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Pediatric cardiac surgery and intensive care

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https://www.readbyqxmd.com/read/29026677/bedside-ultrasound-in-the-diagnosis-and-treatment-of-children-with-respiratory-difficulty-following-cardiac-surgery
#1
REVIEW
Hussam Kanaan Hamadah, Mohamed Salim Kabbani
Many children frequently fail extubation or require a prolonged period of positive pressure ventilation support after cardiac surgery. Pediatric cardiac Intensive Care Unit (PCICU) ultrasound (US) stands as a simple, basic bedside tool that can be performed by trained intensivists for the diagnosis with immediate implication on therapeutic decisions in multiple scenarios that physicians may face in PCICU. Bedside US is widely available, convenient, and inexpensive. This educational article based mainly on our own experience is highlighting the role of US in detecting the most common causes of respiratory weaning difficulties and extubation failure in postoperative cardiac children through proposed illustration and algorithm...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28948337/blood-versus-crystalloid-cardioplegia-in-pediatric-cardiac-surgery-a-systematic-review-and-meta-analysis
#2
REVIEW
Konstantinos S Mylonas, Aspasia Tzani, Panagiotis Metaxas, Dimitrios Schizas, Vasileios Boikou, Konstantinos P Economopoulos
The benefit of blood cardioplegia (BCP) compared to crystalloid cardioplegia (CCP) is still debatable. Our aim was to systematically review and synthesize all available evidence on the use of BCP and CCP to assess if any modality provides superior outcomes in pediatric cardiac surgery. A systematic literature search of the PubMed and Cochrane databases was performed with respect to the PRISMA statement (end-of-search date: January 30th, 2017). We extracted data on study design, demographics, cardioplegia regimens, and perioperative outcomes as well as relevant biochemical markers, namely cardiac troponin I (cTnI), lactate, and ATP levels at baseline, after reperfusion and postoperatively at 1, 4, 12, and 24 h as applicable...
September 25, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28932552/chylothorax-after-pediatric-cardiac-surgery-complicates-short-term-but-not-long-term-outcomes-a-propensity-matched-analysis
#3
Nikoletta R Czobor, György Roth, Zsolt Prodán, Daniel J Lex, Erzsébet Sápi, László Ablonczy, Mihály Gergely, Edgar A Székely, János Gál, Andrea Székely
BACKGROUND: The occurrence of postoperative chylothorax in children with congenital heart disease is a rare and serious complication in cardiac intensive care units (ICUs). The aim of our study was to identify the perioperative characteristics, treatment options, resource utilization and long term complications of patients having chylothorax after a pediatric cardiac surgery. METHODS: Patients were retrospectively assessed for the presence of chylothorax between January 2002 and December 2012 in a tertiary national cardiac center...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28928610/does-heart-type-fatty-acid-binding-protein-predict-clinical-outcomes-after-pediatric-cardiac-surgery
#4
Egmond S Evers, Varsha Walavalkar, Suresh Pujar, Latha Balasubramanian, Frits W Prinzen, Tammo Delhaas, Ward Y Vanagt, Shreesha Maiya
INTRODUCTION: The early identification of vulnerable pediatric cardiac surgery patients can help clinicians provide them with timely support. Heart-type fatty acid-binding protein. (H-FABP) is an early biomarker of myocardial injury in acute myocardial infarction in adults. In this study, we evaluated the correlations between postoperative H-FABP, creatine kinase-myocardial band (CK-MB), troponin-I, total bypass time, and clinical outcomes. METHODS: In 32 pediatric patients that underwent ventricular septal defect...
September 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28884218/use-of-levosimendan-in-postoperative-setting-after-surgical-repair-of-congenital-heart-disease-in-children
#5
Vivianne Amiet, Marie-Hélène Perez, David Longchamp, Tatiana Boulos Ksontini, Julia Natterer, Sonia Plaza Wuthrich, Jacques Cotting, Stefano Di Bernardo
Low cardiac output is one of the most common complications after cardiac surgery. Levosimendan, a new inotrope agent, has been demonstrated in adult patient to be an effective treatment for this purpose when classical therapy is not effective. The aim of this study was to evaluate the effect of Levosimendan on cardiac output parameters in cardiac children with low cardiac output syndrome (LCOS.). We carried out a retrospective analysis on 62 children hospitalized in our pediatric intensive care unit (PICU) after cardiac surgery, which demonstrated LCOS not responding to classical catecholamine therapy and who received levosimendan as rescue therapy...
