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Pediatric Acute Heart Failure

Chiu-Yu Chen, Paul Warner, Erin L Albers, Mariska S Kemna, Meghan Delaney, Borah J Hong, Yuk M Law
ABO-i heart transplantation can be performed in infants with end-stage heart failure to increase organ availability. The development of newly detected DSAs is associated with decreased cardiac graft survival, and the effect of ABO-i transplantation on DSA production is unknown. We examined DSA production and rejection frequency in infant recipients of ABO-i and ABO-c heart transplants via a retrospective cohort study of infant heart transplant recipients transplanted at a single pediatric center between January 2004 and November 2014...
December 4, 2018: Pediatric Transplantation
Kristen A Smith, Heidi R Flori
In caring for critically ill children, recognition and management often begins in the pediatric emergency department. A seamless transition in care is needed to ensure appropriate care to the sickest of children. This review covers the management of critically ill children in the pediatric emergency department beyond the initial stabilization for conditions such as acute respiratory failure and pediatric acute respiratory distress syndrome, traumatic brain injury, status epilepticus, congenital heart disease, and metabolic emergencies...
December 2018: Pediatric Clinics of North America
Mohamed N El-Gamasy, Walid Ahmed El-Shehaby
INTRODUCTION: Acute nephritic syndrome (ANS) is the most common cause of hypertensive heart failure in pediatric population. There are few publications on myocardial evaluation using electrocardiographic and echocardiographic data in pediatric patients with ANS. This study aimed to evaluate myocardial function by electrocardiography and 2-dimensional echocardiography in Egyptian pediatric patients with ANS. MATERIALS AND METHODS: Sixty children with ANS were included and subjected to clinical, laboratory, electrocardiography for corrected QT interval, and 2-dimensional echocardiographic study on admission, and repeated at 6 and 12 weeks to measure left ventricular ejection fraction, left atrium-aorta ratio, and the ratio of peak early filling (E wave) to late diastolic filling (A wave) velocities (E/A ratio)...
October 2018: Iranian Journal of Kidney Diseases
Punkaj Gupta, Jeffrey M Gossett, Danny Kofos, Mallikarjuna Rettiganti
PURPOSE: To create a real-time prediction tool to predict probability of ECMO deployment in children with cardiac or pulmonary failure. MATERIALS AND METHODS: Patients ≤18 years old admitted to an ICU that participated in the Virtual Pediatric Systems database (2009-2015) were included. Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with ECMO use. RESULTS: A total of 538,202 ICU patients from 140 ICUs qualified for inclusion...
February 2019: Journal of Critical Care
Xin Xu, Sheng Nie, Aihua Zhang, Jianhua Mao, Hai-Peng Liu, Huimin Xia, Hong Xu, Zhangsuo Liu, Shipin Feng, Wei Zhou, Xuemei Liu, Yonghong Yang, Yuhong Tao, Yunlin Feng, Chunbo Chen, Mo Wang, Yan Zha, Jian-Hua Feng, Qingchu Li, Shuwang Ge, Jianghua Chen, Yongcheng He, Siyuan Teng, Chuanming Hao, Bi-Cheng Liu, Ying Tang, Wenjuan He, Pinghong He, Fan Fan Hou
BACKGROUND AND OBJECTIVES: High-quality epidemiologic data on AKI in children are particularly lacking in developing countries. This study aimed to assess the epidemiology and clinical correlates of AKI among hospitalized children in China. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a multicenter study, in a cohort of hospitalized children aged 1 month to 18 years, from 25 general and children's hospitals in China during 2013-2015. We obtained patient-level data from the electronic hospitalization information system and laboratory databases of all children who had at least two serum creatinine tests within any 7-day window during their first 30 days of hospitalization...
October 4, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Mayuko Yamamoto, Yoshihiro Oshima, Hironori Matsuhisa, Tomonori Higuma, Ryuma Iwaki, Shunsuke Matsushima, Yu Murakami
Extracorporeal membrane oxygenation via cervical cannulation is an established option for pediatric patients with acute cardiopulmonary failure. However, left heart decompression is sometimes mandatory in patients with severe left ventricular dysfunction. We describe a fast and less invasive technique for placing a left atrial cannula through a left anterior minithoracotomy approach. In 4 critically ill children, this minimally invasive technique provided satisfactory left heart decompression, and we describe a representative case...
September 29, 2018: Annals of Thoracic Surgery
Luyun Fan, Huimin Zhang, Jun Cai, Wenjun Ma, Lei Song, Ying Lou
No abstract text is available yet for this article.
October 2018: Journal of Hypertension
Billy C Wang, Theodore Pei, Cheryl B Lin, Rong Guo, David Elashoff, James A Lin, Carol Pineda
AIM: To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation (NIMV) use in acute pediatric respiratory failure. METHODS: We identified all patients treated with NIMV in the pediatric intensive care unit (PICU) or inpatient general pediatrics between January 2013 and December 2015 at two academic centers. Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included. Data included demographics, vital signs on admission and prior to initiation of NIMV, pediatric risk of mortality III (PRISM-III) scores, complications, respiratory support characteristics, PICU and hospital length of stays, duration of respiratory support, and complications...
