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Cardiogenic shock and neonate

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https://www.readbyqxmd.com/read/29409389/weaning-adult-patients-with-cardiogenic-shock-on-veno-arterial-extracorporeal-membrane-oxygenation-by-pump-controlled-retrograde-trial-off
#1
Lowell Ling, Kai Man Chan
BACKGROUND: There is a lack of consensus on the timing of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) liberation. VA-ECMO weaning usually consists of serial decrements until an idling flow is achieved, supported by echocardiographic and haemodynamic assessments. Even with minimal idling flow, right ventricular (RV) preload is reduced and, hence, right heart function is not fully tested under adequate loading conditions. Following the use of a novel technique called Pump Controlled Retrograde Trial Off (PCRTO) in neonate VA-ECMO weaning, we report the use of this technique in seven adult patients on VA-ECMO...
February 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29335076/-value-of-arterial-blood-lactic-acid-in-the-evaluation-of-disease-severity-and-prognosis-in-neonatal-shock
#2
Wen-Hao Yuan, Ling-Kong Zeng, Bao-Huan Cai, Xiao-Yan Liu, Shi Wang, Ling-Xia Zhao, Yan-Ping Huang, Qiao-Ling Wang, Han-Chu Liu
OBJECTIVE: To evaluate the value of blood lactic acid (BLA) as a predictor for the severity and prognosis of neonatal shock. METHODS: A total of 326 neonates with shock were enrolled and divided into three groups based on the severity, namely mild group (n=147), moderate group (n=105), and severe group (n=74). BLA level was measured during and early after (about 6 hours later) fluid resuscitation, and lactate clearance rate (LCR) was calculated. The receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of BLA in neonatal shock...
January 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29298686/a-single-center-experience-with-12-consecutive-cases-of-pregnancy-among-patients-with-membranous-ventricular-septal-aneurysm
#3
Kana Wang, Xiaodong Wang, Haiyan Yu, Xinghui Liu, Aiyun Xing, Yong You
BACKGROUND: Membranous ventricular septal aneurysm (MVSA) is a rare cardiac anomaly that can occur as an isolated entity or being associated with other cardiac malformations. Complications of MVSA include thromboembolism, arrhythmia, rupture, bacterial endocarditis, right ventricular outflow tract obstruction, and atrioventricular valve diseases.The success rate of pregnancy and delivery in patients with MVSA has not been reported in the literature. This study was to assess the clinical implications of this condition from our center's experience...
January 3, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29176025/a-newborn-with-combined-pituitary-hormone-deficiency-developing-shock-and-sludge
#4
Yasuhiro Ueda, Hayato Aoyagi, Toshihiro Tajima
A male neonate was born at 41 weeks of gestation with a birth weight of 3320 g. Artificial respiratory management was required due to respiratory disturbance 1 h after birth, and subsequently catecholamine-refractory low cardiac output-induced shock occurred. Severe combined pituitary hormone deficiency (CPHD) was considered based on the presence of his respiratory disturbance, hypoglycemia and micropenis. After hydrocortisone (HDC) administration, circulatory dynamics rapidly improved. Brain magnetic resonance imaging (MRI) showed aplasia of the anterior pituitary gland and ectopic posterior gland...
