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Pediatric cardiac intervention

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https://www.readbyqxmd.com/read/29324491/validation-of-a-second-generation-near-infrared-spectroscopy-monitor-in-children-with-congenital-heart-disease
#1
Viviane G Nasr, Lisa T Bergersen, Hung-Mo Lin, Paul B Benni, Rachel S Bernier, Michelle E Anderson, Barry D Kussman
BACKGROUND: Cerebral oximetry using near-infrared spectroscopy is a noninvasive optical technology to detect cerebral hypoxia-ischemia and develop interventions to prevent and ameliorate hypoxic brain injury. Cerebral oximeters are calibrated and validated by comparison of the near-infrared spectroscopy-measured cerebral O2 saturation (SctO2) to a "field" or reference O2 saturation (REF CX) calculated as a weighted average from arterial and jugular bulb oxygen saturations. In this study, we calibrated and validated the second-generation, 5 wavelength, FORE-SIGHT Elite with the medium sensor (source-detector separation 12 and 40 mm) for measurement of SctO2 in children with congenital heart disease...
January 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29317058/whole-body-periodic-acceleration-pgz-as-a-non-invasive-preconditioning-strategy-for-pediatric-cardiac-surgery
#2
Jose A Adams, Peter Pastuszko, Arkady Uryash, David Wilson, Jose R Lopez Padrino, Vinay Nadkarni, Anna Pastuszko
We hypothesized that pGz has cardio and neuroprotective effects due to upregulation of pathways which include eNOS, anti-apoptotic, and anti-inflammatory pathways. We analyze protein expression of these pathways in the brain of neonatal piglets, as well as report on the myocardial function after Deep Hypothermic Circulatory Arrest (DHCA) and pGz preconditioning. Animal data affirms both a cardio and neuroprotective role for pGz. These findings suggest that pGz can be a simple, non-invasive cardio and neuroprotective strategy preconditioning strategy in children requiring surgical intervention...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29315137/reducing-ischemic-injury-from-indwelling-peripheral-arterial-catheters-in-a-pediatric-cardiac-icu-a-quality-improvement-initiative
#3
Adam C Adler, Stephanie Helman, Cynthia Field, Judith J Stellar, Lauren A Brown, Nicole Omensetter, Andrew T Costarino, Mahsun Yuerek, Karen S Bender
OBJECTIVES: To reduce the number of ischemic arterial catheter injuries in children with congenital or acquired heart disease. DESIGN: This is a quality improvement study with pre- and postintervention groups. SETTING: University-affiliated pediatric cardiac center in a quaternary care freestanding children's hospital. PATIENTS: All patients with an indwelling peripheral arterial catheter placed in the Children's Hospital of Philadelphia Cardiac Center associated with an admission to the Cardiac Intensive Cardiac Unit from January 2015 to July 2017 are included...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29309282/utility-of-perioperative-lung-ultrasound-in-pediatric-cardiac-surgery-a-randomized-controlled-trial
#4
In-Kyung Song, Eun-Hee Kim, Ji-Hyun Lee, Pyoyoon Kang, Hee-Soo Kim, Jin-Tae Kim
BACKGROUND: Pediatric cardiac patients are at risk for perioperative respiratory insufficiency. The objective of this study was to assess the utility of perioperative lung ultrasound examination in pediatric cardiac surgery. METHODS: In this randomized, controlled trial, children (5 yr old or younger) undergoing cardiac surgery were allocated into a control (n = 61) or intervention (n = 61) group. The control group received only lung ultrasound examinations at the end of surgery and 6 to 12 h after surgery...
