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Pediatric Heart Network

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https://www.readbyqxmd.com/read/28330522/passive-range-of-motion-exercise-to-enhance-growth-in-infants-following-the-norwood-procedure-a-safety-and-feasibility-trial
#1
Linda M Lambert, Felicia L Trachtenberg, Victoria L Pemberton, Janine Wood, Shelley Andreas, Robin Schlosser, Teresa Barnard, Kaitlyn Daniels, Ann T Harrington, Nicholas Dagincourt, Thomas A Miller
OBJECTIVE: The aim of this study was to evaluate the safety and feasibility of a passive range of motion exercise programme for infants with CHD. Study design This non-randomised pilot study enrolled 20 neonates following Stage I palliation for single-ventricle physiology. Trained physical therapists administered standardised 15-20-minute passive range of motion protocol, for up to 21 days or until hospital discharge. Safety assessments included vital signs measured before, during, and after the exercise as well as adverse events recorded through the pre-Stage II follow-up...
March 23, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28329463/current-practices-in-the-timing-of-stage-2-palliation
#2
James M Meza, Robert D B Jaquiss, Brett R Anderson, Michael-Alice Moga, James K Kirklin, George Sarris, William G Williams, Brian W McCrindle
BACKGROUND: Mortality through single-ventricle palliation remains high and the effect of the timing of stage 2 palliation (S2P) is not well understood. We investigated current practice patterns in the timing of S2P across two professional societies and compared them to actual practice patterns from two databases of patients who underwent S2P. METHODS: A ten-question survey was distributed to the members of the Congenital Heart Surgeons' Society (CHSS) and the European Congenital Heart Surgeons' Association (ECHSA)...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28274558/morbidity-and-mortality-prediction-in-pediatric-heart-surgery-physiological-profiles-and-surgical-complexity
#3
John T Berger, Richard Holubkov, Ron Reeder, David L Wessel, Kathleen Meert, Robert A Berg, Michael J Bell, Robert Tamburro, J Michael Dean, Murray M Pollack
OBJECTIVES: Outcome prediction for pediatric heart surgery has focused on mortality but mortality has been significantly reduced over the past 2 decades. Clinical care practices now emphasize reducing morbidity. Physiology-based profiles assessed by the Pediatric Risk of Mortality (PRISM) score are associated with new significant functional morbidity detected at hospital discharge. Our aims were to assess the relationship between new functional morbidity and surgical risk categories (Risk Adjustment for Congenital Heart Surgery [RACHS] and Society for Thoracic Surgery Congenital Heart Surgery Database Mortality Risk [STAT]), measure the performance of 3-level (intact survival, survival with new functional morbidity, or death) and 2-level (survival or death) PRISM prediction algorithms, and assess whether including RACHS or STAT complexity categories improves the PRISM predictive performance...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28274556/comparison-of-right-ventricle-pulmonary-artery-shunt-position-in-the-single-ventricle-reconstruction-trial
#4
Nicholas D Andersen, James M Meza, Matthew R Byler, Andrew J Lodge, Kevin D Hill, Christoph P Hornik, Robert D B Jaquiss
OBJECTIVE: Placement of a right ventricle-pulmonary artery shunt to the left or right of the neoaorta may influence reinterventions, pulmonary artery development, and survival after the Norwood procedure because of differences in shunt and pulmonary artery geometry and blood flow. METHODS: We analyzed the Pediatric Heart Network Single Ventricle Reconstruction Trial public use dataset. Comparisons were made between patients who received a left- or right-sided right ventricle-pulmonary artery shunt during the Norwood procedure in both the overall (n = 274) and the propensity score-matched (67 pairs) patient cohorts...
February 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28267897/outcomes-of-pediatric-kidney-transplantation-in-recipients-of-a-previous-non-renal-solid-organ-transplant
#5
Gilad Hamdani, Bin Zhang, Chunyan Liu, Jens Goebel, Yue Zhang, Edward Nehus
Children who receive a non-renal solid organ transplant may develop secondary renal failure requiring kidney transplantation. We investigated outcomes of 165 pediatric kidney transplant recipients who previously received a heart, lung, or liver transplant using data from 1988-2012 reported to the United Network for Organ Sharing. Patient and allograft survival were compared with 330 matched primary kidney transplant (PKT) recipients. Kidney transplantation after solid organ transplant (KASOT) recipients experienced similar allograft survival: 5 and 10-year graft survival was 78% and 60% in KASOT recipients, compared to 80% and 61% in PKT recipients (p=0...
