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https://www.readbyqxmd.com/read/28634172/identifying-an-oxygenation-index-threshold-for-increased-mortality-in-acute-respiratory-failure
#1
Brandon G Hammond, Pamela Garcia-Filion, Paul Kang, Mounica Y Rao, Brigham C Willis, Heidi J Dalton
BACKGROUND: The objective of this work was to examine current oxygenation index (OI) data and outcomes using electronic medical record data to identify a specific OI value associated with mortality. METHODS: This study was a retrospective electronic medical record data review from the pediatric ICU of Phoenix Children's Hospital, with data mining for variables to calculate OIs on subjects age 1 month to 20 y mechanically ventilated >24 h, excluding those with known intracardiac shunts or cyanotic heart disease...
June 20, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28632506/adenotonsillectomy-for-the-management-of-pulmonary-hypertension-in-a-patient-with-complex-congenital-heart-disease-a-case-report
#2
Adam C Adler, Yuan-Jiun Nicole Chao
Pulmonary hypertension is a feared complication in congenital heart disease patients. Patients with pulmonary hypertension are at risk for major perioperative cardiopulmonary complications when undergoing any surgical procedure, especially airway and laparoscopic procedures. We present the anesthetic management for a 2-year old with Down syndrome and complex cyanotic congenital heart disease undergoing tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
June 19, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28628576/the-insight-from-foresight-near-infrared-spectroscopy-in-cyanotic-congenital-heart-disease
#3
Adam C Adler, Stephen A Stayer
No abstract text is available yet for this article.
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28623384/the-role-of-cardiopulmonary-exercise-testing-for-decision-making-in-patients-with-repaired-tetralogy-of-fallot
#4
REVIEW
Frederic Dallaire, Rachel M Wald, Ariane Marelli
Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. As a result of the surgical strategies employed at the time of initial repair, chronic pulmonary regurgitation (PR) is prevalent in this population. Despite sustained research efforts, patient selection and timing of pulmonary valve replacement (PVR) to address PR in young asymptomatic patients with repaired tetralogy of Fallot (rToF) remain a fundamental but as yet unanswered question in the field of congenital heart disease...
June 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28619123/chd-and-respiratory-syncytial-virus-global-expert-exchange-recommendations
#5
Robert M R Tulloh, Constancio Medrano-Lopez, Paul A Checchia, Claudia Stapper, Naokata Sumitomo, Matthias Gorenflo, Eun Jung Bae, Antonio Juanico, Juan M Gil-Jaurena, Mei-Hwan Wu, Talal Farha, Ali Dodge-Khatami, Rocky Tsang, Gerard Notario, Colleen Wegzyn
BACKGROUND: Palivizumab is the standard immunoprophylaxis against serious disease due to respiratory syncytial virus infection. Current evidence-based prophylaxis guidelines may not address certain children with CHD within specific high-risk groups or clinical/management settings. METHODS: An international steering committee of clinicians with expertise in paediatric heart disease identified key questions concerning palivizumab administration; in collaboration with an additional international expert faculty, evidence-based recommendations were formulated using a quasi-Delphi consensus methodology...
June 16, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28614229/familial-clustering-of-congenital-deafness-patent-ductus-arteriosus-eisenmenger-complex-and-differential-cyanosis-a-case-report
#6
Ting-Wei Lin, Chih-Wei Tseng, Chi-Yao Huang, Kuo-Yang Wang, Kae-Woei Liang
RATIONALE: Few studies had reported syndromes that include patent ductus arteriosus (PDA) with Eisenmenger syndrome and congenital deafness clustered in male siblings without facial, skeletal, or mental abnormalities. PATIENT CONCERNS: Two brothers, who were deaf and had PDA with Eisenmenger complex, were first seen at our Cardiology clinic at the ages of 25 and 41, respectively. They presented with progressive dyspnea on exertion. Upon physical examination, both brothers had clubbing and/or cyanotic toes, normal fingers, and without facial, skeletal, ophthalmological, or mental abnormalities...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28601176/cyanotic-congenital-heart-disease-essential-primer-for-the-practicing-radiologist
#7
REVIEW
Evan J Zucker, Jeffrey L Koning, Edward Y Lee
The cyanotic congenital heart diseases are a rare and heterogeneous group of disorders, often requiring urgent neonatal management. Although echocardiography is the mainstay for imaging, continued technological advances have expanded the role for computed tomography and magnetic resonance imaging, helping to limit invasive cardiac catheterization. In this article, the authors review the broad spectrum of cyanotic congenital heart disease, focusing on the utility of advanced noninvasive imaging modalities while highlighting key clinical features and management considerations...