January 8, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29287870/postoperative-bradycardia-following-adenotonsillectomy-in-children-does-intraoperative-administration-of-dexmedetomidine-play-a-role
#5
Benjamin Bush, Joseph D Tobias, Chen Lin, James Ruda, Kris R Jatana, Garth Essig, Jennifer Cooper, Dmitry Tumin, Charles A Elmaraghy
INTRODUCTION: Dexmedetomidine is a novel pharmacologic agent that has become a frequently used adjunct during care of pediatric patients with obstructive sleep apnea (OSA) undergoing tonsillectomy. While generally safe and effective, dexmedetomidine is associated with adverse effects of hypotension and bradycardia from its central sympatholytic effects. Due to safety concerns, our institution routinely admits patients with OSA for overnight cardiorespiratory monitoring following tonsillectomy...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29286274/the-2017-seventh-world-congress-of-pediatric-cardiology-cardiac-surgery-week-in-review-interventional-cardiology
#6
Damien P Kenny, Ziyad M Hijazi
The interventional cardiology track at the 7th World Congress of Pediatric Cardiology and Cardiac Surgery reflects the pivotal position of transcatheter interventions in the future of our speciality. The highlights of the week are outlined in this review.
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29286266/the-2017-seventh-world-congress-of-pediatric-cardiology-cardiac-surgery-week-in-review-adults-with-chd
#7
Jolien W Roos-Hesselink, Daniel Tobler, Carole Warnes
For the first time in 2017 adults with CHD was included in the World Congress of Pediatric Cardiology & Cardiac Surgery. With growing numbers and more complex patients reaching adulthood, there is a growing need for more attention to this subspecialty. Although survival is excellent and now over 90% of patients reach adulthood, many have residual problems and complications. Heart failure and arrhythmias are most commonly encountered. Life-expectancy is nearly normal for mild lesions, but remains reduced in moderate-complex lesions and re-interventions are often needed...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29280985/pediatric-hypothermic-submersion-injury-and-protective-factors-associated-with-optimal-outcome-a-case-report-and-literature-review
#8
Daniel Kriz, Juan Piantino, Devin Fields, Cydni Williams
Drowning is the 3rd leading cause of unintentional injury death worldwide, with the highest rates of fatality among young children. Submersion injuries with cardiac arrest can lead to long-term neurologic morbidity. Severe hypothermic submersion injuries have complex treatment courses and survivors have variable neurocognitive outcomes. We describe the course of a hypothermic submersion injury in a 6-year-old previously healthy boy. The description includes premorbid and post-injury neurocognitive functioning...
December 27, 2017: Children
https://www.readbyqxmd.com/read/29261360/precision-medicine-functional-advancements
#9
Thomas Caskey
Precision medicine was conceptualized on the strength of genomic sequence analysis. High-throughput functional metrics have enhanced sequence interpretation and clinical precision. These technologies include metabolomics, magnetic resonance imaging, and I rhythm (cardiac monitoring), among others. These technologies are discussed and placed in clinical context for the medical specialties of internal medicine, pediatrics, obstetrics, and gynecology. Publications in these fields support the concept of a higher level of precision in identifying disease risk...
December 20, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/29239980/derivation-and-internal-validation-of-a-mortality-prediction-tool-for-initial-survivors-of-pediatric-in-hospital-cardiac-arrest
#10
Mathias J Holmberg, Ari Moskowitz, Tia T Raymond, Robert A Berg, Vinay M Nadkarni, Alexis A Topjian, Anne V Grossestreuer, Michael W Donnino, Lars W Andersen
OBJECTIVES: To develop a clinical prediction score for predicting mortality in children following return of spontaneous circulation after in-hospital cardiac arrest. DESIGN: Observational study using prospectively collected data. SETTING: This was an analysis using data from the Get With The Guidelines-Resuscitation registry between January 2000 and December 2015. PATIENTS: Pediatric patients (< 18 yr old) who achieved return of spontaneous circulation...
December 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29228147/association-of-early-postresuscitation-hypotension-with-survival-to-discharge-after-targeted-temperature-management-for-pediatric-out-of-hospital-cardiac-arrest-secondary-analysis-of-a-randomized-clinical-trial
#11
Alexis A Topjian, Russell Telford, Richard Holubkov, Vinay M Nadkarni, Robert A Berg, J Michael Dean, Frank W Moler
Importance: Out-of-hospital cardiac arrest (OHCA) occurs in more than 6000 children each year in the United States, with survival rates of less than 10% and severe neurologic morbidity in many survivors. Post-cardiac arrest hypotension can occur, but its frequency and association with survival have not been well described during targeted temperature management. Objective: To determine whether hypotension is associated with survival to discharge in children and adolescents after resuscitation from OHCA...