March 7, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28251816/inferior-outcomes-on-the-waiting-list-in-low-volume-pediatric-heart-transplant-centers
#6
Abbas Rana, Charles D Fraser, Brandi B Scully, Jeffrey S Heinle, E Dean McKenzie, William J Dreyer, Michael Kueht, Hao Liu, Eileen D Brewer, Todd K Rosengart, Christine A O'Mahony, John A Goss
Low case volume has been associated with poor outcomes in a wide spectrum of procedures. Our objective is to study the association of low case volume and worse outcomes in pediatric heart transplant centers, taking the novel approach of including waitlist outcomes in the analysis. We studied a cohort of 6,482 candidates listed in the Organ Procurement and Transplantation Network for pediatric heart transplantation between 2002 and 2014; 4,665 of the candidates (72%) were transplanted. Candidates were divided into groups according to the average annual transplant volume performed in the listing center during the study period: > 10, 6-10, 3-5, and <3...
March 1, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28183375/translating-clinical-trials-into-clinical-practice-a-survey-assessing-the-potential-impact-of-the-pediatric-heart-network-infant-single-ventricle-trial
#7
Victor Zak, Daphne T Hsu, Victoria L Pemberton, Jami C Levine, Andrew M Atz, James F Cnota, Chitra Ravishankar, Piers Barker, Linda M Lambert, Brian W McCrindle, Michele A Frommelt, Karen Altmann, Shan Chen, Richard V Williams
BACKGROUND: A few studies have evaluated the impact of clinical trial results on practice in paediatric cardiology. The Infant Single Ventricle (ISV) Trial results published in 2010 did not support routine use of the angiotensin-converting enzyme inhibitor enalapril in infants with single-ventricle physiology. We sought to assess the influence of these findings on clinical practice. METHODS: A web-based survey was distributed via e-mail to over 2000 paediatric cardiologists, intensivists, cardiothoracic surgeons, and cardiac advance practice nurses during three distribution periods...
February 10, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28125462/united-states-trends-in-pediatric-ventricular-assist-implantation-as-bridge-to-transplantation
#8
Chet R Villa, Muhammad S Khan, Farhan Zafar, David Ls Morales, Angela Lorts
Ventricular assist devices (VADs) are increasingly used to support children to heart transplant however, it is unclear if this trend is broadly applicable across the age/size spectrum. Children (<18years) listed for transplant were identified within in the United Network of Organ Sharing (UNOS) database from 1/2006-6/2014. Patients were stratified by era (Early: 2006-2010, Current: 2011-2014), size (<25 kg, 25-50 kg, > 50 kg) and device type. Of 3986 patients, 531 (13%) were supported by a VAD. The proportion of patients supported with a VAD has increased in the current era (16% vs...
January 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28098429/natural-history-of-nonimmune-mediated-thrombocytopenia-and-acute-kidney-injury-in-pediatric-open-heart-surgery
#9
Shannon Tew, Manuel L Fontes, Nathaniel H Greene, Miklos D Kertai, George Ofori-Amanfo, Robert D B Jaquiss, Andrew J Lodge, Warwick A Ames, Hercilia Mayumi Homi, Kelly A Machovec, Edmund H Jooste
OBJECTIVE: Thrombocytopenia and acute kidney injury (AKI) are common following pediatric cardiac surgery with cardiopulmonary bypass (CPB). However, the relationship between postoperative nadir platelet counts and AKI has not been investigated in the pediatric population. Our objective was to investigate this relationship and examine independent predictors of AKI. DESIGN: After IRB approval, we performed a retrospective review of the institution's medical records and database...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28073609/interaction-of-older-donor-age-and-survival-after-weight-matched-pediatric-heart-transplantation
#10
Thomas C Westbrook, David L S Morales, Muhammad S Khan, Roosevelt Bryant, Chesney Castleberry, Clifford Chin, Farhan Zafar
BACKGROUND: Donors are matched for weight in pediatric heart transplantation (PHT), yet age differences are not considered in this decision. In this study we attempt to identify the effect of age differences in weight-matched patients and the effect these differences have on post-transplant survival. METHODS: The United Network of Organ Sharing (UNOS) database was queried for the period from October 1987 to March 2014 for all pediatric heart transplant patients...
