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Pediatric catheterization

Shinichi Takatsuki, Shun Yanai, Satoshi Ikehara, Tomotaka Nakayama, Horoyuki Matsuura
Syncope is more common in children with idiopathic pulmonary arterial hypertension (PAH) than in adults with PAH. Although syncope is associated with a poor prognosis in adult PAH, the clinical effects of syncopal events on disease severity and outcome in children have not been carefully investigated. This study assessed the prevalence of syncope in pediatric PAH and examined its clinical, hemodynamic, and prognostic importance. This retrospective study assessed clinical data, including syncope status, from 78 children (37 girls) with idiopathic and heritable PAH (median age at diagnosis, 11 years)...
October 5, 2018: Pediatric Cardiology
Shahnawaz M Amdani, Robert D Ross, Paul A Webster, Daniel R Turner, Thomas J Forbes, Daisuke Kobayashi
INTRODUCTION: Reduction of radiation dosage in the pediatric cardiac catheterization laboratory (PCL) is important to reduce the risk of its stochastic effect in children with congenital heart disease. Lowering the frame rate would reduce radiation dosage possibly at the expense of image quality, potentially resulting in higher fluoroscopic time and procedural complication rate. METHODS: The data were retrospectively analyzed in three eras: era 1 (n = 234), cineangiography 30 frames/sec (f/s) and fluoroscopy 15 pulse/sec (p/s); era 2 (n = 381), cineangiography 30 f/s and fluoroscopy 6 p/s; and era 3 (n = 328), cineangiography 15 f/s and fluoroscopy 6 p/s...
October 2, 2018: Congenital Heart Disease
Michael Wagner, Kirstin Hauser, Francesco Cardona, Georg M Schmölzer, Angelika Berger, Monika Olischar, Tobias Werther
OBJECTIVES: Critically ill neonatal and pediatric patients often require central vascular access. Real-time ultrasound guidance for central venous catheterization is beneficial. Because the diameter of central veins is much smaller in neonates than in adults, extensive training is needed to master the visualization and catheterization of central veins in neonates. This study assessed the learning effect of a standardized simulation-based teaching program on ultrasound-guided cannulation in a low-cost cadaver tissue model...
September 18, 2018: Pediatric Critical Care Medicine
Benjamin I Siegel, Janet Figueroa, Jana A Stockwell
Introduction: In critically ill children, inappropriate urinary catheter (UC) utilization is associated with increased morbidity, including catheter-associated urinary tract infections (CAUTIs). Checklists are effective for reducing medical errors, but there is little data on their impact on device utilization in pediatric critical care. In this study, we evaluated UC utilization trends and CAUTI rate after implementing a daily rounding checklist. Methods: A retrospective review of our checklist database from 2006 through 2016 was performed...
May 2018: Pediatric Quality & Safety
S Javed Zaidi, Lorene Schweig, Dhaval Patel, Alexander Javois, Javeed Akhter
INTRODUCTION: Hemoptysis in children is an uncommon presenting symptom but can be life-threatening if massive. Cardiac catheterization and coil embolization of aorto-pulmonary collateral vessels (APCs) is uncommon in pediatric hemoptysis patients without congenital heart disease. METHODS: We present a series of seven infants (≤12 months of age) with hemoptysis, all of whom underwent cardiac catheterization to look for and intervene upon APCs, if found. Only those patients who underwent both bronchoscopy as well as cardiac catheterization from January 1995 to January 2015 were included in this retrospective review...
September 18, 2018: Pediatric Pulmonology
Sebastien Hascoët, Khaled Hadeed, Clement Karsenty, Yves Dulac, Francois Heitz, Nicolas Combes, Gerald Chausseray, Xavier Alacoque, Francoise Auriol, Pascal Amedro, Alain Fraisse, Philippe Acar
BACKGROUND: Imaging fusion between echocardiography and fluoroscopy was recently developed. The aim of this study was to assess its feasibility and accuracy during pediatric cardiac catheterization. METHODS: Thirty-one patients (median weight, 26 kg; interquartile range [IQR], 21-37 kg) who underwent percutaneous atrial septal defect closure were prospectively included. The feasibility and accuracy of various imaging fusion modalities (live two-dimensional, live color two-dimensional, live three-dimensional and markers) with EchoNavigator software were assessed...
