfusion pressure. However, this approach has been abandoned in our center in favor of one focusing primarily on perfusion pressure, which is presented here and compared to the conventional approach. DESIGN: A retrospective study...
June 5, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28578358/incidence-and-outcome-of-acute-kidney-injury-by-the-prifle-criteria-for-children-receiving-extracorporeal-membrane-oxygenation-after-heart-surgery
#11
Raja Abou Elella, Eiad Habib, Pavla Mokrusova, Princy Joseph, Hani Aldalaty, Mamdouh Al Ahmadi, Zohair Al Halees
BACKGROUND: Acute kidney injury (AKI) is common in patients treated with extracorporeal membrane oxygenation (ECMO). The RIFLE criteria demonstrate clinical relevance for diagnosing AKI and classifying its severity. OBJECTIVES: To systematically define the incidence, clinical course and outcome of AKI using the pediatric pRIFLE criteria. DESIGN: Retrospective, medical records review. SETTINGS: Pediatric cardiac surgical intensive care units at a tertiary care hospital in Riyadh...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28572979/complex-effects-of-high-flow-nasal-cannula-therapy-on-hemodynamics-in-the-pediatric-patient-after-cardiac-surgery
#12
EDITORIAL
Yu Inata, Muneyuki Takeuchi
BACKGROUND: The high-flow nasal cannula (HFNC) system has been widely used for children in various clinical settings. However, the physiological and clinical impact of HFNC therapy on the pediatric patient with respiratory distress after cardiac surgery has not been thoroughly investigated. MAIN BODY OF THE ABSTRACT: It seems logical to use HFNC as a primary therapy for post-extubation respiratory failure after congenital heart surgery, in which low cardiac output syndrome and upper airway obstruction are commonly encountered; the HFNC therapy alleviates the work of breathing and large negative swings of intrathoracic pressure, which in turn helps to decrease the systemic ventricular afterload...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28571730/serum-neuronal-biomarkers-in-neonates-with-congenital-heart-disease-undergoing-cardiac-surgery
#13
Erin Trakas, Yuliya Domnina, Ashok Panigrahy, Tracy Baust, Patrick M Callahan, Victor O Morell, Ricardo Munoz, Michael J Bell, Joan Sanchez-de-Toledo
BACKGROUND: Newborns with congenital heart disease have associated brain damage that affects short-and long-term neurodevelopment. Several neuronal biomarkers exist that could predict brain damage. We investigated the pattern of neuron-specific enolase (NSE) and s100B levels after cardiopulmonary bypass surgery in neonates with congenital heart disease. METHODS: We completed a prospective observational study of neonates with congenital heart disease who were undergoing cardiopulmonary bypass surgery...
July 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28571639/longitudinal-outcomes-of-patients%C3%A2-with%C3%A2-single-ventricle-after%C3%A2-the%C3%A2-fontan%C3%A2-procedure
#14
Andrew M Atz, Victor Zak, Lynn Mahony, Karen Uzark, Nicholas D'agincourt, David J Goldberg, Richard V Williams, Roger E Breitbart, Steven D Colan, Kristin M Burns, Renee Margossian, Heather T Henderson, Rosalind Korsin, Bradley S Marino, Kaitlyn Daniels, Brian W McCrindle
BACKGROUND: Multicenter longitudinal objective data for survival into adulthood of patients who have undergone Fontan procedures are lacking. OBJECTIVES: This study sought to describe transplant-free survival and explore relationships between laboratory measures of ventricular performance and functional status over time. METHODS: Exercise testing, echocardiography, B-type natriuretic peptide, functional health assessment, and medical history abstraction were repeated 9...