November 25, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29110981/distributive-shock-in-a-neonate-with-diffuse-infantile-hepatic-hemangioma
#5
James Brown, Rajan Arora, Usha Sethuraman
BACKGROUND: Hemangiomas are common cutaneous findings on healthy infants. These vascular malformations are generally benign, though in rare circumstances they can potentially be fatal. This is particularly true when the hemangiomas are large or numerous and occurring in visceral organs. Previously unrecognized visceral hemangiomas are part of the differential for any neonate presenting unexpectedly in shock. CASE REPORT: A 10-day-old neonate presented to the pediatric emergency department with difficulty breathing...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28670500/peculiar-clinical-presentation-of-coxsackievirus-b4-infection-neonatal-restrictive-cardiomyopathy
#6
Pauline Le Van Quyen, Philippe Desprez, Angelo Livolsi, Véronique Lindner, Samira Fafi-Kremer, Pauline Helms, Maria Cristina Antal
Introduction  Restrictive cardiomyopathy in fetuses and neonates is extremely rare and has a poor outcome. Its etiology in neonates is elusive: metabolic diseases (e.g., Gaucher, Hurler syndrome), neuromuscular disorders (e.g., muscular dystrophies, myofibrillar myopathies), or rare presentation of genetic syndromes (e.g., Coffin-Lowry syndrome) account for a minority of the cases, the majority remaining idiopathic. Case Study  We report the case of a 17-day-old male infant presenting cardiogenic shock following a restrictive dysfunction of the left ventricle...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28579717/thoracic-ectopia-cordis-in-an-ethiopian-neonate
#7
Henok Tadele, Abeje Chanie
BACKGROUND: Ectopia Cordis is defined as complete or partial displacement of the heart outside the thoracic cavity. It is a rare congenital defect with failure of fusion of the sternum with extra thoracic location of the heart. The estimated prevalence of this case is 5.5 to 7.9 per million live births. CASE PRESENTATION: We had a case of a 16-hour-old male neonate weighing 2.9kg with externally visible, beating heart over the chest wall. Initial treatment included covering the heart with sterile-saline soaked dressing, starting systemic antibiotics and supportive care...
March 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28416430/-extracorporeal-membrane-oxygenation-in-critically-ill-neonates-and-children
#8
J Rambaud, J Guilbert, I Guellec, S Jean, A Durandy, M Demoulin, A Amblard, R Carbajal, P-L Leger
Extracorporeal membrane oxygenation is used as a last resort during neonatal and pediatric resuscitation in case of refractory circulatory or respiratory failure under maximum conventional therapies. Different types of ECMO can be used depending on the initial failure. The main indications for ECMO are refractory respiratory failure (acute respiratory distress syndrome, status asthmaticus, severe pneumonia, meconium aspiration syndrome, pulmonary hypertension) and refractory circulatory failure (cardiogenic shock, septic shock, refractory cardiac arrest)...
June 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27777295/single-ventricle-outcomes-after-neonatal-palliation-of-severe-ebstein-anomaly-with-modified-starnes-procedure
#9
S Ram Kumar, Grace Kung, Nathan Noh, Novel Castillo, Brian Fagan, Winfield J Wells, Vaughn A Starnes
BACKGROUND: We have previously shown that neonates in profound cardiogenic shock caused by a severe Ebstein anomaly can be successfully salvaged with fenestrated right ventricular exclusion and systemic to pulmonary shunt (modified Starnes procedure). The long-term outcome of single-ventricle management in these patients is not known. METHODS: We retrospectively reviewed the records of patients who underwent neonatal Starnes procedure between 1989 and 2015. Patient demographics, clinical variables, and outcome data were collected...
October 25, 2016: Circulation
https://www.readbyqxmd.com/read/27745924/best-practice-critical-cardiac-care-in-the-neonatal-unit
#10
REVIEW
Michael L Rigby
Major congenital or acquired heart disease in neonates presents with cyanosis, hypoxia, acute circulatory failure or cardiogenic shock. Antenatal diagnosis is made in up to 50% but heart disease is unanticipated in the remainder. The presence of significant heart disease in premature infants is also frequently not suspected at first; in general, whatever the underling cardiac anomaly, the clinical condition is worse, deteriorates more quickly and carries a poorer prognosis in premature and low birth weight infants...