July 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28598000/peptidomic-analysis-of-maternal-serum-to-identify-biomarker-candidates-for-prenatal-diagnosis-of-tetralogy-of-fallot
#8
Bin Zhuang, Yin Hu, Xuemei Fan, Mengmeng Li, Jingai Zhu, Heng Liu, Li Cao, Dong Liang, Jingjing Zhang, Zhangbin Yu, Shuping Han
Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. To identify endogenous peptides possibly involved in the progression of TOF, we performed comparative peptidomic profiling of maternal serum between normal fetuses and fetuses suffering from TOF. A total of 278 differentially expressed peptides, including 94 over-expressed peptides and 184 under-expressed peptides, originating from 227 protein precursors were identified by Liquid Chromatography/Mass Spectrometry (LC/MS) in maternal serum of fetuses with TOF compared to normal controls...
June 9, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28595379/does-the-prophylactic-and-therapeutic-use-of-beta-blockers-in-preoperative-patients-with-tetralogy-of-fallot-significantly-prevent-and-treat-the-occurrence-of-cyanotic-spells
#9
Eliana Fanous, Gábor Mogyorósy
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Does the use of beta-blockers significantly prevent and treat the occurrence of cyanotic spells in preoperative infants with tetralogy of Fallot?' Altogether, 80 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The author, journal, date, country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
June 7, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28576635/-infective-endocarditis-prophylaxis-in-congenital-heart-disease
#10
Sylvie Di Filippo
Infective endocarditis can negatively impact prognosis of congenital heart disease and has a 10-15% incidence of mortality. New guidelines recommend prophylaxis of infective endocarditis only for high-risk group (cyanotic congenital heart disease, valvular prosthesis, previous endocarditis) and for some specific invasive dental procedures. New guidelines are focused mainly on oral and cutaneous hygiene. Native shunts and valvular disease are no more targets for prophylaxis. More than half of the physicians do not follow the new guidelines...
May 30, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28566834/the-utility-of-computed-tomographic-angiography-in-a-neonate-on-extracorporeal-membrane-oxygenation-with-extreme-cyanosis-after-blalock-taussig-shunt
#11
Jess D Rames, Minoo N Kavarana, U Joseph Schoepf, Anthony Marcus Hlavacek
A modified Blalock-Taussig shunt (mBTS) is often employed to provide pulmonary blood flow in neonates that are born with cyanotic congenital heart defects. However, acute shunt thrombosis can occur in the postoperative period, resulting in profound cyanosis. In this case report, we describe the utility of computed tomographic angiography (CTA) in the management of a neonate with extreme cyanosis after placement of a mBTS while on extracorporeal membrane oxygenation. Using CTA, several small clots were identified in the shunt as well as stenosis of the left pulmonary artery; neither of which were identified with echocardiography...
May 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28566833/stent-migration-after-right-ventricular-outflow-tract-stenting-in-the-severe-cyanotic-tetralogy-of-fallot-case
#12
Tamaki Hayashi, Saleem Akhtar, Mazeni Alwi
We report our experience with a stent migration after right ventricle outflow tract stenting and converted to patent ductus arteriosus stenting in Tetralogy of Fallot (TOF) with severe infundibular stenosis. Finally, the patient achieved to TOF repair, and the migrated stent was removed without any complication.
May 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28555332/protective-role-of-downregulated-mlk3-in-myocardial-adaptation-to-chronic-hypoxia
#13
Siyi He, Shunbi Liu, Xiaochen Wu, Mei Xin, Sheng Ding, Dong Xin, Hui Ouyang, Jinbao Zhang
A series of protective responses could be evoked to achieve compensatory adaptation once cardiomyocytes are subjected to chronic hypoxia. MLK3/JNK/c-jun signaling pathway was previously demonstrated to be involved in this process. In the present study, we aim to further examine the performance of MLK3 in hypoxic H9C2 cells and potential mechanism. Myocardial samples of patients with congenital heart disease (CHD) were collected. H9C2 cells were cultured in hypoxic conditions for various durations. MLK3 was silenced by transfection of shRNA to evaluate its role in cell viability...
