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Pediatric cardiac risk assessment

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https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#1
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/27855050/-adverse-events-during-diagnostic-and-therapeutic-pediatric-cardiac-catheterization
#2
Armando Zepeda-Arámbula, Lorenzo Gutiérrez-Cobian, Jorge Luis Villatoro-Fernández, Sandra Livier Pacheco-López, Alberto Tlacuilo-Parra
BACKGROUND: The aim of this paper is to determine the frequency of adverse events during heart catheterization, in both categories diagnostic and therapeutic procedures in children. METHODS: We review the clinical charts of those patients undergoing heart catheterization during the period from May 1 to October 31, 2014, in order to determine the frequency of adverse events presented within the first 24 hours after the procedure. RESULTS: During the six month period, 143 procedures were performed, of which 126 met the inclusion criteria...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27832187/risk-factors-for-acute-kidney-injury-after-congenital-cardiac-surgery-in-infants-and-children-a-retrospective-observational-study
#3
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/27793105/assessment-of-risk-factors-for-cerebral-oxygen-desaturation-during-neonatal-and-infant-general-anesthesia-an-observational-prospective-study
#4
Ilona Razlevice, Danguole C Rugyte, Loreta Strumylaite, Andrius Macas
BACKGROUND: Cerebral oxygen saturation (rSO2c) decrease from baseline greater than 20 % during infant cardiac surgery was associated with postoperative neurologic changes and neurodevelopmental impairment at 1 year of age. So far, there is no sufficient evidence to support the routine monitoring of rSO2c during general surgical procedures in children. We aimed to find out the frequency of cerebral desaturation 20 % or more from baseline and to identify possible predictors of change in cerebral oxygen saturation during neonatal and infant general surgery...
October 28, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27716152/rationale-and-design-of-the-children-s-oncology-group-cog-study-alte1621-a-randomized-placebo-controlled-trial-to-determine-if-low-dose-carvedilol-can-prevent-anthracycline-related-left-ventricular-remodeling-in-childhood-cancer-survivors-at-high-risk-for-developing
#5
Saro H Armenian, Melissa M Hudson, Ming Hui Chen, Steven D Colan, Lanie Lindenfeld, George Mills, Aida Siyahian, Sarah Gelehrter, Ha Dang, Wendy Hein, Daniel M Green, Leslie L Robison, F Lennie Wong, Pamela S Douglas, Smita Bhatia
BACKGROUND: Anthracyclines are widely used in the treatment of childhood cancer. One of the well-recognized side-effects of anthracycline therapy is dose-dependent cardiomyopathy that may progress to heart failure (HF) years after completion of cancer-directed therapy. This study will evaluate the efficacy of low-dose beta-blocker (carvedilol) for HF risk reduction in childhood cancer survivors at highest risk for HF. The proposed intervention has the potential to significantly reduce chronic cardiac injury via interruption of neurohormonal systems responsible for left ventricular (LV) remodeling, resulting in improved cardiac function and decreased risk of HF...
October 4, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27679965/pediatric-out-of-hospital-cardiac-arrest-characteristics-and-their-association-with-survival-and-neurobehavioral-outcome
#6
Kathleen L Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate relationships between cardiac arrest characteristics and survival and neurobehavioral outcome among children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Secondary analysis of Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial data. SETTING: Thirty-six PICUs in the United States and Canada. PATIENTS: All children (n = 295) had chest compressions for greater than or equal to 2 minutes, were comatose, and required mechanical ventilation after return of circulation...
September 27, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27665040/risk-of-ventricular-arrhythmias-and-association-with-ondansetron
#7
Jaclyn R Moeller, David D Gummin, Tom J Nelson, Amy L Drendel, Breanne K Shah, Stuart Berger
OBJECTIVES: To evaluate the use of ondansetron in a tertiary care pediatric health system, assess the incidence of ventricular tachyarrhythmia within 24 hours of ondansetron, and identify the characteristics of children experiencing a ventricular tachyarrhythmia after ondansetron, to identify potential risk factors. STUDY DESIGN: This retrospective chart review identified children ≤18 years of age who received ondansetron within 24 hours prior to a ventricular tachyarrhythmia...
September 21, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27651614/evaluation-of-referral-pattern-for-fetal-echocardiography-at-a-tertiary-care-center-in-northern-india-and-its-implications
#8
Anupama Nair, S Radhakrishnan
OBJECTIVE: To determine the referral pattern for fetal echocardiography (FE) at our tertiary referral center for pediatric cardiac care in northern India. We also aimed to determine the incidence of CHD in each group and intend to highlight the need of identifying the various risk factors and appropriate timely referral of patients for detailed evaluation. METHODS: This is a prospective study including 201 consecutive patients referred for fetal echo to our center...
