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Pediatric cardiac surgery and intensive care

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https://www.readbyqxmd.com/read/27878830/clinical-assessment-of-histidine-tryptophan-ketoglutarate-solution-and-modified-st-thomas-solution-in-pediatric-cardiac-surgery-of-tetralogy-of-fallot
#1
Zhao-Hui Wang, Yong An, Ming-Cheng Du, Ting-Jiang Qin, Yin-Bei Liu, Hong-Zhen Xu, Li-Qun Yang
The objective of this study is to compare the myocardium protective effect of Bretschneider's histidine-tryptophan-ketoglutarate (HTK) solution versus Modified St. Thomas' (STH) solution in pediatric cardiac surgery of Tetralogy of Fallot (TOF). Seventy-seven pediatric patients of TOF who received the total surgical repair were reviewed, from January 2014 to October 2015. A horizontal comparison between HTK solution and modified STH solution has been made since the HTK solutions were started to be used in our hospital...
November 22, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27872996/surgical-repair-of-ventricular-septal-defect-contemporary-results-and-risk-factors-for-a-complicated-course
#2
Maartje Schipper, Martijn G Slieker, Paul H Schoof, Johannes M P J Breur
Surgical closure of the ventricular septal defect is the most commonly performed procedure in pediatric cardiac surgery. There are conflicting data on weight at operation as risk factor for a complicated course. We performed a retrospective evaluation of mortality and morbidity in all patients undergoing surgical ventricular septal defect closure at our institution between 2004 and 2012 to identify risk factor for a complicated course. Multivariate logistic regression modeling was performed to identify risk factors for a complicated course...
November 21, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27868338/incomplete-timothy-syndrome-secondary-to-a-mosaic-mutation-of-the-cacna1c-gene-diagnosed-using-next-generation-sequencing
#3
Amandine Baurand, Sylvie Falcon-Eicher, Gabriel Laurent, Elisabeth Villain, Caroline Bonnet, Christel Thauvin-Robinet, Caroline Jacquot, Jean-Christophe Eicher, Jean-Baptiste Gourraud, Sébastien Schmitt, Stéphane Bézieau, Mathilde Giraud, Solenne Dumont, Paul Kuentz, Vincent Probst, Antoine Burguet, Florence Kyndt, Laurence Faivre
Autosomal dominant genetic diseases can occur de novo and in the form of somatic mosaicism, which can give rise to a less severe phenotype, and make diagnosis more difficult given the sensitivity limits of the methods used. We report the case of female child with a history of surgery for syndactyly of the hands and feet, who was admitted at 6 years of age to a pediatric intensive care unit following cardiac arrest. The electrocardiogram (ECG) showed a long QT interval that on occasions reached 500 ms. Despite the absence of facial dysmorphism and the presence of normal psychomotor development, a diagnosis of Timothy syndrome was made given the association of syndactyly and the ECG features...
November 21, 2016: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/27753765/risk-adjustment-for-congenital-heart-surgery-score-as-a-risk-factor-for-candidemia-in-children-undergoing-congenital-heart-defect-surgery
#4
Fabio de Araujo Motta, Libera Maria Dalla-Costa, Marisol Dominguez Muro, Andrea Lenzi, Gledson Luiz Picharski, Marion Burger
BACKGROUND: Candida species are the primary cause of invasive fungal infection in hospitalized children. There are few data on risk factors for postoperative candidemia in pediatric patients with congenital heart defects. This study aimed to identify risk factors for candidemia in patients with congenital heart defects who underwent cardiac surgery. METHODS: This was a case-control study conducted in patients admitted to a pediatric cardiology intensive care unit from January 2006 to December 2013...
November 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27748700/acetazolamide-therapy-for-metabolic-alkalosis-in-pediatric-intensive-care-patients
#5
Carolina López, Andrés José Alcaraz, Blanca Toledo, Lucía Cortejoso, Maite Augusta Gil-Ruiz
OBJECTIVE: Patients in PICUs frequently present hypochloremic metabolic alkalosis secondary to loop diuretic treatment, especially those undergoing cardiac surgery. This study evaluates the effectiveness of acetazolamide therapy for metabolic alkalosis in PICU patients. DESIGN: Retrospective, observational study. SETTING: A tertiary care children's hospital PICU. PATIENTS: Children receiving at least a 2-day course of enteral acetazolamide...
September 29, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27740725/assessment-of-extravascular-lung-water-by-ultrasound-after-congenital-cardiac-surgery
#6
Anu K Kaskinen, Laura Martelius, Turkka Kirjavainen, Paula Rautiainen, Sture Andersson, Olli M Pitkänen
BACKGROUND: Lung ultrasounds show vertical artifacts known as B-lines in the presence of increased extravascular lung water (EVLW). We aimed to investigate whether lung ultrasound could estimate EVLW after congenital cardiac surgery. METHODS: This prospective observational study comprised 61 children (age range 3 days to 7.4 years) undergoing congenital cardiac surgery. We compared postoperative B-line scores from lung ultrasounds, early postoperative ultrasound as our primary interest, with corresponding postoperative chest radiography (CXR) lung edema scores, with static lung compliance, and with short-term clinical outcome interpreted as time on mechanical ventilation and length of pediatric intensive care unit (PICU) stay...
