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Pediatric cardiothoracic

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https://www.readbyqxmd.com/read/29703801/successful-management-of-chylothorax-with-etilefrine-case-report-in-2-pediatric-patients
#1
Gysella Muniz, Jennifer Hidalgo-Campos, Maria Del Carmen Valdivia-Tapia, Nader Shaikh, Nilton Yhuri Carreazo
Chylothorax is defined as the accumulation of chyle within the pleural space. Originally described in 1917 by Pisek, it is the most common cause of pleural effusion in the neonatal period. The leading cause of chylothorax is laceration of the thoracic duct during surgery, which occurs in 0.85% to 6.6% of children undergoing cardiothoracic surgery. Few authors of reports in the literature have looked at etilefrine, a relatively unknown sympathomimetic, as an option for the medical treatment of chylothorax. In this case report, we review the clinical course of 2 infants with type III esophageal atresia who developed chylothorax after thoracic surgery and were successfully treated with intravenous etilefrine after failing initial dietary and pharmacological management...
April 27, 2018: Pediatrics
https://www.readbyqxmd.com/read/29605373/swallowing-outcomes-in-children-after-slide-tracheoplasty
#2
Alexandra J Stewart, Colin R Butler, Nagarajan Muthialu, Debbie Sell, Joseph Marchant, Richard J D Hewitt, Martin J Elliott
INTRODUCTION: Slide tracheoplasty is now considered gold standard treatment for long segment congenital tracheal stenosis. Outcomes are typically focused upon airway patency. Dysphagia is often reported in children undergoing cardiothoracic surgery, but not specifically after slide tracheoplasty. This study was carried out to describe the nature and prevalence of dysphagia following slide tracheoplasty for long segment congenital tracheal stenosis. METHODS: Retrospective case note review was conducted on a series of patients who underwent swallow evaluation following slide tracheoplasty between 2006 and 2014...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29602550/minimally-invasive-repair-of-pectus-excavatum-analysis-of-the-nsqip-database-and-the-use-of-thoracoscopy
#3
Oswald Tetteh, Daniel S Rhee, Emily Boss, Samuel M Alaish, Alejandro V Garcia
BACKGROUND: The minimally invasive repair of pectus excavatum (MIRPE) has been widely accepted and has become a viable alternative to the open Ravitch technique. MIRPE has evolved over time with some advocating that a safe repair can be accomplished without direct visualization utilizing thoracoscopy. The MIRPE with and without a thoracoscopic approach has not been previously analyzed from a nationwide database to determine differences in safety and short-term outcomes. METHODS: The American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2015 database was used in identifying patients that had MIRPE using Current Procedural Terminology (CPT) codes and ICD-9CM/ICD-10CM postoperative diagnosis codes...
March 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29587521/orthotopic-heart-transplantation-in-children
#4
Nagarajan Muthialu
Heart transplantation is a relatively infrequent but technically demanding procedure in pediatric cardiac surgery. Orthotopic heart transplantation is often offered to older children or adolescents following multiple previous operations, but with advances in intensive care, diagnostics, and management, more infants with complex congenital heart diseases are being listed for transplantation. Primary cardiomyopathies remain the most common indication. Outcomes following cardiothoracic transplantation have improved steadily in recent times...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29550149/ishlt-consensus-statement-on-adult-and-pediatric-airway-complications-after-lung-transplantation-definitions-grading-system-and-therapeutics
#5
EDITORIAL
Maria M Crespo, Daniel P McCarthy, Peter M Hopkins, Stephen C Clark, Marie Budev, Christian A Bermudez, Christian Benden, Pirooz Eghtesady, Erika D Lease, Lorriana Leard, Jonathan D'Cunha, Christopher H Wigfield, Marcelo Cypel, Joshua M Diamond, James J Yun, Lonny Yarmus, Michael Machuzak, Walter Klepetko, Geert Verleden, Konrad Hoetzenecker, Göran Dellgren, Michael Mulligan
Airway complications remain a major cause of morbidity and mortality after cardiothoracic transplantation. The reported incidence of airway ischemic complications varies widely, contributed to by the lack of a universally accepted grading system and standardized definitions. Furthermore, the majority of the existing classification systems fail to integrate the wide range of possible bronchial complications that may develop after lung transplant. Hence, a Working Group was created by the International Society for Heart and Lung Transplantation with the aim of elaborating a universal definition of adult and pediatric airway complications and grading system...
May 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29485000/transient-secondary-hypothyroidism-and-thyroid-hormone-replacement-therapy-in-pediatric-postoperative-cardiopulmonary-bypass
#6
Travis F D Souza, Steven G Hoshal, Ridwaan Albeiruti, Mario P Zambito, Giuseppe M Zambito, Faizan M Khan, Bennett P Samuel, Teri L Crumb, Surender Rajasekaran, Joseph J Vettukattil
BACKGROUND: To develop an understanding of current practices in the management of transient secondary hypothyroidism in pediatric postoperative cardiopulmonary bypass (CPB) patients. METHODS: Electronic survey comprising a 10-item questionnaire was sent to sixty-four high volume pediatric heart centers in the United States and United Kingdom. Survey participants included cardiologist, intensivists, cardiothoracic surgeons, and advanced practice providers. A retrospective chart review was also performed at a large regional referral center in the Midwest on subjects 0-18 years old who underwent CPB from 2005-2015...