October 2016: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/27618336/assessment-of-risk-factors-for-a-sustainable-on-table-extubation-program-in-pediatric-congenital-cardiac-surgery-5-year-experience
#9
Reena Khantwal Joshi, Neeraj Aggarwal, Mridul Agarwal, Veronique Dinand, Raja Joshi
OBJECTIVE: To delineate risk factors for failure of extubation in the operating room among pediatric cardiac surgery patients. DESIGN: Prospective, observational study. SETTING: Single center, tertiary care, teaching hospital. PARTICIPANTS: The study comprised 448 congenital cardiac surgery patients who were enrolled for intended extubation in the pediatric cardiac operating room over 5 years. INTERVENTIONS: The airways of enrolled patients were extubated in the operating room if predetermined suitability criteria were met...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27599454/cardiac-catheterization-in-children-with-pulmonary-arterial-hypertension
#10
Hiroyuki Matsuura
Cardiac catheterization of childhood pulmonary arterial hypertension (PAH) plays a pivotal role in assessing the severity of the disease as well as its prognosis, selection of the most adequate pulmonary vasodilators, and evaluation of effectiveness. However, sudden deterioration of cardiovascular hemodynamics can be easily induced by pain, a patient's agitation, catheter manipulation, and by vasodilator provocation tests; these could trigger a pulmonary hypertension crisis, vagotony, respiratory distress, and hemoptysis resulting in critical complications, including death...
September 7, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27590683/mortality-trends-in-pediatric-and-congenital-heart-surgery-an-analysis-of-the-society-of-thoracic-surgeons-congenital-heart-surgery-database
#11
Jeffrey P Jacobs, Xia He, John E Mayer, Erle H Austin, James A Quintessenza, Tom R Karl, Luca Vricella, Constantine Mavroudis, Sean M O'Brien, Sara K Pasquali, Kevin D Hill, S Adil Husain, David M Overman, James D St Louis, Jane M Han, David M Shahian, Duke Cameron, Marshall L Jacobs
BACKGROUND: Previous analyses of The Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database have demonstrated a reduction over time of risk-adjusted operative mortality after coronary artery bypass grafting. The STS Congenital Heart Surgery Database (STS CHSD) was queried to assess multiinstitutional trends over time in discharge mortality and postoperative length of stay (PLOS). METHODS: Since 2009, operations in the STS CHSD have been classified according to STAT (The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery) Congenital Heart Surgery Mortality Categories...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27576370/one-year-results-from-a-prospective-randomized-trial-comparing-phlebotomy-with-deferasirox-for-the-treatment-of-iron-overload-in-pediatric-patients-with-thalassemia-major-following-curative-stem-cell-transplantation
#12
Adlette Inati, Mario Kahale, Nada Sbeiti, Maria Domenica Cappellini, Ali T Taher, Suzanne Koussa, Therese A Nasr, Khaled M Musallam, Hussein A Abbas, John B Porter
BACKGROUND: Iron overload is well documented in patients with β-thalassemia major, and patients who have undergone hematopoietic stem cell transplantation (HSCT) remain at risk as a result of pre- and immediate post-HSCT transfusions. PROCEDURE: This is a prospective, randomized, 1-year clinical trial that compares the efficacy and safety of the once-daily oral iron chelator deferasirox versus phlebotomy for the treatment of iron overload in children with β-thalassemia major following HSCT...
August 31, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27559005/pediatric-patient-blood-management-programs-not-just-transfusing-little-adults
#13
REVIEW
Ruchika Goel, Melissa M Cushing, Aaron A R Tobian
Red blood cell transfusions are a common life-saving intervention for neonates and children with anemia, but transfusion decisions, indications, and doses in neonates and children are different from those of adults. Patient blood management (PBM) programs are designed to assist clinicians with appropriately transfusing patients. Although PBM programs are well recognized and appreciated in the adult setting, they are quite far from standard of care in the pediatric patient population. Adult PBM standards cannot be uniformly applied to children, and there currently is significant variation in transfusion practices...
October 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27553912/faster-rate-of-blood-volume-change-in-pediatric-hemodialysis-patients-impairs-cardiac-index
#14
Jessica J Geer, Shweta Shah, Eric Williams, Ayse Akcan Arikan, Poyyapakkam Srivaths
BACKGROUND: Intradialytic hypotension and myocardial stunning are proposed as contributing to the pathogenesis of increased cardiovascular disease burden and death in patients receiving maintenance hemodialysis (HD). Noninvasive cardiac output measurements provide a dynamic, real-time assessment of hemodynamic parameters. We investigated intradialytic changes in hemodynamic parameters in pediatric outpatients receiving chronic HD and determined patient and treatment risk factors associated with such intradialytic changes...