May 30, 2017: Journal of Physiology and Biochemistry
https://www.readbyqxmd.com/read/28555179/the-management-of-cyanotic-spells-in-children-with-oesophageal-atresia
#14
REVIEW
Mathieu Bergeron, Aliza P Cohen, Robin T Cotton
Cyanotic spells, also known as blue spells, dying spells, or apparent life-threatening events, refer to a bluish tone visible in the mucosal membranes and skin caused by an oxygen decrease in the peripheral circulation. Although this decrease may be transient and benign, it may also be indicative of a severe underlying problem that requires immediate intervention. Children with oesophageal atresia (OA) are at risk for a number of coexisting conditions that may trigger cyanotic spells. This current article will focus on the management of cyanotic spells both in children with innominate artery compression and those with tracheomalacia...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28542655/-risk-factors-associated-with-postoperative-acute-renal-failure-in-pediatric-patients-undergoing-cardiopulmonary-bypass-surgery
#15
Elsa Nohemí Reyes-Flandes, Alejandro Herrera-Landero, Pascual Bobadilla-González, Juan Carlos Núñez-Enríquez
Acute renal failure (ARF) is a complication associated with cardiac surgery with cardiopulmonary bypass (CPB) with an impact on morbidity and mortality. OBJECTIVE: To identify risk factors associated with postoperative IRA according to pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease scale in children undergoing cardiac surgery with CPB. PATIENTS AND METHOD: A nested case-control study was conducted. We included children under 16 years of age attended postoperative for CBP in a pediatric intensive care unit over a period of 18 months...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#16
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28514318/cerebral-oxygen-saturation-in-children-with-congenital-heart-disease-and-chronic-hypoxemia
#17
Barry D Kussman, Peter C Laussen, Paul B Benni, Francis X McGowan, Doff B McElhinney
BACKGROUND: Increased hemoglobin (Hb) concentration accompanying hypoxemia is a compensatory response to maintain tissue oxygen delivery. Near infrared spectroscopy (NIRS) is used clinically to detect abnormalities in the balance of cerebral tissue oxygen delivery and consumption, including in children with congenital heart disease (CHD). Although NIRS-measured cerebral tissue O2 saturation (ScO2) correlates with arterial oxygen saturation (SaO2), jugular bulb O2 saturation (SjbO2), and Hb, little data exist on the interplay between these factors and cerebral O2 extraction (COE)...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28510741/early-or-late-fresh-frozen-plasma-administration-in-newborns-and-small-infants-undergoing-cardiac-surgery-the-appear-randomized-trial
#18
P Bianchi, M Cotza, C Beccaris, S Silvetti, G Isgrò, G Pomè, A Giamberti, M Ranucci
Background: In newborns and small infants undergoing cardiac surgery with cardiopulmonary bypass (CPB) and blood priming, it is unclear whether there is reduced blood loss if fresh frozen plasma (FFP) is added to the CPB priming volume. This single-centre, randomized trial tested the hypothesis that the administration of FFP after CPB (late FFP group) is superior to FFP priming (early FFP group) in terms of postoperative bleeding and overall red blood cell (RBC) transfusion. Methods: Seventy-three infants weighing <10 kg were randomly allocated to receive FFP to supplement RBCs in the CPB priming solution ( n =36) or immediately after CPB ( n =37)...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28508379/-retinal-pigment-epithelial-detachment-in-hyperviscosity-syndrome
#19
V C Müller, N Mihailovic, C R Clemens, F Alten, N Eter
We present a case of a 57-year-old woman who reported bilateral visual impairment since 2 weeks. She had a medical history of congenital, cyanotic heart failure. Funduscopic examination revealed serous retinal detachment on the left side, central subneurosensory detachment on the right side, retinal vessel tortuosity and multiple retinal haemorrhages in the periphery. As blood analysis showed a distinct increase in haemoglobin and haematocrit, hyperviscosity syndrome was suspected to have caused bilateral serous retinal detachment...
May 15, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28484536/association-of-brain-abscess-with-a-mycotic-aneurysm-of-the-contralateral-internal-carotid-artery-in-a-patient-of-cyanotic-heart-disease
#20
Sumit Bansal, Sachin A Borkar, Ashok K Mahapatra
Congenital cyanotic heart disease can lead to intra-cranial involvement. Authors report a very rare case of right intra-cerebral abscess diagnosed on computerized tomography (CT) scan and simultaneous presence of an aneurysm of the left internal carotid artery diagnosed on CT angiogram in a 15-year-old child with congenital cyanotic heart disease with recent onset left hemiparesis. Right cerebral abscess was tapped and left internal carotid aneurysm was planned to be followed up by giving antibiotics and serial angiograms, but he could not survive and died due to non-cranial cause...
April 2017: Asian Journal of Neurosurgery
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