December 11, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29218262/neurologic-outcomes-following-care-in-the-pediatric-intensive-care-unit
#12
Sherrill D Caprarola, Sapna R Kudchadkar, Melania M Bembea
Purpose of review: With increasing survival of children requiring admission to pediatric intensive care units (PICU), neurodevelopmental outcomes of these patients are an area of increased attention. Our goal was to systematically review recently published literature on neurologic outcomes of PICU patients. Recent Findings: Decline in neurofunctional status occurs in 3%-20% of children requiring PICU care. This proportion varies based on primary diagnosis and severity of illness, with children admitted for primary neurologic diagnosis, children who suffer cardiac arrest or who require invasive interventions during the PICU admission, having worse outcomes...
September 2017: Current Treatment Options in Pediatrics
https://www.readbyqxmd.com/read/29216871/mental-health-literacy-among-pediatric-hospital-staff-in-the-united-arab-emirates
#13
Nabeel Al-Yateem, Rachel Rossiter, Walter Robb, Alaa Ahmad, Mahmoud Saleh Elhalik, Sumaya Albloshi, Shameran Slewa-Younan
BACKGROUND: In the United Arab Emirates (UAE) 35% of the population are aged 0-24 years. A significant proportion of these young people are living with chronic conditions (e.g., asthma, type 1 diabetes, cardiac conditions, and genetically-transmitted conditions such as thalassemia and cystic fibrosis). This group has increased vulnerability to developmental delays and mental health problems, and is increasingly coming to the attention of service providers in mainstream schools, primary healthcare centers, and pediatric hospitals...
December 8, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/29212948/elevated-urinary-creld2-is-associated-with-endoplasmic-reticulum-stress-mediated-kidney-disease
#14
Yeawon Kim, Sun-Ji Park, Scott R Manson, Carlos Af Molina, Kendrah Kidd, Heather Thiessen-Philbrook, Rebecca J Perry, Helen Liapis, Stanislav Kmoch, Chirag R Parikh, Anthony J Bleyer, Ying Maggie Chen
ER stress has emerged as a signaling platform underlying the pathogenesis of various kidney diseases. Thus, there is an urgent need to develop ER stress biomarkers in the incipient stages of ER stress-mediated kidney disease, when a kidney biopsy is not yet clinically indicated, for early therapeutic intervention. Cysteine-rich with EGF-like domains 2 (CRELD2) is a newly identified protein that is induced and secreted under ER stress. For the first time to our knowledge, we demonstrate that CRELD2 can serve as a sensitive urinary biomarker for detecting ER stress in podocytes or renal tubular cells in murine models of podocyte ER stress-induced nephrotic syndrome and tunicamycin- or ischemia-reperfusion-induced acute kidney injury (AKI), respectively...
December 7, 2017: JCI Insight
https://www.readbyqxmd.com/read/29211219/incidence-and-treatment-of-chylothorax-in-children-undergoing-corrective-surgery-for-congenital-heart-diseases
#15
Nicolle Martin Christofe, Cristiane Felix Ximenes Pessotti, Laércio Paiva, Ieda Biscegli Jatene
INTRODUCTION: Chylothorax is a lymphatic extravasation into pleural cavity and its incidence is 0.25%-5.3% in children undergoing cardiac surgery. OBJECTIVE: To evaluate the incidence of chylothorax in pediatrics patients operated, linking it in each surgical intervention. Evaluate treatment types and efficiency. METHODS: Retrospective study using medical records of children undergoing cardiac surgery in the Hospital do Coração between 2004 and 2014...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29210925/frequency-of-desaturation-and-association-with-hemodynamic-adverse-events-during-tracheal-intubations-in-picus
#16
Simon Li, Ting-Chang Hsieh, Kyle J Rehder, Sholeen Nett, Pradip Kamat, Natalie Napolitano, David A Turner, Michelle Adu-Darko, J Dean Jarvis, Conrad Krawiec, Ashley T Derbyshire, Keith Meyer, John S Giuliano, Joana Tala, Keiko Tarquinio, Michael D Ruppe, Ronald C Sanders, Matthew Pinto, Joy D Howell, Margaret M Parker, Gabrielle Nuthall, Michael Shepherd, Guillaume Emeriaud, Yuki Nagai, Osamu Saito, Jan Hau Lee, Dennis W Simon, Alberto Orioles, Karen Walson, Paula Vanderford, Asha Shenoi, Anthony Lee, Geoffrey L Bird, Michael Miksa, Ana Lia Graciano, Jesse Bain, Peter W Skippen, Lee A Polikoff, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: Oxygen desaturation during tracheal intubation is known to be associated with adverse ICU outcomes in critically ill children. We aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association with adverse hemodynamic tracheal intubation-associated events. DESIGN: Retrospective cohort study as a part of the National Emergency Airway Registry for Children Network's quality improvement project from January 2012 to December 2014...
