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Pediatric cardiac risk assessment

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https://www.readbyqxmd.com/read/29667902/myocardial-protection-following-del-nido-cardioplegia-in-pediatric-cardiac-surgery
#1
Debasish Panigrahi, Saibal Roychowdhury, Rahul Guhabiswas, Emmanuel Rupert, Mrinalendu Das, Pradeep Narayan
Background This study was designed to compare myocardial protection with del Nido cardioplegia and conventional blood cardioplegia in children undergoing cardiac surgery in Risk Adjustment for Congenital Heart Surgery categories 1 and 2. Methods Sixty patients were randomized into 2 groups receiving del Nido cardioplegia solution or conventional blood cardioplegia. Myocardial injury was assessed using biochemical markers (troponin I and creatine kinase-MB). Vasoactive-inotropic scores were calculated to compare inotropic requirements...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29609642/a-comprehensive-characterization-of-myocardial-and-vascular-phenotype-in-pediatric-chronic-kidney-disease-using-cardiovascular-magnetic-resonance-imaging
#2
Mun Hong Cheang, Nathaniel J Barber, Abbas Khushnood, Jakob A Hauser, Gregorz T Kowalik, Jennifer A Steeden, Michael A Quail, Kjell Tullus, Daljit Hothi, Vivek Muthurangu
BACKGROUND: Children with chronic kidney disease (CKD) have increased cardiovascular mortality. Identifying high-risk children who may benefit from further therapeutic intervention is difficult as cardiovascular abnormalities are subtle. Although transthoracic echocardiography may be used to detect sub-clinical abnormalities, it has well-known problems with reproducibility that limit its ability to accurately detect these changes. Cardiovascular magnetic resonance (CMR) is the reference standard method for assessing blood flow, cardiac structure and function...
March 29, 2018: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29602613/noninvasive-echocardiographic-measures-of-pulmonary-vascular-resistance-in-children-and-young-adults-with-cardiomyopathy
#3
Dor Markush, Robert D Ross, Ronald Thomas, Sanjeev Aggarwal
BACKGROUND: Patients with cardiomyopathy (CM) are at increased risk for pulmonary hypertension (PH). Data are lacking on the use of noninvasive PH measures by echocardiography in patients with CM. The aim of this study was to evaluate the correlation between Doppler-derived echocardiographic indices and catheterization-based measurement of pulmonary vascular resistance (PVR) in children and young adults with CM. METHODS: Imaging studies were retrospectively reviewed from pediatric patients with CM who underwent both echocardiography and cardiac catheterization within a 72-hour period...
March 27, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29565146/stunting-wasting-and-mid-upper-arm-circumference-status-among-children-admitted-to-nemazee-teaching-hospital
#4
Seyed Mohsen Dehghani, Hazhir Javaherizadeh, Masoomeh Heidary, Naser Honar, Maryam Ataollahi, Homa Ilkanipour, Hossein Moravej
INTRODUCTION AND AIM: The aim of this study was to evaluate nutritional status in children without prior hospital admission or evidence of chronic disease. SUBJECTS AND METHODS: The current study is a cross-sectional and observational study which was conducted for assessing the nutritional status of children. In this study, consecutive sampling was used, with a sample size about 400 children aged 6 months to 18 years at first hospital admission. All subjects were hospitalized consecutively in the Pediatric Emergency Department of the Nemazee Teaching Hospital of Shiraz University of Medical Sciences (Shiraz, Islamic Republic of Iran)...
January 10, 2018: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29564522/antibiotic-prophylaxis-practices-in-pediatric-cardiac-implantable-electronic-device-procedures-a-survey-of-the-pediatric-and-congenital-electrophysiology-society-paces
#5
Spenser Y Chen, Scott R Ceresnak, Kara S Motonaga, Anthony Trela, Debra Hanisch, Anne M Dubin
Cardiac implantable electronic device (CIED) infections are associated with significant morbidity in the pediatric device population, with a tenfold higher risk of infection in children compared to adults. The 2010 American Heart Association (AHA) guidelines recommend a single dose of systemic antibiotic (ABX) prophylaxis prior to CIED implantation and no post-operative (OP) ABX. However, there is limited data regarding adherence to this recommendation among the pediatric community. To assess current clinical practices for CIED ABX prophylaxis in pediatrics; whether the AHA guidelines are being followed; and if not, the reasons for non-adherence...
