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anesthesia in children with congenital heart disease

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https://www.readbyqxmd.com/read/29777565/unanticipated-hospital-admission-in-pediatric-patients-with-congenital-heart-disease-undergoing-ambulatory-noncardiac-surgical-procedures
#1
Koichi Yuki, Sophia Koutsogiannaki, Sandra Lee, James A DiNardo
BACKGROUND: An increasing number of surgical and nonsurgical procedures are being performed on an ambulatory basis in children. Analysis of a large group of pediatric patients with congenital heart disease undergoing ambulatory procedures has not been undertaken. AIMS: The objective of this study was to characterize the profile of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis at our institution, to determine the incidence of adverse cardiovascular and respiratory adverse events, and to determine the risk factors for unscheduled hospital admission...
May 18, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29734243/incidence-and-risk-factors-for-perioperative-cardiovascular-and-respiratory-adverse-events-in-pediatric-patients-with-congenital-heart-disease-undergoing-noncardiac-procedures
#2
Sandra Lee, Elise Reddington, Sophia Koutsogiannaki, Michael R Hernandez, Kirsten C Odegard, James A DiNardo, Koichi Yuki
BACKGROUND: While mortality and adverse perioperative events after noncardiac surgery in children with a broad range of congenital cardiac lesions have been investigated using large multiinstitutional databases, to date single-center studies addressing adverse outcomes in children with congenital heart disease (CHD) undergoing noncardiac surgery have only included small numbers of patients with significant heart disease. The primary objective of this study was to determine the incidences of perioperative cardiovascular and respiratory events in a large cohort of patients from a single institution with a broad range of congenital cardiac lesions undergoing noncardiac procedures and to determine risk factors for these events...
April 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29733822/cardiopulmonary-bypass-glial-fibrillary-acidic-protein-correlates-with-neurocognitive-skills
#3
Luca Vedovelli, Massimo Padalino, Agnese Suppiej, Stefano Sartori, Gianclaudio Falasco, Manuela Simonato, Virgilio P Carnielli, Giovanni Stellin, Paola Cogo
BACKGROUND: Neuro-cognitive deficits at school starting age may affect as many as 50% of children who underwent cardiac surgery for complex congenital heart diseases (CHD). The aim of this study was to identify which phases of cardiopulmonary bypass (CPB) are associated with an increased risk of impaired neurodevelopmental skills in children with complex CHD. This was assessed by means of glial fibrillary acidic protein (GFAP) plasma levels during CPB for CHD surgery, as a marker of neurological insult...
May 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29731834/diagnosis-and-treatment-of-postoperative-intestinal-perforation-in-infants-and-young-children-with-congenital-heart-disease-a-report-of-three-cases
#4
Yong-Hong Zhang, Zhen-Liang Chen, Lei Shi, Zhong-Jian Chen, Xiang-Yang Dong, Bo Zhai
The aim of the present study was to analyze risk factors of intestinal perforation following surgery for the treatment of congenital heart disease in infants and young children, and to summarize experiences of diagnosis and treatment. A total of 3,270 children, who underwent congenital heart disease surgery under extracorporeal circulation from January 2010 to July 2015, were retrospectively analyzed. Among these children, three (0.09%) developed postoperative intestinal perforation. Primary diseases were Tetralogy of Fallot (two cases) and ventricular septal defect combined with atrial septal defect (one case)...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29701191/-influential-factors-of-cerebral-oxygen-saturation-in-pediatric-cardiovascular-surgery
#5
Qian Li, Mao'en Zhu, Yanrong Zhang, Sisi Dai, Junjie Zhang, Qulian Guo, E Wang
To determine the intervention measures for the decrease of cerebral tissue oxygen saturation during anesthesia for the congenital heart disease in children.