September 12, 2018: Journal of the American Society of Echocardiography
Kevin D Hill, Wei Du, Gregory A Fleming, Thomas J Forbes, David G Nykanen, Jaxk Reeves, Yan Du, Daisuke Kobayashi
OBJECTIVES: To externally validate the CRISP score, and determine if refinements might improve clinical utility. BACKGROUND: The CRISP score estimates risk of serious adverse events (SAEs) for pediatric catheterization. METHODS: Pediatric (age < 18) procedures reported to the Congenital Cardiovascular Interventional Study Consortium registry from 05/08 to 09/17 (n = 29,830, 27 centers) were divided into a development dataset of 14,784 earlier procedures, and a validation dataset of 15,046 more recent procedures...
September 9, 2018: Catheterization and Cardiovascular Interventions
Christopher D Morrison, Rachel Shannon, Ilina Rosoklija, Oluwarotimi S Nettey, Riccardo Superina, Earl Y Cheng, Edward M Gong
PURPOSE: Ureteral complications following renal transplantation are more common in children than in adults. We identify potential risk factors for ureteral complications in pediatric patients. MATERIALS AND METHODS: We performed a retrospective cohort study of patients who underwent renal transplantation at Lurie Children's Hospital between 2004 and 2016. The associations between patient characteristics, operative factors, graft characteristics and post-operative complications were analyzed...
September 6, 2018: Journal of Urology
Manish Bansal, Vaelan A Molian, Jennifer R Maldonado, Osamah Aldoss, Luis A Ochoa, Ian H Law
BACKGROUND: Patients with congenital heart disease require multiple procedures over their lifetime. These procedures increase cost and time commitment. Previous studies in the field of medicine have shown that combining procedures is an effective method to reduce cost and time. There has been no such study to evaluate the cost and efficiency of combining pediatric cardiac procedures. OBJECTIVE: The objective of this study was to compare the cost and time commitment of combined cardiac catheterization (cath) and electrophysiology (EP) outpatient procedures against separate cath and EP procedure...
August 27, 2018: Pacing and Clinical Electrophysiology: PACE
Awni Al-Subu, Edmund Jooste, Christoph P Hornik, Gregory A Fleming, Ira M Cheifetz, George Ofori-Amanfo
BACKGROUND: Assessment of pulmonary blood flow and cardiac output is critical in the postoperative management of patients with single-ventricle physiology or 2-ventricle physiology with intracardiac shunting. Currently, such hemodynamic data are only obtainable by invasive procedures, such as cardiac catheterization or the use of a pulmonary artery catheter. Ready availability of such information, especially if attainable noninvasively, could be a valuable addition to postoperative management...
July 2018: Paediatric Anaesthesia
Osman Yesilbas, Esra Sevketoglu, Hasan S Kihtir, Mey Talip Petmezci, Nihal Akcay, Ulkem Kocoglu Barlas, Figen Palabiyik
Our study investigated the reliability of appearance of rapid atrial swirl flow (RASF) by ultrasonography (US) in the right atrium (RA), which occurred as a result of rapid isotonic saline infusion (RISI) into the central venous catheter (CVC), in predicting catheter tip position. This prospective observational study included 95 CVC procedures performed on 77 pediatric patients (41 boys and 36 girls) with a median age of 0.6 (0.29-1.53) years. Seventy-three (76.84%) catheter tips were found to be correctly placed, and 22 (23...
August 22, 2018: Artificial Organs
Nathaniel W Taggart, Brent M Gordon, Gareth J Morgan, Bryan H Goldstein
The complex nature of congenital heart disease (CHD) has hindered the establishment of management standards for peri-catheterization anticoagulation. We sought to describe anticoagulation practice variability among providers performing cardiac catheterization in children and adults with CHD. A web-based survey ( ) was distributed to pediatric and congenital interventional cardiologists. Respondents were queried on their training, practice setting, years in practice, and case volume...
August 18, 2018: Pediatric Cardiology
Sophie Duignan, Aedin Ryan, Brian Burns, Damien Kenny, Colin J McMahon
Optimal outcomes are as much influenced by critical decision making pathways as by the technical skill of the operator. The complexity and potential cognitive traps underlying critical decision making has long been recognized in the aviation and business communities, however, remains a largely subconscious, unexamined discipline amongst congenital cardiac interventionalists. Challenges to making good decisions in the catheterization laboratory include heuristics, biases, and cognitive traps. In this paper we discuss some of the more common decision making challenges encountered and we address potential solutions to such decision making with particular focus towards standardization...
October 2018: Pediatric Cardiology
İlknur Tolunay, R Dinçer Yıldızdaş, Hüseyin Elçi, Derya Alabaz
Tolunay İ, Yıldızdaş RD, Elçi H, Alabaz D. Assessment of central venous catheterization and complications in a tertiary pediatric intensive care unit. Turk J Pediatr 2018; 60: 63-69. In catheter-using units as pediatric intensive care, it is important to know the complications that may occur during the insertion and use of central venous catheterization (CVC), and to take appropriate measures in order to reduce the mortality and morbidity of critical patients. The aim of this study was to evaluate CVC and catheter related complications in our tertiary pediatric intensive care unit...
