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Cardiogenic shock and neonate

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https://www.readbyqxmd.com/read/27777295/single-ventricle-outcomes-after-neonatal-palliation-of-severe-ebstein-anomaly-with-modified-starnes-procedure
#1
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
#2
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...
October 13, 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
#3
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...
August 19, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27133548/-cardiogenic-shock-due-to-spontaneous-neonatal-thrombosis-of-the-abdominal-aorta
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/24246601/cardiogenic-shock-as-the-initial-presentation-of-neonatal-systemic-hypertension
#13
N Xiao, A Tandon, S Goldstein, A Lorts
Neonatal systemic hypertension is an underappreciated etiology of cardiac failure. We present a series of three neonates who presented in cardiogenic shock secondary to severe hypertension, recognized after initial resuscitation efforts. Although the underlying etiology of the hypertension varied, all three patients had improved hemodynamics after their blood pressure was controlled. These cases suggest that neonates presenting in cardiogenic shock with hypertension, and without structural heart disease, may benefit from a thorough renal evaluation and institution of anti-hypertensive therapy...
2013: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/23871607/-neonatal-collapse-diagnosis-of-myocarditis
#14
M Leroch, C Grisel, A Crucis Armangaud, P Parisot, P Ou, J Bergounioux
Enteroviruses are single-stranded RNA viruses of the picornavirus family. In the neonatal period, enterovirus can cause severe meningo-encephalitis, sepsis syndrome, hepatitis, or myocarditis. Neonatal enterovirus myocarditis remains a rare but severe cause of neonatal cardiac failure whose prognosis remains poor. Herein, we report the case of neonatal enterovirus myocarditis in a 14-day-old infant transferred to our intensive care unit for cardiogenic shock. Diagnosis and follow-up were confirmed using cardiac magnetic resonance imaging (MRI)...
September 2013: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/23856923/low-dose-vasopressin-improves-cardiac-function-in-newborn-piglets-with-acute-hypoxia-reoxygenation
#15
Jean-Sébastien Pelletier, Joseph LaBossiere, Bryan Dicken, Richdeep S Gill, Consolato Sergi, Nasser Tahbaz, David Bigam, Po-Yin Cheung
Cardiovascular dysfunction in asphyxiated neonates contributes significantly to their morbidity and mortality. We have recently shown that a low-dose vasopressin infusion (0.005 - 0.01 units/kg per hour) may improve myocardial oxygen transport balance in a swine model of neonatal hypoxia-reoxygenation. We aimed to compare the systemic and regional hemodynamic effects of low-dose vasopressin to dobutamine, a synthetic beta-adrenoreceptor agonist. Piglets (1 - 5 days old, 1.6 - 2.2 kg) were anesthetized and instrumented to continuously monitor systemic hemodynamic parameters, including cardiac output and mesenteric flow indices...
October 2013: Shock
https://www.readbyqxmd.com/read/23809294/successful-management-of-neonatal-myocardial-infarction-with-ecmo-and-intracoronary-r-tpa-lysis
#16
Marcus-André Deutsch, Julie Cleuziou, Christian Noebauer, Andreas Eicken, Manfred Vogt, Juergen Hoerer, Ruediger Lange, Christian Schreiber
Acute myocardial infarction (MI) is a life-threatening condition rarely encountered in neonates. The patients usually present with sudden cardiogenic shock. Clinical management in neonates is extremely challenging. If treatment is delayed, the prognosis is dismal. We report on a 4-day-old full-term male newborn presenting with acute MI and cardiogenic shock secondary to proximal thromboembolic occlusion of the left descending coronary artery. Hemodynamic stabilization could only be achieved after extracorporeal membrane oxygenation (ECMO) support...
September 2014: Congenital Heart Disease
https://www.readbyqxmd.com/read/23737567/cardiogenic-shock-in-a-neonate
#17
Eulália Viveiros, Ana Cristina Aveiro, Edite Costa, José Luis Nunes
We describe a case of a healthy male full-term neonate, 21 days old, admitted to the emergency room, presenting a severe cardiovascular collapse with an initial sinus rhythm. The first diagnostic hypothesis was of septic shock, having antibiotics, fluid resuscitation, inotropic drugs and ventilatory support started immediately. After achieving haemodynamic stability, a new cardiovascular collapse occurred with supraventricular tachycardia (SVT). The latter was successfully treated and the neonate did not suffer any organ damage...
June 3, 2013: BMJ Case Reports
https://www.readbyqxmd.com/read/23736012/common-hemodynamic-problems-in-the-neonate
#18
REVIEW
Keith J Barrington
Hemodynamic problems are common in neonatal intensive care. They occur in the context of incomplete myocardial and vascular development and in cardiovascular responses to interventions which are, as a result, limited and often uncertain and unpredictable. In this review, I outline the hemodynamic features of 4 neonatal conditions which often require intervention: (1) persistent pulmonary hypertension of the newborn, (2) cardiogenic shock (most commonly in the context of hypoxic ischemic injury), (3) sepsis and (4) low blood pressure in the transitional period of the extremely preterm infant...
2013: Neonatology
https://www.readbyqxmd.com/read/23344679/a-comparison-of-combination-dopamine-and-epinephrine-treatment-with-high-dose-dopamine-alone-in-asphyxiated-newborn-piglets-after-resuscitation
#19
COMPARATIVE STUDY
Namdar Manouchehri, David L Bigam, Thomas Churchill, David Rayner, Chloe Joynt, Po-Yin Cheung
BACKGROUND: When asphyxiated neonates require additional cardiovascular support to moderate doses of dopamine infusion, controversy exists on the differential hemodynamic effects of two approaches (adding a second inotrope vs. increasing dopamine dosage). We hypothesized that high-dose dopamine (HD) would be detrimental to systemic and regional perfusion as compared with dopamine and epinephrine (D + E) combination therapy using a swine model of neonatal hypoxia-reoxygenation (H-R). METHODS: Twenty-seven piglets (1-4 d, 1...
April 2013: Pediatric Research
https://www.readbyqxmd.com/read/23238219/early-presentation-of-very-long-chain-acyl-coa-dehydrogenase-deficiency-nursing-action-resulting-in-a-positive-outcome
#20
REVIEW
Elizabeth R Sedgwick
A clinical case of very long chain fatty acid acyl-CoA dehydrogenase (VLCAD) deficiency with cardiac manifestation, is presented. A 2-day old newborn, delivered after a normal pregnancy, birth, and immediate post-natal period, was transported from an outside hospital (OSH) with episodic wide complex tachycardia. In this case, the newborn screen returned suggesting VLCAD deficiency, positively redirecting treatment. An overview of VLCAD, one category of inborn error of metabolism (IEM), is presented. Additionally, the importance of newborn screening, the role of genetic testing, and nursing implications to improve outcomes, will also be discussed...
July 2013: Journal of Pediatric Nursing
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