March 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29556752/evaluation-and-management-of-cardiac-tumors
#6
REVIEW
Nicolas Palaskas, Kara Thompson, Gregory Gladish, Ali M Agha, Saamir Hassan, Cezar Iliescu, Peter Kim, Jean B Durand, Juan C Lopez-Mattei
PURPOSE OF REVIEW: Our purpose is to discuss the importance of multimodality imaging in the assessment of cardiac tumors and management. We have compiled a recent review of the scientific literature and embedded our clinical pathways and recommendations based on data and clinical experience. RECENT FINDINGS: The use of contrast echocardiography in the assessment of cardiac masses has been shown to be helpful in distinguishing tumor from thrombus. Deformation imaging of cardiac tumors has been shown to differentiate better rhabdomyomas from fibromas in pediatric patients...
March 20, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29465631/near-infrared-cerebral-oximetry-to-predict-outcome-after-pediatric-cardiac-surgery-a-prospective-observational-study
#7
Marine Flechet, Fabian Güiza, Dirk Vlasselaers, Lars Desmet, Stoffel Lamote, Heidi Delrue, Marc Beckers, Michaël P Casaer, Pieter Wouters, Greet van den Berghe, Geert Meyfroidt
OBJECTIVES: To assess whether near-infrared cerebral tissue oxygen saturation, measured with the FORESIGHT cerebral oximeter (CAS Medical Systems, Branford, CT) predicts PICU length of stay, duration of invasive mechanical ventilation, and mortality in critically ill children after pediatric cardiac surgery. DESIGN: Single-center prospective, observational study. SETTING: Twelve-bed PICU of a tertiary academic hospital. PATIENTS: Critically ill children and infants with congenital heart disease, younger than 12 years old, admitted to the PICU between October 2012 and November 2015...
February 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29449075/cardiac-transplantation-in-children-with-down-syndrome-turner-syndrome-and-other-chromosomal-anomalies-a-multi-institutional-outcomes-analysis
#8
Christopher R Broda, Antonio G Cabrera, Joseph W Rossano, John L Jefferies, Jeffrey A Towbin, Clifford Chin, Pirouz Shamszad
BACKGROUND: The purpose of this study was to describe the prevalence, characteristics, and outcomes in pediatric patients with chromosomal anomalies (CA) undergoing orthotopic heart transplantation (OHT). METHODS: A query of the database of the Pediatric Health Information System, a large administrative and billing database of 43 tertiary children's hospitals, was performed for the Years 2004 to 2016. Pediatric patients who received OHT were analyzed based on presence and type of CA...
January 31, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29405126/evaluation-of-the-uf-nci-hybrid-computational-phantoms-for-use-in-organ-dosimetry-of-pediatric-patients-undergoing-fluoroscopically-guided-cardiac-procedures
#9
Emily L Marshall, David Borrego, Trung Tran, James C Fudge, Wesley E Bolch
Epidemiologic data demonstrate that pediatric patients face a higher relative risk of radiation induced cancers than their adult counterparts at equivalent exposures. Infants and children with congenital heart defects are a critical patient population exposed to ionizing radiation during life-saving procedures. These patients will likely incur numerous procedures throughout their lifespan, each time increasing their cumulative radiation absorbed dose. As continued improvements in long-term prognosis of congenital heart defect patients is achieved, a better understanding of organ radiation dose following treatment becomes increasingly vital...