June 6, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28565849/myocardial-protective-effects-of-dexmedetomidine-in-patients-undergoing-cardiac-surgery-a-meta-analysis-and-systematic-review
#15
Zheng Gong, Li Ma, Yu-Lin Zhong, Jun Li, Jing Lv, Yu-Bo Xie
Arrhythmias are the common complications following cardiac surgery and contribute to hemodynamic instability, cognitive impairment, thromboembolic events, and congestive heart failure. Prevention of atrial fibrillation following cardiac surgery reduces morbidity and among the many available preventive approaches dexmedetomidine shows many positive effects on cardiovascular stability. Even though many studies indicated the beneficial effects of dexmedetomidine, the power of the analysis and conclusion of these studies is rather weak due to relatively smaller number of patients in these studies...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28561998/deposition-of-mannose-binding-lectin-and-ficolins-and-activation-of-the-lectin-pathway-of-complement-on-the-surface-of-polyurethane-tubing-used-for-cardiopulmonary-bypass
#16
Łukasz Eppa, Izabela Pągowska-Klimek, Anna S Świerzko, Maciej Moll, Wojciech R Krajewski, Maciej Cedzyński
The artificial surface used for cardiopulmonary bypass (CPB) is a crucial factor activating the complement system and thus contributing to the generation of a systemic inflammatory response. The activation of classical and alternative pathways on this artificial surface is well known. In contrast, lectin pathway (LP) activation has not been fully investigated, although noted during CPB in several studies. Moreover, we have recently proved the contribution of the LP to the generation of the systemic inflammatory response syndrome after pediatric cardiac surgery...
May 31, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28558846/perioperative-antibiotics-in-pediatric-cardiac-surgery-protocol-for-a-systematic-review
#17
Vijay Anand, Angela Bates, Robin Featherstone, Srinivas Murthy
BACKGROUND: Post-operative infections in pediatric cardiac surgery are an ongoing clinical challenge, with rates between 1 and 20%. Perioperative antibiotics remain the standard for prevention of surgical-site infections, but the type of antibiotic and duration of administration remain poorly defined. Current levels of practice variation through informal surveys are very high. Rates of antibiotic-resistant organisms are increasing steadily around the world. METHODS/DESIGN: We will identify all controlled observational studies and randomized controlled trials examining prophylactic antibiotic use in pediatric cardiac surgery...
May 30, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28552392/diagnostic-accuracy-and-prognostic-valued-of-plasmatic-cystatin-c-in-children-undergoing-pediatric-cardiac-surgery
#18
Massimiliano Cantinotti, Raffaele Giordano, Marco Scalese, Sabrina Molinaro, Simona Storti, Bruno Murzi, Vitali Pak, Vincenzo Poli, Giorgio Iervasi, Aldo Clerico
BACKGROUND: Diagnosis and treatment of acute kidney injury (AKI) is often delayed in children after cardiac surgery due to the lack of an early biomarker of renal damage. Our aim was to evaluate the diagnostic accuracy of plasma cystatin-C as an early biomarker of AKI and its prognostic value in pediatric cardiac surgery. METHODS: Cystatin-C and creatinine were measured pre-operatively and at 2-6-12h post-surgery. The primary outcome was: AKI (defined as an increase of ≥1...
May 26, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28552079/clinical-epidemiology-and-centre-variation-in-chylothorax-rates-after-cardiac-surgery-in-children-a-report-from-the-pediatric-cardiac-critical-care-consortium
#19
Jason R Buckley, Eric M Graham, Michael Gaies, Jeffrey A Alten, David S Cooper, John M Costello, Yuliya Domnina, Darren Klugman, Sara K Pasquali, Janet E Donohue, Wenying Zhang, Mark A Scheurer
Introduction Chylothorax after paediatric cardiac surgery incurs significant morbidity; however, a detailed understanding that does not rely on single-centre or administrative data is lacking. We described the present clinical epidemiology of postoperative chylothorax and evaluated variation in rates among centres with a multicentre cohort of patients treated in cardiac ICU. METHODS: This was a retrospective cohort study using prospectively collected clinical data from the Pediatric Cardiac Critical Care Consortium registry...
May 29, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28549578/pediatric-out-of-hospital-cardiac-arrest-caused-by-left-coronary-artery-agenesis-with-primary-shockable-rhythm-a-brief-report
#20
Moritz Weigeldt, Sabine Lahmann, Konstantin Krieger, Sebastian Buttenberg, Volker Stephan, Brigitte Stiller, Dirk Stengel
BACKGROUND: To illustrate a rare cause of out-of-hospital cardiac arrest in children, its differential diagnoses, emergency and subsequent treatment at various steps in the rescue chain, and potential outcomes. CASE PRESENTATION: A 4-year-old boy with unknown agenesis of the left coronary ostium sustained out-of-hospital cardiac arrest. Bystander cardio-pulmonary resuscitation was initiated and defibrillation was performed via an automated external defibrillator (AED) shortly after paramedics arrived at the scene, restoring sinus rhythm and spontaneous circulation...
May 11, 2017: American Journal of Emergency Medicine
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