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adult and Pediatric cardiac surgery

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https://www.readbyqxmd.com/read/28177675/what-factors-contribute-to-the-elevation-of-serum-free-fatty-acids-ffa-in-newborns-in-the-cardiac-surgical-setting
#1
Carin Wittnich, Michael P Belanger
Elevations in serum free fatty acids (FFA) levels during heart surgery have been reported in humans and experimental animals, causing increased arrhythmias, decreased heart function, and contributing to mortality. Factors such as heparin administration, age, cardiopulmonary bypass (CPB) and cyanosis/hypoxia have been implicated but not proven. This study was designed to clarify the contribution of these factors using an experimental pig model as follows: a) adult (n=10) versus 3-day old piglets (n=18) had FFA levels assessed before and after heparin administration; b) 3 day old piglets, the additional effect of CPB (n=8) or just severe hypoxia (PaO2 = 20-25 mmHg; n=6) exposure on FFA levels...
January 9, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28148615/postoperative-patient-controlled-analgesia-in-the-pediatric-cardiac-intensive-care-unit
#2
Hanna M Epstein
BACKGROUND: High rates of uncontrolled pain in critically ill patients remain common. Patient-controlled analgesia is more effective than traditional intravenous as-needed dosing regimens for managing postoperative pain in older children and adults. OBJECTIVE: To determine whether pain-related clinical outcomes in patients from age 10 years to adult following cardiac surgery are improved by using patient-controlled analgesia as a pain management strategy. METHODS: Using the plan-do-study-act method of quality improvement, a process was instituted to have both staff and patients' families support the use of patient-controlled analgesia postoperatively as opposed to traditional pain control with as-needed analgesics...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28127473/hemadsorption-with-adult-cytosorb%C3%A2-in-a-low-weight-pediatric-case
#3
Catalin Gabriel Cirstoveanu, Ileana Barascu, Samantha Mc Kenzie Stancu
Cytokine adsorber (CytoSorb) has been used successfully as adjunctive treatment for adult patients with elevated cytokine levels in the setting with severe sepsis and septic shock and to reduce blood myoglobin, unconjugated bilirubin, and conjugated bilirubin. In this article we present the case of a nine-month-old male infant who was admitted to the NICU due to sepsis after cardiac surgery, Fallot tetralogy, and multisystem organ failure (MSOF) including liver failure and renal failure which was successfully treated by a combination of continuous hemodiafiltration (HDF) and hemadsorption with CytoSorb...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28126509/-cardiac-rehabilitation-for-children-and-adults-with-congenital-heart-disease
#4
Pascal Amedro, Arthur Gavotto, Charlène Bredy, Sophie Guillaumont
Advances in heart surgery over the past 30 years have significantly improved the prognosis of congenital heart diseases (CHD). Therefore, the epidemiology of CHD has changed dramatically with a shift of mortality from pediatrics to adulthood and an increased prevalence of complex CHD. Today, caregivers and patients focus their interests to new perspectives: improving the quality of life, practicing sports, improving psychosocial care. Cardiac rehabilitation is completely integrated in these new therapeutic strategies...
January 23, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28121832/central-venous-to-arterial-co2-difference-after-cardiac-surgery-in-infants-and-neonates
#5
Leslie A Rhodes, W Clinton Erwin, Santiago Borasino, David C Cleveland, Jeffrey A Alten
OBJECTIVES: Venous to arterial CO2 difference correlates with cardiac output in critically ill adults, but its utility in pediatric patients is unclear. We sought to correlate venous to arterial CO2 difference with other cardiac output surrogates (arteriovenous oxygen saturation difference, central venous oxygen saturation, and lactate) and investigate its capacity to predict poor outcomes associated with low cardiac output (low cardiac output syndrome) in infants after cardiac surgery with cardiopulmonary bypass...