November 2016: Early Human Development
https://www.readbyqxmd.com/read/27543650/bailout-shunt-banding-for-backward-left-heart-failure-after-adequate-neonatal-coarctectomy-in-borderline-left-hearts
#11
Stephen C Brown, Benedicte Eyskens, Derize Boshoff, Bjorn Cools, Ruth Heying, Filip Rega, Bart Meyns, Marc Gewillig
OBJECTIVES: To determine the outcome of a bailout procedure using the right ventricle to re-assist the left ventricle in neonates after technically adequate coarctectomy but a failing borderline left heart. METHODS: The surgical procedure was performed on bypass. A 'reversed' 6-mm surgical shunt was inserted between the pulmonary trunk and the descending aorta together with bilateral branch pulmonary artery banding. RESULTS: Over a 10-year period, 89 neonates presented with coarctation and small left hearts...
December 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27133548/-cardiogenic-shock-due-to-spontaneous-neonatal-thrombosis-of-the-abdominal-aorta
#12
J Brice, P Venot, M Colinart-Thomas, P Morville
Neonatal arterial thrombosis is unusual and generally associated with an arterial umbilical catheter. Spontaneous aortic thrombosis is exceptional but its severity is related to high mortality rate and renovascular morbidity. We report here the observation of a 10-day-old term infant showing a large abdominal aortic thrombosis revealed by cardiogenic shock induced by systemic arterial hypertension. The resolution was fast following anticoagulant and antihypertensive therapy. Etiologic investigations showed renal failure and moderate hyperhomocysteinemia controlled by a vitamin supplement...
September 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/26848884/role-of-extracorporeal-membrane-oxygenation-in-adult-respiratory-failure-an-overview
#13
REVIEW
Suneesh Anand, Divya Jayakumar, Wilbert S Aronow, Dipak Chandy
Extracorporeal membrane oxygenation (ECMO) provides complete or partial support of the heart and lungs. Ever since its inception in the 1960s, it has been used across all age groups in the management of refractory respiratory failure and cardiogenic shock. While it has gained widespread acceptance in the neonatal and pediatric physician community, ECMO remains a controversial therapy for Acute Respiratory Distress Syndrome (ARDS) in adults. Its popularity was revived during the swine flu (H1N1) pandemic and advancements in technology have contributed to its increasing usage...
2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/26370364/optimal-graft-size-of-modified-blalock-taussig-shunt-for-biventricular-circulation-in-neonates-and-small-infants
#14
Miyuki Shibata, Keiichi Itatani, Norihiko Oka, Takeshi Yoshii, Yuki Nakamura, Tadashi Kitamura, Tetsuya Horai, Kagami Miyaji
The modified Blalock-Taussig shunt (mBTS) is one of the most important palliative procedures in congenital heart surgery. However, in neonates and small infants, operative mortality and morbidity due to excessive pulmonary blood flow or shunt failure remains high. In this study, a small shunt graft (3.0-mm diameter) was estimated to determine the optimal shunt graft size of BTS as an initial palliation for ultimate biventricular circulation. Eighteen patients weighing an average 3.5 kg who underwent mBTS from July 2004 to January 2013 at our institute were reviewed...
2015: International Heart Journal
https://www.readbyqxmd.com/read/26033127/blue-protocol-and-falls-protocol-two-applications-of-lung-ultrasound-in-the-critically-ill
#15
REVIEW
Daniel A Lichtenstein
This review article describes two protocols adapted from lung ultrasound: the bedside lung ultrasound in emergency (BLUE)-protocol for the immediate diagnosis of acute respiratory failure and the fluid administration limited by lung sonography (FALLS)-protocol for the management of acute circulatory failure. These applications require the mastery of 10 signs indicating normal lung surface (bat sign, lung sliding, A-lines), pleural effusions (quad and sinusoid sign), lung consolidations (fractal and tissue-like sign), interstitial syndrome (lung rockets), and pneumothorax (stratosphere sign and the lung point)...