October 14, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27734554/revisiting-acute-normovolemic-hemodilution-anh-and-blood-transfusion-during-pediatric-cardiac-surgery-a-prospective-observational-study
#7
Roby Sebastian, Todd Ratliff, Peter D Winch, Dmitry Tumin, Daniel Gomez, Joseph Tobias, Mark Galantowicz, Aymen N Naguib
BACKGROUND: The majority of allogeneic transfusions occur in the perioperative setting, especially during cardiac surgery. In addition to the economic implications, there is emerging evidence that blood transfusion may increase both morbidity and mortality. Acute normovolemic hemodilution (ANH) may limit the need for blood products. OBJECTIVES: The primary objective of this study was to determine if the method of blood collection (syringe or bag) during the ANH process impacted the platelet count and function...
October 13, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27720490/a-retrospective-analysis-of-the-influence-of-ventricular-morphology-on-the-perioperative-outcomes-after-fontan-surgery
#8
Mineto Kamata, Corey Stiver, Aymen Naguib, Dmitry Tumin, Joseph D Tobias
OBJECTIVES: The objectives of this study were to evaluate the effect of ventricular morphology on perioperative outcomes during Fontan surgery. DESIGN: Retrospective cohort study. SETTING: Single standing, not-for-profit pediatric hospital. PARTICIPANTS: A total of 72 patients who underwent Fontan surgery using cardiopulmonary bypass without aortic cross-clamp between January 1, 2009 and December 31, 2014. INTERVENTIONS: None...
July 19, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27716691/the-efficacy-of-pre-emptive-dexmedetomidine-versus-amiodarone-in-preventing-postoperative-junctional-ectopic-tachycardia-in-pediatric-cardiac-surgery
#9
Nagat S El-Shmaa, Doaa El Amrousy, Wael El Feky
OBJECTIVE: The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia (JET) in pediatric cardiac surgery. DESIGN: This is a prospective, controlled study. SETTING: This study was carried out at a single university hospital. SUBJECTS AND METHODS: Ninety patients of both sexes, American Society of Anesthesiologists Physical Status II and III, age range from 2 to 18 years, and scheduled for elective cardiac surgery for congenital and acquired heart diseases were selected as the study participants...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27713672/outcomes-in-postoperative-pediatric-cardiac-surgical-patients-who-received-an-antiepileptic-drug
#10
Mindl M Messinger, Kimberly L Dinh, Erin J McDade, Brady S Moffett, Angus A Wilfong, Antonio G Cabrera
BACKGROUND: Advances in cardiac operations over the last few decades, including corrective operations in early life, have dramatically increased the survival of children with congenital heart disease. However, postoperative care has been associated with neurologic complications, with seizures being the most common manifestation. The primary objective of this study is to describe the outcomes in pediatric patients who received an antiepileptic drug (AED) post-cardiac surgery. METHOD: A retrospective cohort study was performed in all patients less than 18 years of age who received an AED in the cardiovascular intensive care unit at Texas Children's Hospital from June 2002 until June 2012...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
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
#11
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/27583584/protocolized-care-for-early-shock-resuscitation
#12
Matthew Goodwin, Kaori Ito, Arielle H Gupta, Emanuel P Rivers
PURPOSE OF REVIEW: Protocolized care for early shock resuscitation (PCESR) has been intensely examined over the last decade. The purpose is to review the pathophysiologic basis, historical origin, clinical applications, components and outcome implications of PCESR. RECENT FINDINGS: PCESR is a multifaceted systems-based approach that includes early detection of high-risk patients and interventions to rapidly reverse hemodynamic perturbations that result in global or regional tissue hypoxia...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27550555/caudal-analgesia-and-cardiothoracic-surgery-a-look-at-postoperative-pain-scores-in-a-pediatric-population
#13
Khoa N Nguyen, Heather S Byrd, Jonathan M Tan
AIM: Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. METHODS: We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013...