 Methods: Twenty-eight children with cardiac surgery were enrolled. Anesthesia was deepened with propofol (3 mg/kg) intravenous injection. The data of cerebral tissue oxygen saturation(SctO2), mean arterial pressure (MAP), HR, bispectral index (BIS), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), hemoglobin (Hb) and middle cerebral artery (MCA) mean flow velocity (Vm) at different points were collected after intravenous injection of propofol at 3 mg/kg...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#6
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
April 23, 2018: Circulation
https://www.readbyqxmd.com/read/29509264/efficacy-of-inhalational-sevoflurane-anesthesia-induction-on-inhibiting-the-stress-response-to-endotracheal-intubation-in-children-with-congenital-heart-disease
#7
C-H Wang, J Luo, J Li, J-Z Zhang, S-Y Huang, W Shao, H-S Ma
OBJECTIVE: To investigate the efficacy of inhalational sevoflurane anesthesia induction on inhibiting the stress response to endotracheal intubation in pediatric patients with congenital heart disease (CHD). PATIENTS AND METHODS: Forty ASA physical status I/II pediatric patients scheduled for interventricular septal defect repair or interatrial septal defect repair, were randomly divided into two groups (20 each): intravenous induction group (Group C) and inhalational sevoflurane anesthesia induction group (Group D)...
February 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29508477/understanding-cardiac-shunts
#8
REVIEW
Denise C Joffe, Mark R Shi, Carson C Welker
Most patients with congenital heart disease have a cardiac shunt whose direction and magnitude can have a major impact on cardiorespiratory physiology and function. The dynamics of the shunt can be significantly altered by anesthetic management and must be understood in order to provide optimal anesthetic care. Given that there are now more adults than children with congenital heart disease and that the majority of nonpediatric patients are cared for in centers without special expertise in congenital heart disease, it is imperative that all anesthesia providers have a general understanding of the subject...
April 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29339139/improved-coronary-magnetic-resonance-angiography-using-gadobenate-dimeglumine-in-pediatric-congenital-heart-disease
#9
Miguel Silva Vieira, Markus Henningsson, Nathalie Dedieu, Vassilios S Vassiliou, Aaron Bell, Sujeev Mathur, Kuberan Pushparajah, Carlos Alberto Figueroa, Tarique Hussain, René Botnar, Gerald F Greil
BACKGROUND: CMRA in pediatrics remains challenging due to the smaller vessel size, high heart rates (HR), potential image degradation caused by limited patient cooperation and long acquisition times. High-relaxivity contrast agents have been shown to improve coronary imaging in adults, but limited data is available in children. We sought to investigate whether gadobenate dimeglumine (Gd-BOPTA) together with self-navigated inversion-prepared coronary magnetic resonance angiography (CMRA) sequence design improves coronary image quality in pediatric patients...
January 12, 2018: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/29317969/pulse-pressure-analysis-to-guide-intraoperative-phlebotomy-prior-to-cardiac-surgery
#10
Brian Schloss, Dmitry Tumin, Aymen Naguib, Julie Rice, Mark Galantowicz, Joseph D Tobias
Background: The aim of this study was to evaluate the response of the LiDCO-rapid™ during intraoperative phlebotomy in anesthetized children prior to surgery for congenital heart disease. Methods: After the induction of general anesthesia and endotracheal intubation, baseline vital signs were recorded, along with pulse pressure variability (PPV) and stroke volume variability (SVV) from the LiDCO-rapid™ and cerebral oxygenation (rSO2 ) using near-infrared spectroscopy (NIRS)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29315137/reducing-ischemic-injury-from-indwelling-peripheral-arterial-catheters-in-a-pediatric-cardiac-icu-a-quality-improvement-initiative
#11
Adam C Adler, Stephanie Helman, Cynthia Field, Judith J Stellar, Lauren A Brown, Nicole Omensetter, Andrew T Costarino, Mahsun Yuerek, Karen S Bender
OBJECTIVES: To reduce the number of ischemic arterial catheter injuries in children with congenital or acquired heart disease. DESIGN: This is a quality improvement study with pre- and postintervention groups. SETTING: University-affiliated pediatric cardiac center in a quaternary care freestanding children's hospital. PATIENTS: All patients with an indwelling peripheral arterial catheter placed in the Children's Hospital of Philadelphia Cardiac Center associated with an admission to the Cardiac Intensive Cardiac Unit from January 2015 to July 2017 are included...
