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anesthesia in children with congenital heart disease

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https://www.readbyqxmd.com/read/28419616/the-provision-of-pediatric-cardiac-anesthesia-services-in-germany-current-status-of-structural-and-personnel-organization
#1
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. METHOD: All cardiac surgical centers in Germany were reviewed for an active program for congenital heart surgery...
April 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28306681/anesthesia-in-adults-with-congenital-heart-disease
#2
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
#3
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
#4
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...
February 6, 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
#5
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
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#6
Angela K Saettele, Jacob L Christensen, Kelly L Chilson, David J Murray
STUDY OBJECTIVE: Children with congenital or acquired heart disease have an increased risk of anesthesia related morbidity and mortality. The child's anesthetic risk is related to the severity of their underlying cardiac disease, associated comorbidities, and surgical procedure. The goal of this project was to determine the ease of use of a preoperative risk stratification tool for assigning pediatric cardiac staff and to determine the relative frequency that children with low, moderate, and high risk cardiac disease present for non-cardiac surgery at a tertiary pediatric hospital...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27832187/risk-factors-for-acute-kidney-injury-after-congenital-cardiac-surgery-in-infants-and-children-a-retrospective-observational-study
#7
Sun-Kyung Park, Min Hur, Eunhee Kim, Won Ho Kim, Jung Bo Park, Youngwon Kim, Ji-Hyuk Yang, Tae-Gook Jun, Chung Su Kim
Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria...
2016: PloS One
https://www.readbyqxmd.com/read/27711024/reference-intervals-of-thromboelastometric-evaluation-of-coagulation-in-pediatric-patients-with-congenital-heart-diseases-a-retrospective-investigation
#8
Ji Young Kim, Yu Rim Shin, Hae Keum Kil, Mi Ran Park, Jong Wha Lee
BACKGROUND Rotational thromboelastometry (ROTEM®) is a point-of-care test for coagulation, enabling physicians to make a swift decision. The aim of this investigation was to establish reference intervals of thromboelastometric evaluation for coagulation in pediatric patients with congenital heart diseases (CHD). MATERIAL AND METHODS As baseline data, 3 assays of ROTEM® (INTEM, EXTEM, and FIBTEM) were measured after anesthesia induction. ROTEM® parameters were clotting time (CT), amplitude at 10 min (A10), clot formation time (CFT), a angle, maximal clot firmness (MCF), clot lysis index at 60 min (LI60), and maximal clot elasticity (MCE)...
October 6, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27687447/the-risk-factors-of-intraoperative-anesthesia-adverse-events-in-children-with-laryngeal-diseases
#9
Yang Li-Qiao, Zhang Jian-Wei, Li Jing-Jie, Zhang Cheng-Mi
BACKGROUND: This study aimed to investigate the risk factors of intraoperative anesthesia adverse events (IAAEs) in children with laryngeal diseases. METHODS: We retrospectively recruited 118 children with laryngeal diseases who underwent surgical therapy. Based on medical history and preoperative imaging diagnosis, the baseline data, including sex, age, weight, onset age, the number of operation, the degree of airway obstruction, the nature of disease, the location of disease, complications, tracheotomy, and trachea intubation, were defined and recorded...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27537760/unrepaired-tetralogy-of-fallot-related-pathophysiologic-changes-reduce-systemic-clearance-of-etomidate-in-children
#10
Yang Shen, Mei-Hua Cai, Wei Ji, Jie Bai, Yue Huang, Ying Sun, Lin Lin, Jing Niu, Ma-Zhong Zhang
BACKGROUND: Pathophysiologic changes in children with congenital heart disease may alter the effect of drugs by influencing the pharmacokinetics (PK). Considering the limited literature that describes the PK of etomidate in pediatric patients, especially in those with tetralogy of Fallot (TOF), our aim was to characterize the PK of etomidate and explore the effects of TOF. METHODS: Twenty-nine pediatric patients (15 with TOF and 14 with normal cardiac anatomy) scheduled to undergo elective surgery under general anesthesia were recruited in the study...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27397451/comparison-of-speed-of-inhalational-induction-in-children-with-and-without-congenital-heart-disease
#11
COMPARATIVE STUDY
Suruchi Hasija, Sandeep Chauhan, Pawan Jain, Arin Choudhury, Neelam Aggarwal, Ravinder Kumar Pandey
BACKGROUND: Conduct of stable inhalational anesthetic induction in children with congenital heart disease (CHD) presents special challenges. It requires in-depth understanding of the effect of congenital shunt lesions on the uptake, delivery, and equilibration of anesthetic drugs. Intracardiac shunts can alter the induction time and if delivery of anesthetic agent is not carefully titrated, can lead to overdosing and undesirable myocardial depression. AIMS: To study the effect of congenital shunt lesions on the speed of inhalational induction and also the impact of inhalational induction on hemodynamics in the presence of congenital shunt lesions...