August 23, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27542078/donor-predictors-of-allograft-utilization-for-pediatric-heart-transplantation
#15
Asma M Khan, Robert S Green, Irene D Lytrivi, Raj Sahulee
BACKGROUND: Pediatric heart transplantations are limited by the supply of donor allografts. We sought to determine the cardiac allograft utilization rate for pediatric donors and identify donor factors that predict graft use for transplantation. METHODS: The United Network for Organ Sharing deceased donor database was queried from 4/30/2006 to 3/31/2014. Donor risk factors that might affect graft use for cardiac transplantation were evaluated. The pediatric cardiac graft utilization rate was calculated, and logistic regression modeling was performed to determine the risk factors relationship with graft use for transplantation...
August 19, 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/27522052/pediatric-radiation-dose-during-cardiac-catheterization-procedures-in-sudan
#16
Nada A Ahmed, A I Nayel
Children are more radio sensitive than adult. This study aims to assess radiation doses and the associated hazards to pediatric during cardiac catheterization procedures. Radiation dose for 112 patients was estimated in the biggest cardiac center in Sudan. The median KAP in Gy cm(2), CK in mGy, number of frames and fluoroscopy time in minutes were (4.6, 29.0, 340.4, 13.5) and (6.0, 35.0, 318, 9.8) for the diagnostic and therapeutic cardiac procedures, respectively. The median (KAP in Gy cm(2), effective dose in mSv) for different age groups in the intervals of less than 1 year, 1-<5 years, 5-<10 years and 10-15 years old were (2...
August 13, 2016: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/27521991/ultrasound-guided-central-venous-catheterization-a-review-of-the-relevant-anatomy-technique-complications-and-anatomical-variations
#17
Taryn Hoffman, Maira du Plessis, Matthew P Prekupec, Jerzy Gielecki, Anna Zurada, R Shane Tubbs, Marios Loukas
Central venous catheterization is a commonly used and important intervention. Despite its regular use it is still associated with a high incidence of complications especially infection and catheter tip embolization. Addition of ultrasound guidance to the technique has shown great improvement to the time and number of attempts for successful catheterization. The preference of vein depends greatly on the situation; subclavian vein is the preferred method overall but internal jugular vein is preferred in patients undergoing cardiac or thoracic surgery...
August 13, 2016: Clinical Anatomy
https://www.readbyqxmd.com/read/27478508/association-of-cardiac-nt-pro-%C3%AE-type-natriuretic-peptide-with-metabolic-and-endothelial-risk-factors-in-young-obese-hypertensive-patients-a-perspective-on-the-hypothalamic-pituitary-adrenal-axis-activation
#18
Mona Schaalan, Waleed Mohamed, Rania Rahmo
BACKGROUND: In practice, there is increasing recognition of the importance of hypothalamic pituitary adrenal axis in the cardiovascular disease progression. The association of brain natriuretic peptide with obesity and characteristics of the metabolic syndrome in adults and aged patients is well established, but that in pediatrics needs thorough elucidation. AIM: The aim of this study was to assess the association of hypothalamic pituitary adrenal axis mediators (cortisol and aldosterone) with plasma NT-pro β-type natriuretic peptide (NT-proBNP) levels on metabolic, immune-inflammatory and endothelial markers in young obese pediatric patients...
2016: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/27451455/impact-of-surgical-complexity-on-health-related-quality-of-life-in-congenital-heart-disease-surgical-survivors
#19
Amy M O'Connor, Jo Wray, Ryan S Tomlinson, Amy Cassedy, Jeffrey P Jacobs, Kathy J Jenkins, Kate L Brown, Rodney C G Franklin, Lynn Mahony, Kathleen Mussatto, Jane W Newburger, Gil Wernovsky, Richard F Ittenbach, Dennis Drotar, Bradley S Marino
BACKGROUND: Surgical complexity and related morbidities may affect long-term patient quality of life (QOL). Aristotle Basic Complexity (ABC) score and Risk Adjustment in Congenital Heart Surgery (RACHS-1) category stratify the complexity of pediatric cardiac operations. The purpose of this study was to examine the relationship between surgical complexity and QOL and to investigate other demographic and clinical variables that might explain variation in QOL in pediatric cardiac surgical survivors...
July 22, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27428483/advances-in-pediatric-cardiac-mri
#20
Puja Banka, Tal Geva
PURPOSE OF REVIEW: Spurred by numerous recent technological advances, cardiac MRI (CMR) is now the gold standard for anatomic evaluation, quantitative assessment of chamber size and function, flow quantification, and tissue characterization. This review focuses on recent advances in pediatric and congenital CMR, highlighting recent safety data, and discussing future directions. RECENT FINDINGS: CMR has become an important component of risk stratification and procedural planning in numerous congenital and pediatric heart diseases...
October 2016: Current Opinion in Pediatrics
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