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Paediatric cardiac surgery

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https://www.readbyqxmd.com/read/30115252/validation-of-capnodynamic-determination-of-cardiac-output-by-measuring-effective-pulmonary-blood-flow-a-study-in-anaesthetised-children-and-piglets
#1
J Karlsson, P Winberg, B Scarr, P A Lönnqvist, E Neovius, M Wallin, M Hallbäck
BACKGROUND: Effective pulmonary blood flow (COEPBF ) has recently been validated as a technique for determining cardiac output (CO) in animals of varying sizes. The primary aim of our study was to investigate this new technique in paediatric surgical patients, compared with suprasternal two-dimensional Doppler (COSSD ). METHODS: A total of 15 children undergoing cleft lip/palate surgery were investigated. Before the start of surgery, manoeuvres that were anticipated to reduce (increase in PEEP from 3 to 10 cm H2 O) and increase (atropine) CO were undertaken...
September 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/30107514/restrictive-compared-with-liberal-red-cell-transfusion-strategies-in-cardiac-surgery-a-meta-analysis
#2
Nadine Shehata, Nikhil Mistry, Bruno R da Costa, Tiago V Pereira, Richard Whitlock, Gerard F Curley, David A Scott, Gregory M T Hare, Peter Jüni, C David Mazer
Aims: To determine whether a restrictive strategy of red blood cell (RBC) transfusion at lower haemoglobin concentrations is inferior to a liberal strategy of RBC transfusion at higher haemoglobin concentrations in patients undergoing cardiac surgery. Methods and results: We conducted a systematic review, meta-analysis, and trial sequential analysis of randomized controlled trials of the effect of restrictive and liberal RBC transfusion strategies on mortality within 30 days of surgery as the primary outcome...
August 10, 2018: European Heart Journal
https://www.readbyqxmd.com/read/30095360/cardioplegia-practice-in-paediatric-cardiac-surgery-a-uk-ireland-survey
#3
Nigel E Drury, Angela Horsburgh, Rehana Bi, Robert G Willetts, Timothy J Jones
INTRODUCTION: Many techniques are available for cardioplegic arrest in children, but there is a lack of late phase clinical trials to guide practice. We surveyed paediatric cardiac surgeons and perfusionists to establish current practice and willingness to change within a clinical trial. METHODS: An online survey was sent to all consultant paediatric cardiac surgeons and chief perfusionists in paediatric centres in the UK and Ireland. Information was sought on cardioplegia type, composition, temperature, topical cooling, dosing for induction and maintenance, interval between doses, whether practice changed with patient age or complexity and whether respondents would be willing and able to use different cardioplegia solutions within a randomised trial...
August 10, 2018: Perfusion
https://www.readbyqxmd.com/read/30073903/methods-for-determination-of-stagnation-in-pneumatic-ventricular-assist-devices
#4
Damian Obidowski, Piotr Reorowicz, Dariusz Witkowski, Krzysztof Sobczak, Krzysztof Jóźwik
BACKGROUND: A pneumatic paediatric ventricular assist device developed at the Foundation of Cardiac Surgery Development, Zabrze, equipped with valves based on J. Moll's design, with later modifications introduced at the Institute of Turbomachinery, Lodz University of Technology, was tested numerically and experimentally. The main aim of those investigations was to detect stagnation zones within the ventricular assist device and indicate advantages and limitations of both approaches. METHODS: In the numerical transient test, a motion of the diaphragm and discs was simulated...