March 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29187656/-perioperative-safety-of-tibetan-children-with-congenital-heart-disease-undergoing-cardiac-surgery-and-anesthesia-in-low-altitude-area
#12
Yundan Pan, Jiaojiao Niu, Gang Qin, Lu Wang, Fan Zhang, E Wang
To observe the clinical parameters and short-term prognosis of Tibetan high-altitude area children with congenital heart disease undergoing surgery and anaesthesia in low-altitude area, and to investigate the perioperative safety of the treatment.
 Methods: From January, 2016 to December, 2016, 14 children with congenital heart disease who underwent surgery were assigned into 2 groups (n=7 each): the high-altitude area group (X group, children from Tibetan Autonomous Region) and the low-altitude area group (H group, children from Hunan Province)...
November 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28872734/xenon-as-an-adjuvant-to-sevoflurane-anesthesia-in-children-younger-than-4%C3%A2-years-of-age-undergoing-interventional-or-diagnostic-cardiac-catheterization-a-randomized-controlled-clinical-trial
#13
Sarah Devroe, Roselien Meeusen, Marc Gewillig, Bjorn Cools, Koen Poesen, Robert Sanders, Steffen Rex
BACKGROUND: Xenon has repeatedly been demonstrated to have only minimal hemodynamic side effects when compared to other anesthetics. Moreover, in experimental models, xenon was found to be neuroprotective and devoid of developmental neurotoxicity. These properties could render xenon attractive for the anesthesia in neonates and infants with congenital heart disease. However, experience with xenon anesthesia in children is scarce. AIMS: We hypothesized that in children undergoing cardiac catheterization, general anesthesia with a combination of sevoflurane with xenon results in superior hemodynamic stability, compared to sevoflurane alone...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28668199/chronic-respiratory-failure-utilization-of-a-pediatric-specialty-integrated-care-program
#14
Robert J Graham, Michael L McManus, Angie Mae Rodday, Ruth Ann Weidner, Susan K Parsons
OBJECTIVE: Describe utilization and satisfaction in a specialty integrated care program for children with severe, chronic respiratory insufficiency (CRI). SUBJECTS: Enrollees of the Critical Care, Anesthesia, Perioperative Extension (CAPE) and Home Ventilation Program. METHODS: Children with CRI received home visits, care coordination, and "on-demand" 24/7 access to physicians. Program activity and outcomes were recorded for 3 years using an adapted Care Coordination Measurement Tool© version...
March 2017: Healthcare
https://www.readbyqxmd.com/read/28624838/dental-management-of-pediatric-patients-affected-by-pulmonary-atresia-with-ventricular-septal-defect-a-scoping-review
#15
A Garrocho-Rangel, A-C Echavarría-García, M-A Rosales-Bérber, J Flores-Velázquez, A Pozos-Guillén
BACKGROUND: Congenital Heart Diseases (CHD) involves a wide range of pathological conditions, such as Pulmonary Atresia with Ventricle Septal Defect (PA/VSD). This disorder leads to the systemic circulation of oxygen-poor blood (cyanosis), with associated features and consequences in the oral cavity. MATERIAL AND METHODS: Using scoping review methodology for screening and article selection, the primary objectives of this paper were as follows: first, to pose a research question; second, to identify relevant studies in order to answer the research question; third, to select and retrieve the studies; fourth, to chart the critical data, and finally, to collate, summarize, and report the results from the most important articles on the dental management of children affected with PA/VSD...