July 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27352321/the-optimum-level-of-sevoflurane-in-pediatric-echocardiography
#12
Fan Conghai, Zhang Fengchao, Shan Chengjing, Wen Cheng, Wang Yunji, Li Xiaobo
Sevoflurane is shown to be safe and effective in pediatric echocardiography. This study explores the optimum level in pediatric echocardiography. One hundred and twenty children, with an age range of 35 days-3 years, were included in this study. The children with severe cyanotic congenital heart disease or severe pneumonia, which was Grade I or II according to the American College of Physicians Guideline Grading, were excluded. All children received the anesthesia with sevoflurane. The inhalation anesthesia level decreased from 2...
November 2015: Cell Biochemistry and Biophysics
https://www.readbyqxmd.com/read/27228360/cognitive-dysfunction-in-children-with-heart-disease-the-role-of-anesthesia-and-sedation
#13
REVIEW
Danton Char, Chandra Ramamoorthy, Lisa Wise-Faberowski
As physicians and caregivers of children with congenital heart disease, we are aware of the increasing need for procedures requiring anesthesia. While these procedures may be ideal for medical and cardiac surgical management, the risks and benefits must be assessed carefully. There are well known risks of cardiovascular and respiratory complications from anesthesia and sedation and a potentially under-appreciated risk of neurocognitive dysfunction. Both animal and human studies support the detrimental effects of repeated anesthetic exposure on the developing brain...
May 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27192858/-peculiarities-of-anesthesia-and-mechanical-ventilation-in-children-with-surgical-pathology-and-related-congenital-heart-defects
#14
REVIEW
E M Svarinskaya, E G Agavelyan, A V Khilikhnyov
Unfortunately, last years there are more and more children with multiple malformations. Often in the intensive care unit appears children with problems requiring urgent surgical intervention. Congenital heart diseases (CHD) are often accompanying pathology. There are specific changes in hemodynamics in this category of children, which influence parameters of mechanical ventilation, leading sometimes to extremely undesirable consequences. Accordingly, this review deals with the features of anesthesia for various surgical interventions in children with severe (often uncorrected) accompanying CHD...
January 2016: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/27192847/-analysis-of-the-postoperative-course-of-complex-congenital-heart-diseases-simultaneous-correction-with-an-open-sternotomy-in-children-during-the-first-months-of-life
#15
I M Habibullin, P I Mironov, D V Onegov, R I Zaripova, I E Nikolaeva
UNLABELLED: In children during the first months of life delayed sternum closure is one of the few techniques increasing cardiac output after simultaneous correction of complex congenital heart defects (CHD). The aim of study was evaluating mortality, predictors of adverse outcome and frequency noncardial complications at of delayed sternum closure after correction of CHD. METHODS: Study design: a prospective, uncontrolled, cohort. 22 children were studied 6 children died...