September 7, 2018: World Journal of Critical Care Medicine
Stacey L Valentine, Melania M Bembea, Jennifer A Muszynski, Jill M Cholette, Allan Doctor, Phillip C Spinella, Marie E Steiner, Marisa Tucci, Nabil E Hassan, Robert I Parker, Jacques Lacroix, Andrew Argent, Jeffrey L Carson, Kenneth E Remy, Pierre Demaret, Guillaume Emeriaud, Martin C J Kneyber, Nina Guzzetta, Mark W Hall, Duncan Macrae, Oliver Karam, Robert T Russell, Paul A Stricker, Adam M Vogel, Robert C Tasker, Alexis F Turgeon, Steven M Schwartz, Ariane Willems, Cassandra D Josephson, Naomi L C Luban, Leslie E Lehmann, Simon J Stanworth, Nicole D Zantek, Timothy E Bunchman, Ira M Cheifetz, James D Fortenberry, Meghan Delaney, Leo van de Watering, Karen A Robinson, Sara Malone, Katherine M Steffen, Scot T Bateman
OBJECTIVES: To date, there are no published guidelines to direct RBC transfusion decision-making specifically for critically ill children. We present the recommendations from the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. DESIGN: Consensus conference series of multidisciplinary, international experts in RBC transfusion management of critically ill children. SETTING: Not applicable. INTERVENTION: None...
September 2018: Pediatric Critical Care Medicine
Leonardo A Miana, Guilherme Viotto Rodrigues da Silva, Luiz Fernando Caneo, Aida Luisa Turquetto, Carla Tanamati, Gustavo Foronda, Maria Raquel Massoti, Juliano G Penha, Estela Azeka, Filomena R B G Galas, Fabio B Jatene, Marcelo B Jatene
INTRODUCTION: Donor shortage and organ allocation is the main problem in pediatric heart transplant. Mechanical circulatory support is known to increase waiting list survival, but it is not routinely used in pediatric programs in Latin America. METHODS: All patients listed for heart transplant and supported by a mechanical circulatory support between January 2012 and March 2016 were included in this retrospective single-center study. The endpoints were mechanical circulatory support time, complications, heart transplant survival and discharge from the hospital...
May 2018: Brazilian Journal of Cardiovascular Surgery
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Piotr Ładziński, Aleksander Pawlak, Marcin Zieliński, Agata Dąbrowska, Aniela Artyńska, Mariusz Gezela, Paweł Sobczyński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
The implemented "ECMO for Greater Poland" program takes full advantage of the ECMO (extracorporeal membrane oxygenation) perfusion therapy to promote health for 3.5 million inhabitants in the region. The predominant subjects of implementation are patients with hypothermia, with severe reversible respiratory failure (RRF), and treatment of other critical states leading to heart failure such as sudden cardiac arrest, cardiogenic shock or acute intoxication. Finally, it promotes donation after circulatory death (DCD) strategy in selected organ donor cases...
November 2018: Artificial Organs
Kathleen C Woulfe, Cortney E Wilson, Shane Nau, Sarah Chau, Elisabeth K Phillips, Shulun Zang, Christine Tompkins, Carmen C Sucharov, Shelley D Miyamoto, Brian L Stauffer
Sudden cardiac death from ventricular arrhythmias is more common in adult patients with with heart failure compared with pediatric patients with heart failure. We identified age-specific differences in arrhythmogenesis using a guinea pig model of acute β-adrenergic stimulation. Young and adult guinea pigs were exposed to the β-adrenergic agonist isoproterenol (ISO; 0.7 mg/kg) for 30 min in the absence or presence of flecainide (20 mg/kg), an antiarrhythmic that blocks Na+ and ryanodine channels. Implanted cardiac monitors (Reveal LINQ, Medtronic) were used to monitor heart rhythm...
October 1, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Suguru Takeuchi, Jun-Ichi Kawada, Yusuke Okuno, Kazuhiro Horiba, Takako Suzuki, Yuka Torii, Kazushi Yasuda, Atsushi Numaguchi, Taichi Kato, Yoshiyuki Takahashi, Yoshinori Ito
Myocarditis is an inflammatory disease of the myocardium and leads to cardiac dysfunction and heart failure. Although viral infections are considered to be the most common etiology of myocarditis, the identification of the causative virus is still challenging. Recently, next-generation sequencing (NGS) has been applied in the diagnosis of infectious diseases. The aim of the current study was to comprehensively analyze potential pathogenic microorganisms using NGS in the sera of patients with myocarditis. Twelve pediatric and five adult patients hospitalized for acute myocarditis were included...