February 6, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29397933/associations-between-unplanned-cardiac-reinterventions-and-outcomes-after-pediatric-cardiac-operations
#10
John M Costello, Michael C Mongé, Kevin D Hill, Sunghee Kim, Sara K Pasquali, Babatunde A Yerokun, Jeffrey P Jacobs, Carl L Backer, Mjaye L Mazwi, Marshall L Jacobs
BACKGROUND: After pediatric heart operations, we sought to determine the incidence of unplanned cardiac reinterventions during the same hospitalization, assess risk factors for these reinterventions, and explore associations between reinterventions and outcomes. We hypothesized that younger patients undergoing more complex operations would be at greater risk for unplanned cardiac reinterventions and that operative mortality and postoperative length of stay (PLOS) would be greater in patients who undergo reintervention than in those who do not...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29395177/delirium-is-a-common-and-early-finding-in-patients-in-the-pediatric-cardiac-intensive-care-unit
#11
Rita V Alvarez, Claire Palmer, Angela S Czaja, Chris Peyton, Gabrielle Silver, Chani Traube, Peter M Mourani, Jon Kaufman
OBJECTIVE: To determine incidence, associated risk factors, and characteristics of delirium in a pediatric cardiac intensive care unit (CICU). Delirium is a frequent and serious complication in adults after cardiac surgery, but there is limited understanding of its impact in children with critical cardiac disease. STUDY DESIGN: Single-center prospective observational study of CICU patients ≤21 years old. All were screened for delirium using the Cornell Assessment for Pediatric Delirium each 12-hour shift...
January 29, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29362623/the-prevalence-and-risk-factors-of-early-arrhythmias-following-pediatric-open-heart-surgery-in-egyptian-children
#12
Tarek Ahmed Abdel Gawad, Waleed Mohamed Elguindy, Omneya Ibrahim Youssef, Tamer Ashraf Abosalem
AIM: This study aimed to assess the prevalence of early postoperative arrhythmias after cardiac operation in the pediatric population, and to analyse possible risk factors. MATERIAL AND METHODS: Cross-sectional study included 30 postoperative patients, with age range four up to 144 months. They were selected from those admitted to the Cardiology Unit in the Pediatric department of Ain Shams University hospitals, after undergoing cardiopulmonary bypass (CPB) surgery for correction of congenital cardiac defects...
December 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29357785/safety-efficacy-and-timeliness-of-intravenous-potassium-chloride-replacement-protocols-in-a-pediatric-cardiothoracic-intensive-care-unit
#13
Rambod Amirnovin, Phuong Lieu, Flerida Imperial-Perez, Carol Taketomo, Barry P Markovitz, David Y Moromisato
OBJECTIVE: Hypokalemia in children following cardiac surgery occurs frequently, placing them at risk of life-threatening arrhythmias. However, renal insufficiency after cardiopulmonary bypass warrants careful administration of potassium (K+ ). Two different nurse-driven protocols (high dose and tiered dosing) were implemented to identify an optimal K+ replacement regimen, compared to an historical low-dose protocol. Our objective was to evaluate the safety, efficacy, and timeliness of these protocols...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29342993/-analysis-of-prognosis-and-associated-risk-factors-in-pediatric-idiopathic-pulmonary-arterial-hypertension
#14
Q Liu, C Zhang, Q Q Li, Y Zhu, D Zhang, W G Zhao, H Gu
Objective: To analyze the prognosis and associated risk factors of pediatric idiopathic pulmonary arterial hypertension. Methods: A total of 119 patients under 18 years of age diagnosed as idiopathic pulmonary arterial hypertension in the Pulmonary Arterial Hypertension Center in Beijing Anzhen Hospital between June 2007 and May 2017 were enrolled in this retrospective study. The clinical informations and follow-up data were collected. The endpoints of follow-up were defined as death or undergoing lung transplantation...
January 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29329164/a-systematic-review-of-risk-factors-associated-with-cognitive-impairment-after-pediatric-critical-illness
#15
Alicia G Kachmar, Sharon Y Irving, Cynthia A Connolly, Martha A Q Curley
OBJECTIVES: To identify risk factors associated with cognitive impairment as assessed by neuropsychologic tests in neurotypical children after critical illness. DATA SOURCES: For this systematic review, we searched the Cochrane Library, Scopus, PubMed, Ovid, Embase, and CINAHL databases from January 1960 to March 2017. STUDY SELECTION: Included were studies with subjects 3-18 years old at the time of post PICU follow-up evaluation and use of an objective standardized neuropsychologic test with at least one cognitive functioning dimension...