February 26, 2018: Current Cardiology Reviews
https://www.readbyqxmd.com/read/29408244/risk-factors-for-development-and-progression-of-scoliosis-after-pediatric-cardiothoracic-operations
#7
Carlos M Mery, Francisco A Guzmán-Pruneda, Luis E De León, Wei Zhang, Frederick H Kuo, Kyle L Carpenter, Lisa D Stringer, Iki Adachi, Jeffrey S Heinle, E Dean McKenzie, Charles D Fraser, Darrell S Hanson
BACKGROUND: The purpose of this study was to determine the incidence and risk factors for the development and rate of progression of scoliosis and moderate/severe scoliosis in patients undergoing cardiothoracic operations (CTOs). METHODS: Included were patients aged younger than 12 years who underwent CTOs in 1995 to 2006 with a preoperative chest roentgenogram (CRG) and a CRG at least 8 years after CTOs. Scoliosis and moderate/severe scoliosis were defined as a Cobb angle of 10 degrees or more and an angle of 25 degrees or more or the need for surgical intervention, respectively...
February 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29397933/associations-between-unplanned-cardiac-reinterventions-and-outcomes-after-pediatric-cardiac-operations
#8
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/29357785/safety-efficacy-and-timeliness-of-intravenous-potassium-chloride-replacement-protocols-in-a-pediatric-cardiothoracic-intensive-care-unit
#9
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/29344778/the-relationship-between-vancomycin-trough-concentrations-and-auc-mic-ratios-in-pediatric-patients-a-qualitative-systematic-review
#10
REVIEW
Stacey Tkachuk, Kyle Collins, Mary H H Ensom
BACKGROUND: In adults, the area under the concentration-time curve (AUC) divided by the minimum inhibitory concentration (MIC) is associated with better clinical and bacteriological response to vancomycin in patients with methicillin-resistant Staphylococcus aureus who achieve target AUC/MIC ≥ 400. This target is often extrapolated to pediatric patients despite the lack of similar evidence. The impracticalities of calculating the AUC in practice means vancomycin trough concentrations are used to predict the AUC/MIC...
April 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29331011/transfusion-related-acute-lung-injury-in-a-paediatric-intensive-care-unit-of-pakistan
#11
Muhammad Tariq Jamil, Zehra Dhanani, Qalab Abbas, Humaira Jurair, Farheen Karim Mahar, Anwarul Haque
Background: Transfusion-Related Acute Lung Injury (TRALI) is a major cause of transfusionrelated morbidity and mortality in the intensive care unit setting. There is a paucity of such data from Pakistan. The purpose of this study is to assess the incidence and outcome of TRALI in critically ill children admitted in a pediatric intensive care unit (PICU) of Pakistan. Methods: This is a retrospective cohort study of all critically ill or injured children who developed TRALI or "possible" TRALI after blood transfusion based on Canadian Conference Consensus criteria in a closed multidisciplinary-cardiothoracic PICU from January 2012 to June 2016...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29286263/bridging-together-teamwork-in-caring-for-the-family-touched-by-chd
#12
Richard A Jonas
In the opening plenary address of the 2017 7th World Congress of Pediatric Cardiology and Cardiac Surgery the author, who represented the World Society for Pediatric and Congenital Heart Surgery at the Congress and is currently the Society's president, described the history of the formation of the World Society. He listed accomplishments of the World Society including publication of the only journal devoted to congenital cardiac surgery, development of a global database, and convening several international conferences dating back to the inaugural conference in Washington, DC in 2007...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29206729/extracorporeal-cardiopulmonary-resuscitation-in-the-pediatric-cardiac-population-in-search-of-a-standard-of-care
#13
Javier J Lasa, Parag Jain, Tia T Raymond, Charles G Minard, Alexis Topjian, Vinay Nadkarni, Michael Gaies, Melania Bembea, Paul A Checchia, Lara S Shekerdemian, Ravi Thiagarajan
OBJECTIVES: Although clinical and pharmacologic guidelines exist for the practice of cardiopulmonary resuscitation in children (Pediatric Advanced Life Support), the practice of extracorporeal cardiopulmonary resuscitation in pediatric cardiac patients remains without universally accepted standards. We aim to explore variation in extracorporeal cardiopulmonary resuscitation procedures by surveying clinicians who care for this high-risk patient population. DESIGN: A 28-item cross-sectional survey was distributed via a web-based platform to clinicians focusing on cardiopulmonary resuscitation practices and extracorporeal membrane oxygenation team dynamics immediately prior to extracorporeal membrane oxygenation cannulation...