December 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28043455/validation-of-a-simple-score-to-determine-risk-of-hospital-mortality-after-the-norwood-procedure
#11
Shahryar M Chowdhury, Eric M Graham, Andrew M Atz, Scott M Bradley, Minoo N Kavarana, Ryan J Butts
The ability to quantify patient-specific hospital mortality risk before the Norwood procedure remains elusive. This study aimed to develop an accurate and clinically feasible score to assess the risk of hospital mortality in neonates undergoing the Norwood procedure. All patients (n = 549) in the publically available Pediatric Heart Network Single Ventricle Reconstruction trial database were included in the analysis. Patients were randomly divided into a derivation (75%) and validation (25%) cohort. Preoperative factors found to be associated with mortality upon univariable analysis (P < 0...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28009713/outcomes-and-trends-of-ventricular-assist-device-selection-in-children-with-end-stage-heart-failure
#12
Jacob R Miller, Timothy S Lancaster, Deirdre J Epstein, Nicholas C DuPont, Kathleen E Simpson, Chesney Castleberry, Charles E Canter, Pirooz Eghtesady, Umar S Boston
We aimed to examine trends in VAD selection, continuous-flow devices (CFD) versus pulsatile (PFD), and their associated outcomes in children eligible for both device types. To accomplish this, the United Network for Organ Sharing database was reviewed for pediatric patients listed for heart transplant (HT) from January of 2007 through June of 2014. Patients were included if a durable VAD was present at wait listing or when removed from the waiting list, and who met size eligibility for a CFD (BSA > 1.0 m2)...
December 20, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/27939495/development-and-impact-of-arrhythmias-after-the-norwood-procedure-a-report-from-the-pediatric-heart-network
#13
Matthew E Oster, Shan Chen, Nicholas Dagincourt, Yaniv Bar-Cohen, Matthew Brothers, Nicole Cain, Steven D Colan, Richard J Czosek, Jamie A Decker, David G Gamboa, Salim F Idriss, Joel A Kirsh, Martin J LaPage, Richard G Ohye, Elizabeth Radojewski, Maully Shah, Eric S Silver, Anoop K Singh, Joel D Temple, John Triedman, Jonathan R Kaltman
OBJECTIVES: The study objective was to determine the predictors of new-onset arrhythmia among infants with single-ventricle anomalies during the post-Norwood hospitalization and the association of those arrhythmias with postoperative outcomes (ventilator time and length of stay) and interstage mortality. METHODS: After excluding patients with preoperative arrhythmias, we used data from the Pediatric Heart Network Single Ventricle Reconstruction Trial to identify risk factors for tachyarrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, junctional ectopic tachycardia, and ventricular tachycardia) and atrioventricular block (second or third degree) among 544 eligible patients...
March 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27933693/heart-transplantation-in-children-with-intellectual-disability-an-analysis-of-the-unos-database
#14
Alexander N Goel, Amit Iyengar, Kenneth Schowengerdt, Andrew C Fiore, Charles B Huddleston
Heart transplantation in children with intellectual disability (ID) is an issue of debate due to the shortage of available donor organs. We sought to perform the first large-scale retrospective cohort study describing the prevalence and outcomes of heart transplantation in this population. The United Network of Organ Sharing database was queried from 2008 to 2015 for pediatric patients (age <19 years) receiving first, isolated heart transplant. Recipients were divided into three subgroups: definite ID, probable ID, and no ID...
December 9, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27887664/translating-sickle-cell-guidelines-into-practice-for-primary-care-providers-with-project-echo
#15
Lisa M Shook, Christina B Farrell, Karen A Kalinyak, Stephen C Nelson, Brandon M Hardesty, Angeli G Rampersad, Kay L Saving, Wanda J Whitten-Shurney, Julie A Panepinto, Russell E Ware, Lori E Crosby
BACKGROUND: Approximately 100,000 persons with sickle cell disease (SCD) live in the United States, including 15,000 in the Midwest. Unfortunately, many patients experience poor health outcomes due to limited access to primary care providers (PCPs) who are prepared to deliver evidence-based SCD care. Sickle Treatment and Outcomes Research in the Midwest (STORM) is a regional network established to improve care and outcomes for individuals with SCD living in Indiana, Illinois, Michigan, Minnesota, Ohio, and Wisconsin...
