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Pediatric cardiac risk assessment

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https://www.readbyqxmd.com/read/28060126/pediatric-acquired-von-willebrand-syndrome-in-cardiopulmonary-disorders-do-laboratory-abnormalities-predict-bleeding-risk
#1
Saman K Hashmi, Mireya P Velasquez, Donald L Yee, Shiu-Ki Hui, Donald Mahoney, Lakshmi V Srivaths
There are conflicting reports on whether or not laboratory abnormalities in pediatric acquired von Willebrand syndrome (AVWS) predict bleeding manifestations in patients with cardiopulmonary disorders (CPD). We retrospectively reviewed charts of patients with AVWS and CPD (n=16) seen at Texas Children's Hospital from 2003 to 2012. The most common CPD were valve stenoses, ventricular septal defects, and pulmonary hypertension. All patients had loss of high molecular weight multimers. Fifteen (94%) patients presented with bleeding symptoms, with menorrhagia and epistaxis being the most common...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28035425/myocardial-stress-perfusion-magnetic-resonance-initial-experience-in-a-pediatric-and-young-adult-population-using-regadenoson
#2
Cory V Noel, Ramkumar Krishnamurthy, Brady Moffett, Rajesh Krishnamurthy
BACKGROUND: Dipyridamole and adenosine are traditional pharmacological stressors for myocardial perfusion. Regadenoson, a selective adenosine A2A agonist, has a lower side effect profile with lower incidence of bronchospasm and bradycardia. There is a growing need for myocardial perfusion assessment within pediatrics. There is no report on the utility of regadenoson as a stress agent in children. OBJECTIVE: To observe the safety and feasibility of regadenoson as a pharmacologic stressor for perfusion cardiac MR in a pilot cohort of pediatric patients weighing more than 40 kg who have congenital heart disease and pediatric acquired heart disease...
December 29, 2016: Pediatric Radiology
https://www.readbyqxmd.com/read/27988092/safety-of-tranexamic-acid-in-pediatric-cardiac-surgery-a-nationwide-database-study
#3
Takuma Maeda, Yusuke Sasabuchi, Hiroki Matsui, Yoshihiko Ohnishi, Shigeki Miyata, Hideo Yasunaga
OBJECTIVES: The present study aimed to examine the association between tranexamic acid (TXA) use and adverse effects (seizures, thromboembolism, and renal dysfunction) in a pediatric cardiac surgery population using a national inpatient database in Japan. The authors also assessed the association between TXA use and other clinical outcomes (length of hospital stay and in-hospital mortality). DESIGN: A nationwide, retrospective cohort study using propensity score analyses...
October 4, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27977539/delirium-in-children-after-cardiac-bypass-surgery
#4
Anita K Patel, Katherine V Biagas, Eunice C Clarke, Linda M Gerber, Elizabeth Mauer, Gabrielle Silver, Paul Chai, Rozelle Corda, Chani Traube
OBJECTIVES: To describe the incidence of delirium in pediatric patients after cardiac bypass surgery and explore associated risk factors and effect of delirium on in-hospital outcomes. DESIGN: Prospective observational single-center study. SETTING: Fourteen-bed pediatric cardiothoracic ICU. PATIENTS: One hundred ninety-four consecutive admissions following cardiac bypass surgery, 1 day to 21 years old. INTERVENTIONS: Subjects were screened for delirium daily using the Cornell Assessment of Pediatric Delirium...
December 13, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27966803/yield-of-screening-echocardiograms-during-pediatric-follow-up-in-survivors-treated-with-anthracyclines-and-cardiotoxic-radiation
#5
Michael B Spewak, Rebecca S Williamson, Ann C Mertens, William L Border, Lillian R Meacham, Karen J Wasilewski-Masker
BACKGROUND: Guidelines published by the Children's Oncology Group recommend screening echocardiograms for childhood cancer survivors exposed to anthracyclines and/or cardiotoxic radiation. This study aims to assess risk factors for cardiac late effects while evaluating the overall yield of screening echocardiograms. PROCEDURE: Demographics, exposures, and echocardiogram results were abstracted from the medical records of survivors diagnosed at ≤ 21 years old and ≥ 2 years off therapy who were exposed to anthracyclines and/or potentially cardiotoxic radiotherapy...
December 14, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27965948/do-self-and-proxy-reports-of-cognitive-problems-reflect-intellectual-functioning-in-children-and-adolescents-with-congenital-heart-defects
#6
Sandra Buratti, Carmen Ryberg, Malin Broberg, Jan Sunnegårdh
AIM: Children with congenital heart defects (CHD) who suffer from cognitive impairments and school difficulties need to be identified as early as possible in order to set appropriate interventions in place that may enhance the school situation and quality of life for these children. Identifying children and adolescents at risk for cognitive difficulties requires specific screening tools. This study assessed such a tool - Pediatric Quality of Life Inventory Cardiac Module subscale: Cognitive Problems - to investigate whether proxy reported and self-reported cognitive problems were associated with measured intellectual functioning in children and adolescents with CHD treated with surgery or by catheter interventions...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27871578/children-with-heart-disease-risk-stratification-for-non-cardiac-surgery
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27665040/risk-of-ventricular-arrhythmias-and-association-with-ondansetron
#13
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
#14
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
#15
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
#16
REVIEW
Hiroyuki Matsuura
Cardiac catheterization of childhood pulmonary arterial hypertension (PAH) is used to assess the severity of the disease as well as prognosis, selection of the most adequate pulmonary vasodilators, and evaluation of effectiveness. Sudden deterioration of cardiovascular hemodynamics, however, can be easily induced by pain, patient 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...
January 2017: 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
#17
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
#18
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
#19
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
#20
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...
February 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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