September 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28876431/analysis-of-the-availability-of-the-resources-necessary-for-urgent-and-emergency-healthcare-in-s%C3%A3-o-paulo-between-2009-2013
#6
Silvana Hebe Coimbra, Eliete Dominguez Lopez Camanho, Lindolfo Carlos Heringer, Ricardo Vieira Botelho, Cidia Vasconcellos
Introduction: The Regulatory Complex is the structure that operationalizes actions for making resources available to meet the needs of urgent and emergency care in the municipality of São Paulo. In the case of urgent care, needs are immediate and associated with high morbidity and mortality. Objective: To identify the most frequently requested resources, the resolution capacity and the mortality rate associated with the unavailability of a certain resource. Method: Our study was based on data from medical bulletins issued by the Urgent and Emergency Regulation Center (CRUE) in the city of São Paulo from 2009 to 2013...
June 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28866320/differences-in-perioperative-femoral-and-radial-arterial-blood-pressure-in-neonates-and-infants-undergoing-pediatric-cardiac-surgery-requiring-cardiopulmonary-bypass
#7
Hwa Jin Cho, Sang Hoon Lee, In Seok Jeong, Nam Sik Yoon, Jae Sook Ma, Byoung Hee Ahn
OBJECTIVE: Several reports claim that blood pressure (BP) in the radial artery may underestimate the accurate BP in critically ill patients. Here, the authors evaluated differences in mean blood pressure (MBP) between the radial and femoral artery during pediatric cardiac surgery to determine the effectiveness of femoral arterial BP monitoring. METHOD: The medical records of children under 1 year of age who underwent open-heart surgery between 2007 and 2013 were retrospectively reviewed...
August 30, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28696880/performance-of-pediatric-risk-of-mortality-score-among-critically-ill-children-with-heart-disease
#8
MULTICENTER STUDY
Rebecca A Russell, Mallikarjuna Rettiganti, Nancy Brundage, Howard E Jeffries, Punkaj Gupta
OBJECTIVE: To evaluate the performance of the Pediatric Risk of Mortality 3 (PRISM-3) score in critically ill children with heart disease. METHODS: Patients <18 years of age admitted with cardiac diagnoses (cardiac medical and cardiac surgical) to one of the participating pediatric intensive care units in the Virtual Pediatric Systems, LLC, database were included. Performance of PRISM-3 was evaluated with discrimination and calibration measures among both cardiac surgical and cardiac medical patients...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28676203/-frequency-type-and-predictors-of-pleuropulmonary-complications-during-the-first-thirty-days-after-cardiopulmonary-bypass-surgery-in-children
#9
Jessica Jacqueline Hernández-López, Alejandro Solano-Gutiérrez, Flor Teresita Rosas-Aragón, Airam Gabriela Antúnez-Soto, Janet Flores-Lujano, Juan Carlos Nuñez-Enríquez
OBJECTIVE: To determine the frequency, type and predictors of pleuropulmonary complications in the first thirty postoperative days of patients undergoing surgery without cardiopulmonary bypass. METHODS: A retrospective cohort study was carried out between January 2013 and December 2014. It includes all patients with congenital heart disease who underwent cardiac surgery with a sternal or thoracic approach, without cardiopulmonary bypass with a registered admission to Neonatal or Pediatric Intensive Care...
July 1, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28672079/acute-kidney-injury-in-congenital-cardiac-surgery-comparison-of-prifle-akin
#10
Murat Tanyildiz, Mesiha Ekim, Tanil Kendirli, Ercan Tutar, Zeynep Eyileten, Zeynep Birsin Ozcakar, Asli Kavaz, Fatos Yalcınkaya, Adnan Uysalel, Semra Atalay
BACKGROUND: Acute kidney injury (AKI) is associated with an increased risk of mortality especially in pediatric intensive care units. The aim of this study is to determine the risk factors of AKI in children undergoing cardiac surgery for congenital heart disease and compare two different classification systems: pRIFLE and AKIN. METHODS: We retrospectively analyzed 145 patient undergoing pediatric congenital heart surgery who were between 1 month and 18 years and treated by the cardiovascular surgery department from January 2009 to October 2011...