November 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27513688/pharmacodynamics-and-pharmacokinetics-of-morphine-after-cardiac-surgery-in-children-with-and-without-down-syndrome
#14
Abraham J Valkenburg, Elisa A M Calvier, Monique van Dijk, Elke H J Krekels, Brendan P O'Hare, William F Casey, Ron A A Mathôt, Catherijne A J Knibbe, Dick Tibboel, Cormac V Breatnach
OBJECTIVE: To compare the pharmacodynamics and pharmacokinetics of IV morphine after cardiac surgery in two groups of children-those with and without Down syndrome. DESIGN: Prospective, single-center observational trial. SETTING: PICU in a university-affiliated pediatric teaching hospital. PATIENTS: Twenty-one children with Down syndrome and 17 without, 3-36 months old, scheduled for cardiac surgery with cardiopulmonary bypass...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27490613/endocrinologic-diseases-in-pediatric-cardiac-intensive-care
#15
Carmen L Soto-Rivera, Steven M Schwartz, Jaclyn E Sawyer, Duncan J Macrae, Michael S D Agus
OBJECTIVES: The objectives of this review are to discuss the pathophysiology, clinical impact and treatment of hyperglycemia, and disturbances in thyroid and adrenal function prior to and following cardiac surgery in children. DATA SOURCE: MEDLINE and PubMed. CONCLUSIONS: Disturbances in glucose metabolism and thyroid and adrenal function are common in critically ill children with cardiac disease and in particular in children undergoing cardiac surgery for complex congenital heart disease...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27490607/acute-kidney-injury-and-cardiorenal-syndromes-in-pediatric-cardiac-intensive-care
#16
David S Cooper, David M Kwiatkowski, Stuart L Goldstein, Catherine D Krawczeski
OBJECTIVES: The objectives of this review are to discuss the definition, diagnosis, and pathophysiology of acute kidney injury and its impact on immediate, short-, and long-term outcomes. In addition, the spectrum of cardiorenal syndromes will be reviewed including the pathophysiology on this interaction and its impact on outcomes. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: The field of cardiac intensive care continues to advance in tandem with congenital heart surgery...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27436222/distal-superficial-femoral-vein-cannulation-for-peripherally-inserted-central-catheter-placement-in-infants-with-cardiac-disease
#17
Robert P Richter, Mark A Law, Santiago Borasino, Jessica A Surd, Jeffrey A Alten
OBJECTIVE: To describe a novel real-time ultrasound (US)-guided distal superficial femoral vein (DSFV) cannulation technique for insertion of peripherally inserted central catheters (PICC) in critically ill infants with congenital heart disease. DESIGN: Descriptive retrospective cohort study SETTING: Pediatric cardiac intensive care unit in a pediatric tertiary hospital PATIENTS: First 28 critically ill infants that received DSFV PICCs via this new technique. RESULTS: Thirty-seven US-guided DSFV PICCs were attempted on 31 infants from September 2012 to November 2014; 34 PICCs were placed in 28 patients (success rate 92%)...
December 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27431598/does-postoperative-cardiac-troponin-i-have-any-prognostic-value-in-predicting-midterm-mortality-after-congenital-cardiac-surgery
#18
Mona Momeni, Alain Poncelet, Jean Rubay, Amine Matta, Laurent Veevaete, Thierry Detaille, Laurent Houtekie, Stéphan Clement de Clety, Emilien Derycke, Stéphane Moniotte, Thierry Sluysmans, Francis Veyckemans
OBJECTIVES: This study evaluated the prognostic value of postoperative cardiac troponin-I (cTnI) in predicting all-cause mortality up to 3 months after normothermic congenital cardiac surgery. DESIGN: Prospective observational study. SETTING: University hospital. PARTICIPANTS: All children ages 0 to 10 years. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: cTnI was measured after the induction of anesthesia but before the surgery, at the pediatric intensive care unit arrival, and at 4, 12, and 24 hours postoperatively...
February 23, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27377529/red-blood-cell-transfusion-in-the-postoperative-care-of-pediatric-cardiac-surgery-survey-on-stated-practice
#19
Jean-Sébastien Tremblay-Roy, Nancy Poirier, Thierry Ducruet, Jacques Lacroix, Karen Harrington
The optimal red blood cell transfusion threshold for postoperative pediatric cardiac surgery patients is unknown. This study describes the stated red blood cell transfusion practice of physicians who treat postoperative pediatric cardiac surgery patients in intensive care units. A scenario-based survey was sent to physicians involved in postoperative intensive care of pediatric cardiac surgery patients in all Canadian centers that perform such surgery. Respondents reported their red blood cell transfusion practice in four postoperative scenarios: acyanotic or cyanotic cardiac lesion, in a neonate or an infant...
October 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27343912/syndecan-1-improves-severe-acute-kidney-injury-prediction-after-pediatric-cardiac-surgery
#20
Candice Torres de Melo Bezerra Cavalcante, Klébia Magalhães Castelo Branco, Valdester Cavalcante Pinto Júnior, Gdayllon Cavalcante Meneses, Fernanda Macedo de Oliveira Neves, Nayana Maria Gomes de Souza, Kiarelle Lourenço Penaforte, Alice Maria Costa Martins, Alexandre Braga Libório
OBJECTIVE: Acute kidney injury is a common occurrence after pediatric cardiac surgery and is associated with adverse patient outcomes. Syndecan-1 is a biomarker of endothelial glycocalyx damage, and its early increment after surgery can be associated with acute kidney injury. METHODS: We performed a prospective cohort study with 289 patients aged less than 18 years who underwent cardiac surgery at 1 reference institution. Postoperative plasma syndecan-1 was collected within the first 2 hours after cardiac surgery...
July 2016: Journal of Thoracic and Cardiovascular Surgery
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