2016: Medical Education Online
https://www.readbyqxmd.com/read/27884629/urgent-listing-exceptions-and-outcomes-in-pediatric-heart-transplantation-comparison-to-standard-criteria-patients
#16
Ryan R Davies, Michael A McCulloch, Shylah Haldeman, Samuel S Gidding, Christian Pizarro
BACKGROUND: United Network for Organ Sharing (UNOS) policy enables listing exceptions to avoid penalizing patients with waitlist mortality not captured by standard criteria. Outcomes among patients listed by exception have not been analyzed. METHODS: We performed a retrospective analysis of pediatric (≤17 years of age, n = 4,706) listings (2006 to 2015) for primary, isolated heart transplantation within the UNOS data set, assessing Status 1A exception (n = 211, 4...
October 1, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27882424/influence-of-transplant-center-procedural-volume-on-survival-outcomes-of-heart-transplantation-for-children-bridged-with-mechanical-circulatory-support
#17
Alex Hsieh, Dmitry Tumin, Patrick I McConnell, Mark Galantowicz, Joseph D Tobias, Don Hayes
Transplant center expertise improves survival after heart transplant (HTx) but it is unknown whether center expertise ameliorates risk associated with mechanical circulatory support (MCS) bridge to transplantation. This study investigated whether center HTx volume reduced survival disparities among pediatric HTx patients bridged with extracorporeal membrane oxygenation (ECMO), left ventricular assist device (LVAD), or no MCS. Patients ≤18 years of age receiving first-time HTx between 2005 and 2015 were identified in the United Network of Organ Sharing registry...
November 24, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27855999/assessment-of-growth-6-years-after-the-norwood-procedure
#18
Phillip T Burch, Chitra Ravishankar, Jane W Newburger, Linda M Lambert, Victoria L Pemberton, Suzanne Granger, Alejandro A Floh, Jeffrey B Anderson, Garick D Hill, Kevin D Hill, Matthew E Oster, Alan B Lewis, Kurt R Schumacher, Sinai C Zyblewski, Ryan R Davies, Jeffrey P Jacobs, Wyman W Lai, L LuAnn Minich
At 6 years of age, patients with hypoplastic left heart syndrome had mean age-adjusted z-scores for weight and height below the normative population, and body mass index was similar to the normative population. Males had the greatest increase in z-scores for body mass index. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00115934.
January 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/27852427/monitoring-the-hospital-management-of-acute-asthma-the-italian-pediatric-network-experience
#19
A G Martelli, R Bianchi, B Boldrighini, M Bosoni, A De Vuono, A Flores D'Arcais, G Gargantini, R Longhi, M T Ortisi, E Racchi, L Parola
BACKGROUND: The Study Group on Accreditation and Quality Improvement of the Italian Society of Pediatrics has developed an observational study about the hospital management of pediatric patients affected by severe asthma, in order to evaluate how the Guidelines for severe asthma in childhood are applied in the daily practice. METHODS: This study included patients between 2 and 17 years, hospitalized or under short intensive observation for acute asthma. The data collection was carried out through the compilation of on-line forms...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27826711/safety-of-enalapril-in-infants-admitted-to-the-neonatal-intensive-care-unit
#20
Lawrence C Ku, Kanecia Zimmerman, Daniel K Benjamin, Reese H Clark, Christoph P Hornik, P Brian Smith
Enalapril is used to treat hypertension and congestive heart failure in infants. However, enalapril is not labeled for neonates, and safety data in infants are sparse. To evaluate the safety of enalapril in young infants, we conducted a retrospective cohort study of infants who were exposed to enalapril in the first 120 days of life and were cared for in 348 neonatal intensive care units from 1997 to 2012. We determined the proportion of exposed infants who developed adverse events, including death, hypotension requiring pressors, hyperkalemia, and elevated serum creatinine...
January 2017: Pediatric Cardiology
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