July 1, 2017: Medicina Oral, Patología Oral y Cirugía Bucal
https://www.readbyqxmd.com/read/28419616/the-provision-of-pediatric-cardiac-anesthesia-services-in-germany-current-status-of-structural-and-personnel-organization
#16
Torsten Baehner, Oliver Dewald, Ingo Heinze, Matthias Mueller, Ehrenfried Schindler, Uwe Schirmer, Georg Baumgarten, Andreas Hoeft, Richard K Ellerkmann
BACKGROUND: Anesthesia for pediatric cardiac surgery requires a high level of expert knowledge. There are currently no recommendations and standards for anesthetic management for congenital cardiac surgery in Germany. AIM: The aim of the present study was to assess the current status of structural and personnel anesthetic standards at pediatric cardiac surgery centers in Germany. METHODS: All cardiac surgical centers in Germany were reviewed for an active program for congenital heart surgery...
August 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28306681/anesthesia-in-adults-with-congenital-heart-disease
#17
REVIEW
Torsten Baehner, Richard K Ellerkmann
PURPOSE OF REVIEW: The current review focuses on patients with congenital heart disease (CHD) with regard to recent trends in global demographics, healthcare provision for noncardiac surgery, as well as anesthetic and perioperative care for these patients. RECENT FINDINGS: About 40 years after milestones of surgical innovation in CHD, the number of adults with CHD (ACHD) now surpasses those of children with CHD. This development leads to the fact that even patients with complex CHD managed for noncardiac surgery are not restricted to highly specialized centers...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28243884/role-of-ct-in-congenital-heart-disease
#18
REVIEW
Prabhakar Rajiah, Sachin S Saboo, Suhny Abbara
Congenital heart diseases (CHD) are being increasingly encountered in cardiac imaging due to improved outcomes from surgical and interventional techniques. Imaging plays an important role in the evaluation of CHD, both prior to and after surgeries and interventions. Computed tomography (CT) has several advantages in the evaluation of these disorders, particularly its high spatial resolution, multi-planar reconstruction capabilities at sub-millimeter isotropic resolution, good temporal resolution, wide field of view, and rapid turnaround time, which minimizes the need for sedation and anesthesia in young children or children with disabilities...
January 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28185643/oral-triiodothyronine-for-infants-and-children-undergoing-cardiopulmonary-bypass
#19
RANDOMIZED CONTROLLED TRIAL
Eva M Marwali, Cindy E Boom, Novik Budiwardhana, Dicky Fakhri, Poppy S Roebiono, Anwar Santoso, Sudigdo Sastroasmoro, April Slee, Michael A Portman
BACKGROUND: This study evaluated the efficacy and safety of oral triiodothyronine (T3; Tetronine, Dalim BioTech, Korea) for infants and children undergoing cardiopulmonary bypass in an Indonesian population. METHODS: We performed a single-center, randomized, double-blind, and placebo-controlled trial in children aged 3 years and younger undergoing congenital heart disease operations with cardiopulmonary bypass. We administered oral T3 (1 μg/kg per body weight/dose) or placebo (saccharum lactis) by nasogastric tube every 6 hours for 60 hours after induction of anesthesia...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27935164/kaolin-activated-thromboelastography-and-standard-coagulation-assays-in-cyanotic-and-acyanotic-infants-undergoing-complex-cardiac-surgery-a-prospective-cohort-study
#20
Alessandra Rizza, Zaccaria Ricci, Chiara Pezzella, Isabella Favia, Giovina Di Felice, Marco Ranucci, Paola Cogo
BACKGROUND AND AIMS: Several studies report the use of thromboelatography (TEG) to monitor coagulation in pediatric cardiac surgery. The aim of this study was to compare baseline and intraoperative TEG, TEG-functional fibrinogen, and standard coagulation assays in children with cyanotic and acyanotic congenital heart disease (CHD) undergoing cardiac surgery. METHODS: This is a prospective observational study of 63 children aged <24 months undergoing cardiac surgery with cardiopulmonary bypass (CPB)...
February 2017: Paediatric Anaesthesia
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