March 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29320927/benefits-of-using-high-volume-low-pressure-tracheal-tube-in-children-undergoing-congenital-cardiac-surgery-evidence-from-a-prospective-randomized-study
#16
Rakesh Chand, Saibal Roy Chowdhury, Emmanuel Rupert, Chandan Kumar Mandal, Pradeep Narayan
BACKGROUND: In the past 2 decades, usage of high-volume-low-pressure microcuffed tracheal tubes in smaller children has increased. However, there is paucity of evidence of its usage in smaller children undergoing congenital cardiac surgery. The aim of this study was to assess if microcuff endotracheal tubes in neonates and younger children undergoing congenital cardiac surgery is associated with better outcomes than uncuffed tubes. METHODS: We carried out this single-center, prospective, randomized study between June and November 2016...
January 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29319633/risk-factors-for-healthcare-associated-infections-after-pediatric-cardiac-surgery
#17
Takeshi Hatachi, Kazuya Tachibana, Yu Inata, Yuji Tominaga, Aiko Hirano, Miyako Kyogoku, Kazue Moon, Yoshiyuki Shimizu, Kanako Isaka, Muneyuki Takeuchi
OBJECTIVES: Healthcare-associated infections after pediatric cardiac surgery are significant causes of morbidity and mortality. We aimed to identify the risk factors for the occurrence of healthcare-associated infections after pediatric cardiac surgery. DESIGN: Retrospective, single-center observational study. SETTING: PICU at a tertiary children's hospital. PATIENTS: Consecutive pediatric patients less than or equal to 18 years old admitted to the PICU after cardiac surgery, between January 2013 and December 2015...
March 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29310561/endotoxin-activity-in-neonates-undergoing-cardiac-surgery-cohort-study
#18
Zaccaria Ricci, Simona Benegni, Cristiana Garisto, Isabella Favia, Roberta Haiberger, Luca Di Chiara
BACKGROUND: Endotoxemia in pediatric cardiac surgical patients is poorly understood. The endotoxin activity assay (EAA) levels were examined in neonates undergoing cardiac surgery in order to assess their reference levels and their association with other pre-, intra-, and postoperative risk factors for gut hypoperfusion. We finally observed if refeeding was associated with modification of endotoxin levels. METHODS: In a prospective cohort study, neonates undergoing surgery for correction or palliation were enrolled...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29239978/picu-length-of-stay-factors-associated-with-bed-utilization-and-development-of-a-benchmarking-model
#19
Murray M Pollack, Richard Holubkov, Ron Reeder, J Michael Dean, Kathleen L Meert, Robert A Berg, Christopher J L Newth, John T Berger, Rick E Harrison, Joseph Carcillo, Heidi Dalton, David L Wessel, Tammara L Jenkins, Robert Tamburro
OBJECTIVES: ICU length of stay is an important measure of resource use and economic performance. Our primary aims were to characterize the utilization of PICU beds and to develop a new model for PICU length of stay. DESIGN: Prospective cohort. The main outcomes were factors associated with PICU length of stay and the performance of a regression model for length of stay. SETTING: Eight PICUs. PATIENTS: Randomly selected patients (newborn to 18 yr) from eight PICUs were enrolled from December 4, 2011, to April 7, 2013...
March 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29222881/development-and-validation-of-a-pediatric-nutritional-screening-score-pnss-for-hospitalized-children
#20
Lina Lu, Xiaomeng Mao, Jinye Sheng, Jianhu Huang, Ying Wang, Qingya Tang, Wei Cai
BACKGROUND AND OBJECTIVES: There is no evidence on the most effective nutritional screening tool for hospitalized children. The objective of this study was to develop and validate a pediatric nutritional screening tool to assess undernutrition risk upon hospital admission. METHODS AND STUDY DESIGN: The study had a two-phase prospective observational design. A novel pediatric nutritional screening score (PNSS) was developed and sensitivity, specificity, and reliability were evaluated by comparing with a complete dietetic assessment...
2018: Asia Pacific Journal of Clinical Nutrition
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