2018: Turkish Journal of Pediatrics
Sana Dastgheyb, Keith Fishlock, Constantine Daskalakis, Jami Kessel, Paul Rosen
Introduction: Management of pediatric pain from medical procedures is of great importance for improving both patient care and experience. In this study, we investigated methods of managing acute pain in infants and children by studying the correlation between the number of attempts to complete painful procedures, given different comfort measures. Methods: The study is a retrospective review of 74,276 procedures performed at two pediatric hospitals in an integrated academic children's health system between 2013 and 2016...
2018: Journal of Pain Research
Valeria P Alencar, Cristiano M Gomes, Eduardo P Miranda, Maria A Dos Santos Lelis, Patrícia Fera, Jose de Bessa, Miguel Srougi, Homero Bruschini
AIMS: To compare the impact of the different routes for clean intermittent catheterization on the quality of life of children with lower urinary tract dysfunction. METHODS: In this cross-sectional study, all children and adolescents under treatment in our clinic from August 2011 to May 2012 who were on CIC for bladder dysfunction were included. To evaluate the technical difficulty and the discomfort associated with the procedure we used a standard visual analog scale...
August 10, 2018: Neurourology and Urodynamics
Mary Hunt Martin, Jeffery Meadows, Doff B McElhinney, Bryan H Goldstein, Lisa Bergersen, Athar M Qureshi, Shabana Shahanavaz, Jamil Aboulhosn, Darren Berman, Lynn Peng, Matthew Gillespie, Aimee Armstrong, Cindy Weng, L LuAnn Minich, Robert G Gray
OBJECTIVES: This study sought to determine the safety and feasibility of transcatheter pulmonary valve replacement (TPVR) using the Melody valve in native (nonconduit) right ventricular outflow tracts (nRVOT), and to identify factors associated with successful TPVR. BACKGROUND: The Melody valve is Food and Drug Administration-approved for TPVR within right ventricle-to-pulmonary artery conduits and bioprosthetic pulmonary valves. However, most patients needing pulmonary valve replacement have nRVOT and TPVR has been adapted for this indication...
August 27, 2018: JACC. Cardiovascular Interventions
Savine C S Minderhoud, Femke van der Stelt, Mirella M C Molenschot, Michel S Koster, Gregor J Krings, Johannes M P J Breur
Previously, median effective dose (ED) of 1.6 mSv per three-dimensional rotational angiography (3DRA) has been reported. This study evaluated ED and image quality in 3DRA after implementation of a simple dose reduction protocol in pediatric catheterizations. Simple conversion factors between 3DRA ED and readily available parameters at the cathlab were determined. The dose reduction protocol consisted of frame reduction (60-30 frames/s (f/s)), active collimation of the X-ray beam, usage of a readily available low dosage program, and a pre-3DRA run check...
August 3, 2018: Pediatric Cardiology
Julien Le Coz, Silvia Orlandini, Luigi Titomanlio, Victoria Elisa Rinaldi
IMPORTANCE: Point-of-care ultrasonography (POCUS) allows to obtain real-time images to correlate with the patient's presenting signs and symptoms. It can be used by various specialties and may be broadly divided into diagnostic and procedural applications. OBJECTIVE: We aimed at reviewing current knowledge on the use of POCUS in Pediatric Emergency Departments (PEDs). FINDINGS: US diagnostic capacity in paediatric patients with suspected pneumonia has been studied and debated whereas literature regarding the usefulness of point-of-care echocardiography in the pediatric setting is still limited...
July 27, 2018: Italian Journal of Pediatrics
Heather Y Sun, James A Proudfoot, Rachel T McCandless
BACKGROUND: Fetal echocardiography can accurately diagnose critical congenital heart disease prenatally, but relies on referrals from abnormalities identified on routine obstetrical ultrasounds. Critical congenital heart disease that is frequently missed due to inadequate outflow tract imaging includes anomalies such as truncus arteriosus, double outlet right ventricle, transposition of the great arteries, tetralogy of Fallot, pulmonary stenosis, and aortic stenosis. OBJECTIVE: This study evaluated the prenatal detection rate of critical outflow tract anomalies in a single urban pediatric hospital before and after "AIUM Practice Guideline for the Performance of Obstetric Ultrasound Examinations," which incorporated outflow tract imaging...
July 18, 2018: Congenital Heart Disease
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