June 2015: Chest
https://www.readbyqxmd.com/read/25647388/preoperative-management-of-the-neonate-with-critical-aortic-valvar-stenosis
#16
REVIEW
Jeremy T Affolter, Nancy S Ghanayem
Neonatal critical aortic stenosis is a rare form of CHD that often presents with cardiogenic shock. Although surgical and cardiac catheterisation-based interventions have been successful in alleviating left ventricular outflow tract obstruction, it remains associated with high morbidity and mortality. Critical aortic stenosis results in elevated left ventricular wall stress, which ultimately increases myocardial oxygen consumption and disrupts coronary artery perfusion during diastole, leading to ventricular dysfunction and cardiogenic shock...
December 2014: Cardiology in the Young
https://www.readbyqxmd.com/read/24808782/emergent-surgical-pulmonary-embolectomy-in-a-pregnant-woman-case-report-and-literature-review
#17
REVIEW
Giovanni Saeed, Michael Möller, Jörg Neuzner, Rainer Gradaus, Werner Stein, Uwe Langebrake, Thomas Dimpfl, Meradjoddin Matin, Ali Peivandi
Acute pulmonary embolism is a leading cause of death during pregnancy and delivery in the United States. We describe the case of a 25-year-old woman who presented in cardiogenic shock in week 38 of her first pregnancy. After the emergent cesarean delivery of a healthy male neonate, the mother underwent immediate surgical pulmonary embolectomy. We confirmed the diagnosis of pulmonary embolism intraoperatively by means of transesophageal echocardiography and removed large clots from the patient's pulmonary arteries...
April 2014: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/24756850/catastrophic-presentation-of-anomalous-origin-of-right-pulmonary-artery-in-a-neonate-an-interesting-differential
#18
Maitri Chaudhuri, Jayranganath Mahimarangaiah, Subash Chandra, Devananda Nijagal Shivanna
A 36-hour-old term neonate presented with refractory cardiogenic shock and multi-organ dysfunction. On suspecting coarctation of aorta, intravenous prostaglandin was started but without any benefit. Echocardiography revealed isolated anomalous origin of right pulmonary artery from ascending aorta causing massive aortic steal, supra-systemic pulmonary arterial hypertension (PAH), multi-organ dysfunction and right ventricular failure. The main pulmonary artery was solely continued as left pulmonary artery. Emergency surgery at 48 h was life-saving and mid-term follow-up is excellent...
October 2014: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/24401163/lung-ultrasound-in-the-critically-ill
#19
Daniel A Lichtenstein
Lung ultrasound is a basic application of critical ultrasound, defined as a loop associating urgent diagnoses with immediate therapeutic decisions. It requires the mastery of ten signs: the bat sign (pleural line), lung sliding (yielding seashore sign), the A-line (horizontal artifact), the quad sign, and sinusoid sign indicating pleural effusion, the fractal, and tissue-like sign indicating lung consolidation, the B-line, and lung rockets indicating interstitial syndrome, abolished lung sliding with the stratosphere sign suggesting pneumothorax, and the lung point indicating pneumothorax...
January 9, 2014: Annals of Intensive Care
https://www.readbyqxmd.com/read/24335448/postresuscitation-administration-of-doxycycline-preserves-cardiac-contractile-function-in-hypoxia-reoxygenation-injury-of-newborn-piglets
#20
Joseph R LaBossiere, Jean-Sebastian Pelletier, Mohammad A Ali, Aducio Thiesen, Richard Schulz, David L Bigam, Po-Yin Cheung
OBJECTIVE: Cardiac injury is common in asphyxiated neonates and is associated with matrix metalloproteinase-2 activation. Although studies have demonstrated the cardioprotective effects of matrix metalloproteinase inhibition, this has not been tested in clinically translatable models of hypoxia-reoxygenation injury. We aimed to elucidate the effect of doxycycline, a matrix metalloproteinase inhibitor, on cardiac injury and functional recovery in a swine model of neonatal hypoxia-reoxygenation...
April 2014: Critical Care Medicine
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