December 2018: Journal of Medical Virology
José Colleti Junior, Tâmara Eleamen Longui, Werther Brunow de Carvalho
OBJECTIVE: To report a case of a patient who required tracheal intubation in a pediatric emergency department due to acute laryngitis and that, after the planned extubation, has successfully used the high-flow nasal cannula, which possibly prevented extubation failure. CASE DESCRIPTION: A male 8-month-old child was admitted to the pediatric emergency room with acute respiratory distress due to a high airway obstruction secondary to severe acute laryngitis. He was immediately intubated and referred to the pediatric intensive care unit...
July 2018: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
Magdalena Stârcea, Cristina Gavrilovici, Andra Elsayed, Mihaela Munteanu, Vasile Valeriu Lupu, Elena Cojocaru, Ingrith Miron, Lucian Miron
RATIONALE: Though to be rare, calcific uremic arteriolophathy (CUA) is an ectopic calcification entity causing pain and disabilities in patients with chronic renal insufficiency, thus increasing the morbidity and mortality. PATIENT CONCERN: We report a case of four years old boy admitted with acute respiratory failure. Physical examination revealed: irritability, purple subcutaneous hard nodules, tachypnea, dry spasmodic cough, respiratory rate 45/min, heart rate 110/min, blood pressure 100/60 mmHg, with normal heart sounds, no murmurs, hepatomegaly with hepato-jugular reflux...
July 2018: Medicine (Baltimore)
Judit C Sági, Bálint Egyed, Andrea Kelemen, Nóra Kutszegi, Márta Hegyi, András Gézsi, Martina Ayaka Herlitschke, Andrea Rzepiel, Lili E Fodor, Gábor Ottóffy, Gábor T Kovács, Dániel J Erdélyi, Csaba Szalai, Ágnes F Semsei
BACKGROUND: The treatment of acute lymphoblastic leukemia (ALL) and osteosarcoma (OSC) is very effective: the vast majority of patients recover and survive for decades. However, they still need to face serious adverse effects of chemotherapy. One of these is cardiotoxicity which may lead to progressive heart failure in the long term. Cardiotoxicity is contributed mainly to the use of anthracyclines and might have genetic risk factors. Our goal was to test the association between left ventricular function and genetic variations of candidate genes...
July 3, 2018: BMC Cancer
Deepak Chellapandian, Jason D Pole, Paul C Nathan, Lillian Sung
The purpose was to describe the incidence and risk factors of congestive heart failure (CHF) among children with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). We included 2053 children (≤18 years) with first primary ALL and AML diagnosed 1992-2010 and registered in the Pediatric Oncology Group of Ontario Networked Information System. We identified CHF events through linked administrative databases. At 10 years, the cumulative incidence of CHF was 1.7% in ALL and 7.5% in AML. Factors associated with CHF in ALL were female gender, age <1 year at cancer diagnosis, irradiation and cumulative anthracycline dose ≥250 mg/m2 ...
July 3, 2018: Leukemia & Lymphoma
Takuto Takahashi, Yusuke Okubo, Maria A Pereda, Atsuhiko Handa, Scott Miller
OBJECTIVES: Acute chest syndrome is the leading cause of death in children with sickle cell disease and is generally due to respiratory failure. Epidemiologic factors for a need for mechanical ventilation in children with acute chest syndrome require further clarification. DESIGN: Retrospective observational study. SETTING: Nationally representative pediatric inpatient records in the United States by using the Kids' Inpatient Database for the years 2003, 2006, 2009, and 2012...
September 2018: Pediatric Critical Care Medicine
Marissa A Brunetti, J William Gaynor, Lauren B Retzloff, Jessica L Lehrich, Mousumi Banerjee, Venugopal Amula, David Bailly, Darren Klugman, Josh Koch, Javier Lasa, Sara K Pasquali, Michael Gaies
OBJECTIVES: Cardiopulmonary failure in children with cardiac disease differs from the general pediatric critical care population, yet the epidemiology of extracorporeal membrane oxygenation support in cardiac ICUs has not been described. We aimed to characterize extracorporeal membrane oxygenation utilization and outcomes across surgical and medical patients in pediatric cardiac ICUs. DESIGN: Retrospective analysis of the Pediatric Cardiac Critical Care Consortium registry to describe extracorporeal membrane oxygenation frequency and outcomes...
June 2018: Pediatric Critical Care Medicine
Peter C Chen, Rodrigo Zea-Vera, Cole Burgman, E Dean McKenzie, Barbara Elias, Iki Adachi
The Berlin EXCOR ventricular assist device has become a standard treatment in pediatric bridge to transplantation. Despite its increased use in pediatric heart failure, the patient population supported with this technology continues to suffer from hematologic issues such as postoperative hemorrhage and neurologic dysfunction secondary to thrombotic events. Finding a balance between hemorrhagic and thrombotic risks in the acute postoperative period poses a significant challenge. In this report, we describe our approach using a temporary centrifugal pump connected to cannulas designed for the Berlin EXCOR ventricular assist device...
May 29, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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