November 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29208756/neurally-adjusted-ventilatory-assist-after-pediatric-cardiac-surgery-clinical-experience-and-impact-on-ventilation-pressures
#17
Benjamin Crulli, Mariam Khebir, Baruch Toledano, Suzanne Vobecky, Nancy Poirier, Guillaume Emeriaud
INTRODUCTION: After pediatric cardiac surgery, ventilation with high airway pressures can be detrimental to right ventricular function and pulmonary blood flow. Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interactions, helping maintain spontaneous ventilation. This study reports our experience with the use of NAVA in children after a cardiac surgery. We hypothesize that using NAVA in this population is feasible and allows for lower ventilation pressures. METHODS: We retrospectively studied all children ventilated with NAVA (invasively or noninvasively) after undergoing cardiac surgery between January 2013 and May 2015 in our pediatric intensive care unit...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29201159/cardiovascular-risks-in-chronic-kidney-disease-pediatric-patients
#18
Jing Tian, Ling Niu, Xinjiang An
One of the common factors for the premature death in children is advanced chronic kidney disease (CKD). Most often cardiovascular disease (CVD) is the reason for mortality. The cardiovascular (CV) morbidity starts early in the disease process and renal transplanted children (CKD-T) are also at risk. The present review is focused on the current views of the cardiovascular risks during CKD in pediatric patients. Variable data sources for the latest literature collection were explored which mainly included PubMed and Google Scholar...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29193160/multicenter-experience-with-mechanical-circulatory-support-using-a-new-diagonal-pump-in-233-children
#19
Brigitte Stiller, Robert Jan Houmes, André Rüffer, Matthias Kumpf, Andreas Müller, Florian Kipfmüller, Harald Köditz, Susanne Herber Jonat, Claudia Schmoor, Christoph Benk, Dick Tibboel, Thilo Fleck
Technological innovations in pediatric extracorporeal life support circuits can reduce system-related complications and may improve patients' outcome. The Deltastream DP3 (Medos Medizintechnik AG, Stolberg, Germany) is a novel rotational pump with a diagonally streamed impeller that can be used over a broad range of flows. We collected patient data from seven pediatric centers to conduct a retrospective cohort study. We examined 233 patients whose median age was 1.9 (0-201) months. The DP3 system was used for cardiopulmonary support as veno-arterial extracorporeal membrane oxygenation (ECMO) in 162 patients...
November 29, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29189669/measurement-of-dead-space-fraction-upon-icu-admission-predicts-length-of-stay-and-clinical-outcomes-following-bidirectional-cavopulmonary-anastomosis
#20
Claire L Cigarroa, Sarah J van den Bosch, Xiaoqi Tang, Kimberlee Gauvreau, Christopher W Baird, James A DiNardo, John Nagi Kheir
OBJECTIVES: Increased alveolar dead space fraction has been associated with prolonged mechanical ventilation and increased mortality in pediatric patients with respiratory failure. The association of alveolar dead space fraction with clinical outcomes in patients undergoing bidirectional cavopulmonary anastomosis for single ventricle congenital heart disease has not been reported. We describe an association of alveolar dead space fraction with postoperative outcomes in patients undergoing bidirectional cavopulmonary anastomosis...
January 2018: Pediatric Critical Care Medicine
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