August 3, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/30031844/classification-of-ventricular-septal-defects-for-the-eleventh-iteration-of-the-international-classification-of-diseases-striving-for-consensus-a-report-from-the-international-society-for-nomenclature-of-paediatric-and-congenital-heart-disease
#5
Leo Lopez, Lucile Houyel, Steven D Colan, Robert H Anderson, Marie J Béland, Vera D Aiello, Frederique Bailliard, Meryl S Cohen, Jeffrey P Jacobs, Hiromi Kurosawa, Stephen P Sanders, Henry L Walters, Paul M Weinberg, Jeffrey R Boris, Andrew C Cook, Adrian Crucean, Allen D Everett, J William Gaynor, Jorge Giroud, Kristine J Guleserian, Marina L Hughes, Amy L Juraszek, Otto N Krogmann, Bohdan J Maruszewski, James D St Louis, Stephen P Seslar, Diane E Spicer, Shubhika Srivastava, Giovanni Stellin, Christo I Tchervenkov, Lianyi Wang, Rodney C G Franklin
The definition and classification of ventricular septal defects have been fraught with controversy. The International Society for Nomenclature of Paediatric and Congenital Heart Disease is a group of international specialists in pediatric cardiology, cardiac surgery, cardiac morphology, and cardiac pathology that has met annually for the past nine years in an effort to unify by consensus the divergent approaches to describe ventricular septal defects. These efforts have culminated in acceptance of the classification system by the World Health Organization into the 11th Iteration of the International Classification of Diseases (ICD-11)...
July 19, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29954472/treatment-of-unilateral-vocal-fold-paralysis-with-ansa-cervicalis-to-recurrent-nerve-anastomosis-in-a-young-adolescent-european-case-report
#6
C van den Boer, A L Wiersma, J P Marie, J T van Lith-Bijl
BACKGROUND: Laryngeal re-innervation in paediatric unilateral vocal fold paralysis is a relatively new treatment option, of which there has been little reported experience in Europe. METHODS: In this European case report of a 13-year-old boy with dysphonia secondary to left-sided unilateral vocal fold paralysis after cardiac surgery, the patient underwent re-innervation using an ansa cervicalis to recurrent laryngeal nerve transfer, in combination with fat augmentation, after 12 years of nerve denervation...
July 2018: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29947787/cardioplegia-in-paediatric-cardiac-surgery-a-systematic-review-of-randomized-controlled-trials
#7
Nigel E Drury, Ivan Yim, Akshay J Patel, Nicola K Oswald, Cher-Rin Chong, John Stickley, Timothy J Jones
OBJECTIVES: Cardioplegia is the primary method for myocardial protection during cardiac surgery. We conducted a systematic review of randomized controlled trials of cardioplegia in children to evaluate the current evidence base. METHODS: We searched MEDLINE, CENTRAL and LILACS and manually screened retrieved references and systematic reviews to identify all randomized controlled trials comparing cardioplegia solutions or additives in children undergoing cardiac surgery published in any language; secondary publications and those reporting inseparable adult data were excluded...
June 26, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29923133/what-raises-troponins-in-the-paediatric-population
#8
Debbra Chong, Yan Ting Chua, Shu-Ling Chong, Gene Yong-Kwang Ong
Troponin I is a cardiac enzyme that is released during myocardial injury. However, cardiac enzymes are non-specific and can occur in many cardiac and non-cardiac pathologies. We aim to (1) describe the range of acute conditions that were associated with raised troponins in the paediatric population in our institution and (2) quantify the extent of troponin elevation and correlate it with the underlying aetiology. We performed a retrospective observational study in a tertiary institution which included patients from 1 January 2009 to 31 December 2013...
June 19, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29910113/evaluation-of-the-vasoactive-inotropic-score-mid-regional-pro-adrenomedullin-and-cardiac-troponin-i-as-predictors-of-low-cardiac-output-syndrome-in-children-after-congenital-heart-disease-surgery
#9
J L Pérez-Navero, C Merino-Cejas, I Ibarra de la Rosa, S Jaraba-Caballero, M Frias-Perez, E Gómez-Guzmán, M Gil-Campos, M J de la Torre-Aguilar
OBJECTIVE: To determine the predictive value of the inotropic score (IS) and vasoactive-inotropic score (VIS) in low cardiac output syndrome (LCOS) in children after congenital heart disease surgery involving cardiopulmonary bypass (CPB), and to establish whether mid-regional pro-adrenomedullin (MR-proADM) and cardiac troponin I (cTn-I), associated to the IS and VIS scores, increases the predictive capacity in LCOS. DESIGN: A prospective observational study was carried out...