January 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28120051/adverse-effects-and-surgical-complications-in-pediatric-patients-undergoing-vagal-nerve-stimulation-for-drug-resistant-epilepsy
#6
A Trezza, A Landi, D Grioni, D Pirillo, L Fiori, C Giussani, E P Sganzerla
Vagal nerve stimulation (VNS) is an effective treatment for drug-resistant epilepsy that is not suitable for resective surgery, both in adults and in children. Few reports describe the adverse effects and complications of VNS. The aim of our study was to present a series of 33 pediatric patients who underwent VNS for drug-resistant epilepsy and to discuss the adverse effects and complications through a review of the literature.The adverse effects of VNS are usually transient and are dependent on stimulation of the vagus and its efferent fibers; surgical complications of the procedure may be challenging and patients sometimes require further surgery; generally these complications affect VNS efficacy; in addition, hardware complications also have to be taken into account...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28074792/remifentanil-prevents-increases-of-blood-glucose-and-lactate-levels-during-cardiopulmonary-bypass-in-pediatric-cardiac-surgery
#7
Tomohiro Chaki, Yuko Nawa, Keishi Tamashiro, Eri Mizuno, Naoyuki Hirata, Michiaki Yamakage
INTRODUCTION: Cardiopulmonary bypass (CPB) can cause stress response that increases levels of cytokine and catecholamine in plasma, resulting in hyperglycemia. In adults, it has been demonstrated that remifentanil infusion during CPB could prevent increases of cytokine, catecholamine, and blood glucose levels, but such effects of remifentanil in children have not been elucidated. AIM: In this study, we investigated the preventive effects of remifentanil on blood glucose and lactate levels during CPB in children...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28007061/the-evolution-of-an-adult-congenital-heart-surgery-program-the-emory-system
#8
REVIEW
Brian Kogon, Joshua Rosenblum, Bahaaldin Alsoufi, Subhadra Shashidharan, Wendy Book
The Emory Adult Congenital Heart (Emory University, Atlanta, GA) program was founded in 2001. In 2004, the surgical component transitioned from a pediatric facility to an adult facility. The aim of this article is characterize the program as a whole, outline changes in the program, and discuss the challenges of the transition process. Between 2001 and 2015, changes in program structure and personnel were evaluated. There has been significant growth of the program between 2001 and 2015. There are currently 19 half-day clinics per week, with 2,700 clinic visits per year...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/27986229/vi%C3%A1-n-tim-institut-du-coeur-success-of-a-congenital-heart-disease-center-in-a-developing-country
#9
EDITORIAL
Paul S Lajos, Alain F Carpentier
OBJECTIVE: The goal of the Viện Tim Institute du Coeur is to provide high quality cardiac surgical care to the Vietnamese population with 25% of care allocated to the indigent. This article discusses the history; functional and financial implementation of creating a long-term fully sustainable adult and pediatric cardiac surgery center in Southeast Asia in a developing country. METHODS: The Institut du Coeur in Ho Chi Minh City, Vietnam is a fully functional and financially solvent cardiac surgery center that was formed 28 years ago...
July 2016: Annals of Global Health
https://www.readbyqxmd.com/read/27901294/performance-of-functional-fibrinogen-thromboelastography-in-children-undergoing-congenital-heart-surgery
#10
Nischal K Gautam, Chunyan Cai, Olga Pawelek, Muhammad B Rafique, Davide Cattano, Evan G Pivalizza
BACKGROUND: Functional Fibrinogen assay of the Thromboelastography (FFTEG), a whole blood viscoelastic hemostatic assay, has been used to estimate fibrinogen levels in adult patients undergoing major surgery but its performance in pediatric patients undergoing cardiac surgery requires evaluation. In this study, we evaluate the correlation between FFTEG parameters and standard laboratory tests for fibrinogen and platelet counts before and after cardiopulmonary bypass in children undergoing repair for congenital heart disease...
February 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27844091/preoperative-staphylococcus-aureus-carriage-and-risk-of-surgical-site-infection-after-cardiac-surgery-in-children-younger-than-1%C3%A2-year-a-pilot-cohort-study
#11
J Macher, C Gras Le Guen, A Chenouard, J M Liet, B Gaillard Le Roux, A Legrand, J Mahuet, E Launay, V Gournay, N Joram
Surgical site infections (SSI) increase length of stay, morbidity, mortality and cost of hospitalization. Staphylococcus aureus (SA) carriage is a known risk factor of SSI in adults, but its role in pediatrics remains uncertain. The main objective of this pilot prospective monocentric cohort study was to describe the prevalence of SA colonization in children under 1 year old before cardiac surgery. The secondary objectives were to compare the incidence of SSI and other nosocomial infections (NI) between preoperative carriers and non-carriers...
January 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/27785879/intravascular-and-hybrid-intraoperative-stent-placement-for-baffle-obstruction-in-transposition-of-the-great-arteries-after-atrial-switch
#12
Joseph T Poterucha, Nathaniel W Taggart, Jonathan N Johnson, Bryan C Cannon, Allison K Cabalka, Donald J Hagler, Joseph A Dearani, Frank Cetta
OBJECTIVES: To report our experience with intravascular and hybrid intra-operative stent placement for baffle obstruction in patients with complete transposition of the great arteries (TGA) after the atrial switch (Mustard/Senning) operation. BACKGROUND: Venous baffle obstruction is a challenging complication after atrial switch operation in patients with TGA. Traditional treatment options include intravascular stenting or surgery. METHODS: A retrospective analysis of Mayo Clinic's electronic medical record was completed to identify consecutive pediatric and adult patients with TGA after atrial switch who underwent baffle stent implantation from 1994 to 2015...
October 27, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27785133/application-of-the-cardiocel-bovine-pericardial-patch-a-preliminary-report
#13
Michał Sobieraj, Edyta Cudak, Wojciech Mrówczyński, Tomasz K Nałęcz, Przemysław Westerski, Michał Wojtalik
INTRODUCTION: Animal pericardial patches are widely used in adult and pediatric cardiac surgery. A search is ongoing for a new material with optimal surgical properties that will reduce intraoperative bleeding and the occurrence of restenosis, calcification, and pseudoaneurysms in long-term observation. One product of interest is the CardioCel bovine pericardial patch. AIM: Evaluation of the short-term results of CardioCel bovine pericardial patch implantation during pediatric cardiac surgery...