July 3, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28663640/sonographic-evaluation-of-internal-jugular-vein-diameter-and-cross-sectional-area-measurements-in-correlation-with-left-ventricular-end-diastolic-area-as-a-tool-for-perioperative-assessment-of-volume-status-in-pediatric-patients-undergoing-cardiac-surgery
#11
Wafaa Mohamed Elsadek, Amal Hanfy Abo Elaela, Heba Mohamed Nassar, Mohamed Maher Kamel, Ahmed Abdelaziz Mohamed, Hassan Mohamed Ali
AIM: The aim of this study is to compare the ultrasound estimation of the cross-sectional area (CSA) and diameter of internal jugular vein (IJV) with left ventricular end diastolic area (LVEDA) for the assessment of intravascular volume in pediatric patients during cardiac surgery. PATIENTS AND METHODS: The CSA and diameter of the left IJV were defined, using ultrasound machine, and compared with LVEDA, estimated by transesophageal echo, in four times intervals (immediately after induction [T1], before the start of cardiopulmonary bypass [CPB] [T2], immediately after weaning of CPB [T3], and at the end of surgery before transfer to the Intensive Care Unit [T4]) as a tool for intravascular volume assessment in 16 pediatric patients undergoing cardiac surgery...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28658196/late-term-gestation-is-associated-with-improved-survival-in-neonates-with-congenital-heart-disease-following-postoperative-extracorporeal-life-support
#12
Jane M McKenzie, Thomas Scodellaro, Yves d'Udekem, Roberto Chiletti, Warwick Butt, Siva P Namachivayam
OBJECTIVE: Several population-based studies have shown that gestational age 39-40 weeks at birth is associated with superior outcomes in various pediatric settings. A high proportion of births for neonates with congenital heart disease occur before 39 weeks. We aimed to assess the influence of late-term gestation (39-40 wk) on survival in neonates requiring extracorporeal life support following surgery for congenital heart disease. DESIGN: Retrospective cohort study...
September 2017: Pediatric Critical Care Medicine
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
#13
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/28571730/serum-neuronal-biomarkers-in-neonates-with-congenital-heart-disease-undergoing-cardiac-surgery
#14
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/28549578/pediatric-out-of-hospital-cardiac-arrest-caused-by-left-coronary-artery-agenesis-with-primary-shockable-rhythm-a-brief-report
#15
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
https://www.readbyqxmd.com/read/28542655/-risk-factors-associated-with-postoperative-acute-renal-failure-in-pediatric-patients-undergoing-cardiopulmonary-bypass-surgery
#16
Elsa Nohemí Reyes-Flandes, Alejandro Herrera-Landero, Pascual Bobadilla-González, Juan Carlos Núñez-Enríquez
Acute renal failure (ARF) is a complication associated with cardiac surgery with cardiopulmonary bypass (CPB) with an impact on morbidity and mortality. OBJECTIVE: To identify risk factors associated with postoperative IRA according to pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease scale in children undergoing cardiac surgery with CPB. PATIENTS AND METHOD: A nested case-control study was conducted. We included children under 16 years of age attended postoperative for CBP in a pediatric intensive care unit over a period of 18 months...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28533072/relationship-between-transfusion-of-blood-products-and-the-incidence-of-thrombotic-complications-in-neonates-and-infants-undergoing-cardiac-surgery
#17
David Faraoni, Sirisha Emani, Erin Halpin, Rachel Bernier, Sitaram Emani, James A DiNardo, Juan C Ibla
OBJECTIVES: The authors hypothesized that transfusion of blood products in neonates and infants undergoing high-risk cardiac surgery in the absence of intraoperative coagulation monitoring increases the risk of thrombotic complications. DESIGN: Prospective observational study. SETTING: Neonates and infants undergoing cardiac surgery at a tertiary pediatric center. PARTICIPANTS: Neonates weighing >2.5 kg and infants ≤12 months of age undergoing elective cardiac surgery with cardiopulmonary bypass were included in this prospective observational study...
April 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#18
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28503704/use-of-eeg-in-critically-ill-children-and-neonates-in-the-united-states-of-america
#19
Marina Gaínza-Lein, Iván Sánchez Fernández, Tobias Loddenkemper
The objective of the study was to estimate the proportion of patients who receive an electroencephalogram (EEG) among five common indications for EEG monitoring in the intensive care unit: traumatic brain injury (TBI), extracorporeal membrane oxygenation (ECMO), cardiac arrest, cardiac surgery and hypoxic-ischemic encephalopathy (HIE). We performed a retrospective cross-sectional descriptive study utilizing the Kids' Inpatient Database (KID) for the years 2010-2012. The KID is the largest pediatric inpatient database in the USA and it is based on discharge reports created by hospitals for billing purposes...
June 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28492405/a-case-control-analysis-of-postoperative-fluid-balance-and-mortality-after-pediatric-cardiac-surgery
#20
Meth R Delpachitra, Siva P Namachivayam, Johnny Millar, Carmel Delzoppo, Warwick W Butt
OBJECTIVES: A positive fluid balance after cardiac surgery may be associated with poor outcomes; however, previous studies looking at this association have been limited by the number of deaths in the study population. Our primary aim was to determine the relationship between postoperative cumulative fluid balance and mortality in cardiac surgical patients. Secondary aims were to study the association between fluid balance and duration of mechanical ventilation, intensive care and hospital length of stay...
July 2017: Pediatric Critical Care Medicine
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