June 14, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29906523/ventricular-fibromas-in-children-arrhythmia-risk-and-outcomes-a-multicenter-study
#10
John P Jones, Tristan Ramcharan, Milind Chaudhari, Vinay Bhole, Karen Mcleod, Shankar Sadagopan, Orhan Uzun, Andrew Parry, Jan Till, Colin J McMahon, Alan G Stuart, Mark A Walsh
BACKGROUND: Although ventricular fibromas are rare, they are the second most common type of cardiac tumor in children. While histologically benign, they have a propensity to cause malignant arrhythmias, with cardiac arrest often being the first presentation. OBJECTIVE: The purpose of this study was to evaluate the arrhythmia risk and management strategies for pediatric ventricular fibromas. METHODS: Fifteen centers in the British Paediatric Arrhythmia Group network were contacted to partake in the study to contribute cases...
June 12, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29754203/prospective-analysis-of-decision-making-during-joint-cardiology-cardiothoracic-conference-in-treatment-of-107-consecutive-children-with-congenital-heart-disease
#11
Sophie Duignan, Aedin Ryan, Dara O'Keeffe, Damien Kenny, Colin J McMahon
The complexity and potential biases involved in decision making have long been recognised and examined in both the aviation and business industries. More recently, the medical community have started to explore this concept and its particular importance in our field. Paediatric cardiology is a rapidly expanding field and for many of the conditions we treat, there is limited evidence available to support our decision-making. Variability exists within decision-making in paediatric cardiology and this may influence outcomes...
May 12, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29717636/importance-of-cardiovascular-examination-in-patients-with-multiple-lentigines-two-cases-of-leopard-syndrome-with-hypertrophic-cardiomyopathy
#12
Tomas Jurko, Alexander Jurko, Jana Krsiakova, Alexander Jurko, Milan Minarik, Michal Mestanik
Introduction LEOPARD syndrome is a rare genetic disorder characterised by lentigines, electrocardiographic conduction abnormalities, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, retardation of growth and sensorineural deafness. Clinical manifestations are often mild, which may result in difficult and late diagnosis. Cardiac involvement may have a significant impact on the prognosis, however, appearance of severe abnormalities such as hypertrophic cardiomyopathy usually precedes the occurrence of multiple lentigines and may be asymptomatic...
May 2, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29706495/effect-of-red-blood-cell-storage-duration-on-outcome-after-paediatric-cardiac-surgery-a-prospective-observational-study
#13
Arvind Kumar Bishnoi, Pankaj Garg, Kartik Patel, Chandrasekaran Ananthanarayanan, Ritesh Shah, Atul Solanki, Himani Pandya, Sanjay Patel
BACKGROUND: Retrospective reviews have found the use of stored packed red blood cells (PRBCs) in priming to be associated with increased risk of postoperative complications. The purpose of study was to prospectively investigate the influence of duration of storage of PRBCs used in priming the cardiopulmonary bypass (CPB) circuit on the metabolic profile of the patients, and postoperative outcome after paediatric cardiac surgery. METHODS: Between January 2015 and December 2015, 198 consecutive children operated for cardiac surgery using CPB and received blood for priming the circuit were included...
March 31, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29706438/-current-situation-of-the-organisation-resources-and-activity-in-paediatric-cardiology-in-spain
#14
Francisco Sánchez Ferrer, Francisco José Castro García, Javier Pérez-Lescure Picarzo, Ferrán Roses Noguer, Fernándo Centeno Malfaz, María Dolores Grima Murcia, Dimpna Albert Brotons
INTRODUCTION: The results are presented on the «current situation of the organisation, resources and activity in paediatric cardiology in Spain». It was promoted by the Spanish Society of Paediatric Cardiology and Congenital Heart disease. MATERIAL AND METHODS: An analysis was carried out on the results obtained from a specifically designed questionnaire, prepared by the Spanish Society of Paediatric Cardiology and Congenital Heart disease, that was sent to all hospitals around the country that offer the speciality of paediatric cardiology...