September 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27780555/relation-of-left-atrial-size-to-atrial-fibrillation-in-patients-aged-%C3%A2-22%C3%A2-years
#14
Douglas Y Mah, Divya Shakti, Kimberlee Gauvreau, Steven D Colan, Mark E Alexander, Dominic J Abrams, David W Brown
Left atrial (LA) dilation has been shown to be associated with atrial fibrillation (AF) in the adult population, with some studies indicating that larger LAs are more prone to AF recurrence. The relation of LA size to AF in the pediatric and young adult population has not been investigated. In this study, all pediatric patients (aged ≤22 years) who presented to Boston Children's Hospital from January 2002 to December 2012 with AF were reviewed. Patients with significant congenital heart disease, cardiomyopathies, proven channelopathies, previous cardiac surgery, end-stage renal disease, or severe lung disease/cystic fibrosis were excluded...
January 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27716703/strategies-for-blood-conservation-in-pediatric-cardiac-surgery
#15
REVIEW
Sarvesh Pal Singh
Cardiac surgery accounts for the majority of blood transfusions in a hospital. Blood transfusion has been associated with complications and major adverse events after cardiac surgery. Compared to adults it is more difficult to avoid blood transfusion in children after cardiac surgery. This article takes into account the challenges and emphasizes on the various strategies that could be implemented, to conserve blood during pediatric cardiac surgery.
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27645949/robert-lee-replogle-september-30-1931-may-9-2016
#16
Mark K Ferguson
The world of cardiothoracic surgery lost a friend and remarkable colleague on May 9, 2016. Robert L. Replogle, the 31st President of The Society of Thoracic Surgeons, died at the University of Chicago Medical Center after a brief illness, surrounded by his loving family. Known to his friends as "Rep," he will be remembered as an excellent pediatric and adult cardiac surgeon and as a visionary leader.
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27621853/sufficient-myocardial-protection-of-del-nido-cardioplegia-regardless-of-ventricular-mass-and-myocardial-ischemic-time-in-adult-cardiac-surgical-patients
#17
Ji Seong Kim, Jin Hee Jeong, Sin Ju Moon, Hyuk Ahn, Ho Young Hwang
BACKGROUND: Del Nido (DN) cardioplegic solution (CPS) has been widely used during pediatric cardiac surgery. However, its use in the field of adult cardiac surgery is not popular yet. We evaluated efficacy of DN cardioplegia in adult cardiac surgical patients. METHODS: Fifty-three adult patients (mean age, 54±16 years) who underwent cardiovascular surgery using DN cardioplegia were enrolled. Myocardial troponin I (TnI) level up to three days after surgery and early clinical outcomes were evaluated...
August 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27618336/assessment-of-risk-factors-for-a-sustainable-on-table-extubation-program-in-pediatric-congenital-cardiac-surgery-5-year-experience
#18
Reena Khantwal Joshi, Neeraj Aggarwal, Mridul Agarwal, Veronique Dinand, Raja Joshi
OBJECTIVE: To delineate risk factors for failure of extubation in the operating room among pediatric cardiac surgery patients. DESIGN: Prospective, observational study. SETTING: Single center, tertiary care, teaching hospital. PARTICIPANTS: The study comprised 448 congenital cardiac surgery patients who were enrolled for intended extubation in the pediatric cardiac operating room over 5 years. INTERVENTIONS: The airways of enrolled patients were extubated in the operating room if predetermined suitability criteria were met...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27591466/intraoperative-goal-directed-hemodynamic-therapy-in-noncardiac-surgery-a-systematic-review-and-meta-analysis
#19
Javier Ripollés, Angel Espinosa, Eugenio Martínez-Hurtado, Alfredo Abad-Gurumeta, Rubén Casans-Francés, Cristina Fernández-Pérez, Francisco López-Timoneda, José María Calvo-Vecino
BACKGROUND: The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. METHODS: A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27590683/mortality-trends-in-pediatric-and-congenital-heart-surgery-an-analysis-of-the-society-of-thoracic-surgeons-congenital-heart-surgery-database
#20
Jeffrey P Jacobs, Xia He, John E Mayer, Erle H Austin, James A Quintessenza, Tom R Karl, Luca Vricella, Constantine Mavroudis, Sean M O'Brien, Sara K Pasquali, Kevin D Hill, S Adil Husain, David M Overman, James D St Louis, Jane M Han, David M Shahian, Duke Cameron, Marshall L Jacobs
BACKGROUND: Previous analyses of The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database have demonstrated a reduction over time of risk-adjusted operative mortality after coronary artery bypass grafting. The STS Congenital Heart Surgery Database (STS CHSD) was queried to assess multiinstitutional trends over time in discharge mortality and postoperative length of stay (PLOS). METHODS: Since 2009, operations in the STS CHSD have been classified according to STAT (The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery) Congenital Heart Surgery Mortality Categories...
October 2016: Annals of Thoracic Surgery
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