January 2016: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/27167685/the-perioperative-use-of-dexmedetomidine-in-pediatric-patients-with-congenital-heart-disease-an-analysis-from-the-congenital-cardiac-anesthesia-society-society-of-thoracic-surgeons-congenital-heart-disease-database
#16
Lawrence I Schwartz, Mark Twite, Brian Gulack, Kevin Hill, Sunghee Kim, David F Vener
BACKGROUND: Dexmedetomidine is a selective α-2 receptor agonist with a sedative and cardiopulmonary profile that makes it an attractive anesthetic for pediatric patients with congenital heart disease (CHD). Although several smaller, single-center studies suggest that dexmedetomidine use is gaining traction in the perioperative setting in children with CHD, there are limited multicenter data, with little understanding of the variation in use across age ranges, procedural complexity, and centers...
September 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26803698/outcome-of-noncardiac-surgery-in-children-with-congenital-heart-disease-performed-outside-a-cardiac-center
#17
Shermayne M Ng, Xi Jin, Robert Yates, Anthony W R Kelsall
OBJECTIVE: The objective of this study was to review the outcome of children with congenital heart disease (CHD) undergoing noncardiac surgery requiring general anesthesia (GA) in a tertiary pediatric center between January 2010 and December 2012. STUDY DESIGN: A retrospective case note review of children <16years of age with confirmed CHD undergoing a surgical or interventional procedure requiring GA was performed. Patients were categorized into three risk groups according to White and Peyton's anesthetic risk classification of children with CHD undergoing noncardiac surgery [Critical Care and Pain 2012;12:17-22]...
February 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26542436/effect-of-intercurrent-operation-and-cerebral-oxygenation-on-developmental-trajectory-in-congenital-heart-disease
#18
George M Hoffman, Cheryl L Brosig, Laurel M Bear, James S Tweddell, Kathleen A Mussatto
BACKGROUND: Children with congenital heart disease are at increased risk of abnormal neurodevelopment (ND). Demographic and perioperative physiologic factors have both been associated with developmental outcome. The acute physiologic effect of a surgical procedure, anesthesia, and hospitalization may offset any potential advantage gained from anatomic correction and circulatory palliation. The specific risk/benefit balance on ND outcome of the insult of the operation, offset by the benefit of improved anatomy and physiology, has not been addressed...
February 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26161325/oral-dexmedetomidine-versus-midazolam-as-anesthetic-premedication-in-children-undergoing-congenital-heart-surgery
#19
Seyedeh Zahra Faritus, Mehrdad Khazaee-Koohpar, Mohsen Ziyaeifard, Mohammad Javad Mehrabanian
BACKGROUND: Premedication is required for reducing anxiety and child's struggling against mask acceptance on anesthesia in pediatric surgery for congenital heart disease. Midazolam has been widely used for this purpose, but because of its side effects, finding an effective replacement with less complication is necessary. OBJECTIVES: In the present study, we compared the efficacy of oral midazolam versus dexmedetomidine in terms of anxiolysis and mask acceptance behavior...
June 2015: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/26121811/-management-of-pulmonary-blood-flow-for-a-patient-with-congenital-pulmonary-vein-stenosis-undergoing-pulmonary-venous-obstruction-release-and-pulmonary-artery-banding
#20
Satoshi Ideno, Shinichi Yamamoto, Fujiko Oda, Rie Wakamiya, Kana Ozawa, Haruka Kaneko, Taku Matsuoka, Atsushi Shinto, Hiromi Mikasa, Noriko Miyazawa
Congenital pulmonary vein stenosis (CPVS) is a rare fetal congenital heart disease with a prevalence of 1.7 per 100,000 children younger than two years of age. Because of the difficulty of maintaining the pulmonary blood flow, CPVS is associated with a 50% survival rate within five years of diagnosis. We describe a successful management of pulmonary blood flow for a 4-month-old-girl with CPVS, combined with atrial septal defect and ventricular septal defect, undergoing pulmonary vein obstruction release (PVOR)...
February 2015: Masui. the Japanese Journal of Anesthesiology
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