April 26, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29705730/paediatric-traumatic-cardiac-arrest-a-delphi-study-to-establish-consensus-on-definition-and-management
#15
Annette C Rickard, James Vassallo, Tim Nutbeam, Mark D Lyttle, Ian K Maconochie, Doyo G Enki, Jason E Smith
AIMS: Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. METHODS: An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA...
July 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29704905/the-development-of-a-consensus-based-nutritional-pathway-for-infants-with-chd-before-surgery-using-a-modified-delphi-process
#16
Luise V Marino, Mark J Johnson, Nigel J Hall, Natalie J Davies, Catherine S Kidd, M Lowri Daniels, Julia E Robinson, Trevor Richens, Tara Bharucha, Anne-Sophie E Darlington
IntroductionDespite improvements in the medical and surgical management of infants with CHD, growth failure before surgery in many infants continues to be a significant concern. A nutritional pathway was developed, the aim of which was to provide a structured approach to nutritional care for infants with CHD awaiting surgery.Materials and methodsThe modified Delphi process was development of a nutritional pathway; initial stakeholder meeting to finalise draft guidelines and develop questions; round 1 anonymous online survey; round 2 online survey; regional cardiac conference and pathway revision; and final expert meeting and pathway finalisation...
July 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29701424/perioperative-family-centered-care-nursing-interventions-that-support-child-and-family-s-emotional-management
#17
Dario Antunes, Paula Diogo
INTRODUCTION: Hospitalization is a negative tonality experience for both child and family, being fear and anxiety their emotional mirror. Concerning the surgical experience, the environment, invasiveness, fear of pain, of not waking up from anaesthesia and parental separation are both causes and enhancers of child and family perioperative distress. A study concerning parent's emotional experience of child's submitted to cardiac surgery, refer guilt for their son's cardiopathy, a roller coaster of emotions, impotence and being seated on pins and needles while waiting during the surgery...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696293/the-ten-things-you-need-to-know-about-long-term-outcomes-following-paediatric-cardiac-surgery
#18
Katherine L Brown, Elisabeth Utens, Bradley S Marino
No abstract text is available yet for this article.
June 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29690945/a-protocol-to-decrease-postoperative-chylous-effusion-duration-in-children
#19
Melissa M Winder, Aaron W Eckhauser, Claudia Delgado-Corcoran, Randall J Smout, Jennifer Marietta, David K Bailly
OBJECTIVE: Our primary goal was to decrease time to resolution of postoperative chylothorax as demonstrated by total days of chest tube utilisation through development and implementation of a management protocol. METHODS: A chylothorax management protocol was implemented as a quality improvement project at a tertiary-care paediatric hospital in July, 2015. Retrospective analysis was completed on patients aged 0-17 years diagnosed with chylothorax within 30 days of cardiac surgery in a pre-protocol cohort (February, 2014 to June, 2015, n=20) and a post-protocol cohort (July, 2015 to March, 2016, n=22)...
June 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29627395/impact-of-the-mother-nurse-partnership-programme-on-mother-and-infant-outcomes-in-paediatric-cardiac-intensive-care-unit
#20
Ju-Yeon Uhm, Hee Soon Kim
OBJECTIVES: To identify the effects of a mother-nurse partnership programme based on the core components of information sharing, negotiation and participation in care. Specifically, we examined the programme's effects on parental satisfaction, parental self-efficacy, perceived partnership and anxiety, as well as infants' time to reach full oral feeding and length of postoperative hospital stay, following cardiac surgery on infants at a paediatric intensive care unit with a restrictive visiting policy...
April 4, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
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