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29179572/when-and-why-do-neonatal-and-pediatric-critical-care-physicians-consult-palliative-care
#14
Claire A Richards, Helene Starks, M Rebecca O'Connor, Erica Bourget, Taryn Lindhorst, Ross Hays, Ardith Z Doorenbos
BACKGROUND: Parents of children admitted to neonatal and pediatric intensive care units (ICUs) are at increased risk of experiencing acute and post-traumatic stress disorder. The integration of palliative care may improve child and family outcomes, yet there remains a lack of information about indicators for specialty-level palliative care involvement in this setting. OBJECTIVE: To describe neonatal and pediatric critical care physician perspectives on indicators for when and why to involve palliative care consultants...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29076929/delirium-in-the-pediatric-cardiac-extracorporeal-membrane-oxygenation-patient-population-a-case-series
#15
Anita K Patel, Katherine V Biagas, Eunice C Clark, Chani Traube
OBJECTIVE: To determine the prevalence of delirium in children who require extracorporeal membrane oxygenation. DESIGN: Prospective observational longitudinal cohort study. SETTING: Urban academic cardiothoracic ICU. PATIENTS: All consecutive admissions to the cardiothoracic ICU who required venoarterial extracorporeal membrane oxygenation support. INTERVENTIONS: Daily delirium screening with the Cornell Assessment for Pediatric Delirium...
December 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29028762/intermittent-versus-continuous-and-intermittent-medications-for-pain-and-sedation-after-pediatric-cardiothoracic-surgery-a-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Jamie S Penk, Cheryl A Lefaiver, Colleen M Brady, Christine M Steffensen, Kimberly Wittmayer
OBJECTIVES: Compare continuous infusions of morphine and midazolam in addition to intermittent doses with an intermittent only strategy for pain and sedation after pediatric cardiac surgery. DESIGN: Randomized controlled trial. SETTING: Advocate Children's Hospital, Oak Lawn, IL. PATIENTS: Sixty patients 3 months to 4 years old with early extubation after pediatric cardiac surgery. INTERVENTIONS: Patients received a continuous infusion of morphine and midazolam or placebo for 24 hours...
January 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/28990396/physicians-perceptions-of-shared-decision-making-in-neonatal-and-pediatric-critical-care
#17
Claire A Richards, Helene Starks, M Rebecca O'Connor, Erica Bourget, Ross M Hays, Ardith Z Doorenbos
BACKGROUND: Most children die in neonatal and pediatric intensive care units after decisions are made to withhold or withdraw life-sustaining treatments. These decisions can be challenging when there are different views about the child's best interest and when there is a lack of clarity about how best to also consider the interests of the family. OBJECTIVE: To understand how neonatal and pediatric critical care physicians balance and integrate the interests of the child and family in decisions about life-sustaining treatments...
April 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28904266/clinical-impact-of-main-pulmonary-artery-dilatation-on-outcome-in-pediatric-idiopathic-and-heritable-pulmonary-arterial-hypertension
#18
Satoshi Ikehara, Shinichi Takatsuki, Tomotaka Nakayama, Kazuyuki Naoi, Hiroyuki Matsuura, Tsutomu Saji
BACKGROUND: Few studies have investigated the clinical impact of pulmonary artery (PA) dilatation on outcomes in pediatric pulmonary arterial hypertension (PAH).Methods and Results:This study investigated the clinical outcomes of idiopathic or heritable PAH in 66 children aged <18 years at diagnosis. Main PA/thorax (MPA/T) ratio was measured on chest radiography in PAH patients. Patients were divided into 2 groups based on MPA/T ratio, and compared with a control group of 166 age- and gender-matched healthy children...
January 25, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28870711/the-economics-of-academic-advancement-within-surgery
#19
Maria Baimas-George, Brian Fleischer, James R Korndorffer, Douglas Slakey, Christopher DuCoin
BACKGROUND: The success of an academic surgeon's career is often viewed as directly related to academic appointment; therefore, the sequence of promotion is a demanding, rigorous process. This paper seeks to define the financial implication of academic advancement across different surgical subspecialties. STUDY DESIGN: Data was collected from the Association of American Medical College's 2015 report of average annual salaries. Assumptions included 30 years of practice, 5 years as assistant professor, and 10 years as associate professor before advancement...
March 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/28713211/early-extubation-in-pediatric-heart-surgery-across-a-spectrum-of-case-complexity-impact-on-hospital-length-of-stay-and-chest-tube-days
#20
Staci Beamer, Sunita Ferns, Lloyd Edwards, Greer Gunther, Jennifer Nelson
Early extubation is increasingly common in congenital heart surgery, but there are limited outcomes data across the spectrum of case complexity. We performed a retrospective review of 201 pediatric operations using cardiopulmonary bypass between 2012 and 2014. Patients extubated in the operating room or immediately on arrival to the ICU were compared to those extubated by traditional protocols. In-hospital mortality, major complications, need for re-intubation, hospital length of stay, and chest-tube days were compared between groups and by Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Congenital Heart Surgery (STAT) mortality category...
June 2017: Progress in Pediatric Cardiology
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