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9 papers 0 to 25 followers Cardiac Care with Infants diagnosed with Trisomy 18
By Victoria Miller Trisomy 18 Foundation
Stephanie Mifsud, Maureen Bezzina, Simon Paris
The use of suxamethonium in our case was uneventful and despite craniofacial anomalies, airway management was straightforward. This case illustrates that pediatric patients with trisomy 18, presenting with potentially acute life-threatening conditions and requiring emergency major surgery can be managed successfully with a multidisciplinary approach.
August 2016: Clinical Case Reports
Minoo N Kavarana
The management of children born with trisomy 18 is controversial, and both providers and parents often have differing opinions. Many parents choose to terminate the pregnancy while others go forward, making decisions based on their beliefs, understanding, and physician recommendations. Physicians are similarly divided regarding treatment of these children, as some feel that aggressive treatments are futile while others defer to the parents' wishes.Interrupted aortic arch with ventricular septal defect in children with trisomy 18 presents an ethical dilemma that highlights the kinds of controversies in medical decision making facing physicians on a daily basis...
June 2016: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
Eric M Graham
Aggressive medical and surgical interventions have not been clearly demonstrated to improve survival in neonates with trisomy 18; there are no data that demonstrates improved quality of life for these children after these interventions; and these interventions are clearly associated with significant morbidity, resource allocation, and cost.
June 2016: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
Annie Janvier, Barbara Farlow, Keith Barrington
The objective is to examine whether cardiac surgery should be considered for children with trisomy 13 or 18 (T13 or 18).T13 or 18 were previously referred to as "lethal" conditions due to high mortality rates and severe disability among survivors. In the last decade, investigations have revealed these conditions are heterogeneous, with increasing numbers of studies describing interventions for these children. A number of factors makes the interpretation of reported outcomes after cardiac surgery challenging: (1) dissimilarities in practice lead to a wide variation in reported outcomes after cardiac surgery; (2) cardiac surgery is generally offered to older, healthier children; (3) cardiac surgeries of widely varying risks are often lumped together in individual studies, and (4) cases where cardiac surgery has been withheld are generally not included in publications...
June 2016: Seminars in Perinatology
William E Benitz
Despite a large body of basic science and clinical research and clinical experience with thousands of infants over nearly 6 decades,(1) there is still uncertainty and controversy about the significance, evaluation, and management of patent ductus arteriosus in preterm infants, resulting in substantial heterogeneity in clinical practice. The purpose of this clinical report is to summarize the evidence available to guide evaluation and treatment of preterm infants with prolonged ductal patency in the first few weeks after birth...
January 2016: Pediatrics
Yosuke Nakai, Miki Asano, Norikazu Nomura, Hidekazu Matsumae, Akira Mishima
BACKGROUND: Surgical repair for cardiac lesions has rarely been offered to patients with trisomy 18 because of their very short lifespans. We investigated the effectiveness of cardiac surgery in patients with trisomy 18. Patients and methods We performed a retrospective analysis of 20 consecutive patients with trisomy 18 and congenital cardiac anomalies who were evaluated between August, 2003 and July, 2013. All patients developed respiratory or cardiac failure due to excessive pulmonary blood flow...
October 2016: Cardiology in the Young
George Imataka, Hiroshi Suzumura, Osamu Arisaka
Trisomy 18 syndrome is a common autosomal aneuploidy chromosomal abnormality caused by the presence of extra chromosome 18 that leads to malformations of various parts of the body. In this study, we retrospectively investigated the effect of the medical progression and prognosis of 44 cases of trisomy 18, admitted to our neonatal intensive care unit between 1992 and 2013. The patients were divided into group A (n=20, 1992‑2002) and group B (n=24, 2003‑2012). Following delivery, karyotype, gender, gestational weeks, birth place, cesarean section, Apgar score and birth weight were analyzed using the Fisher's exact test, unpaired t‑test and Mann‑Whitney U test...
March 2016: Molecular Medicine Reports
Gianluca Terrin, Francesca Conte, Mehmet Yekta Oncel, Antonella Scipione, Patrick J McNamara, Sinno Simons, Rahul Sinha, Omer Erdeve, Kadir S Tekgunduz, Mustafa Dogan, Irena Kessel, Cathy Hammerman, E Nadir, Sadik Yurttutan, Bonny Jasani, Serdar Alan, Francesco Manguso, Mario De Curtis
OBJECTIVES: We performed a systematic review and meta-analysis of all the available evidence to assess the efficacy and safety of paracetamol for the treatment of patent ductus arteriosus (PDA) in neonates, and to explore the effects of clinical variables on the risk of closure. DATA SOURCE: MEDLINE, Scopus and ISI Web of Knowledge databases, using the following medical subject headings and terms: paracetamol, acetaminophen and patent ductus arteriosus. Electronic and manual screening of conference abstracts from international meetings of relevant organisations...
March 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Jeffrey A Feinstein, D Woodrow Benson, Anne M Dubin, Meryl S Cohen, Dawn M Maxey, William T Mahle, Elfriede Pahl, Juan Villafañe, Ami B Bhatt, Lynn F Peng, Beth Ann Johnson, Alison L Marsden, Curt J Daniels, Nancy A Rudd, Christopher A Caldarone, Kathleen A Mussatto, David L Morales, D Dunbar Ivy, J William Gaynor, James S Tweddell, Barbara J Deal, Anke K Furck, Geoffrey L Rosenthal, Richard G Ohye, Nancy S Ghanayem, John P Cheatham, Wayne Tworetzky, Gerard R Martin
In the recent era, no congenital heart defect has undergone a more dramatic change in diagnostic approach, management, and outcomes than hypoplastic left heart syndrome (HLHS). During this time, survival to the age of 5 years (including Fontan) has ranged from 50% to 69%, but current expectations are that 70% of newborns born today with HLHS may reach adulthood. Although the 3-stage treatment approach to HLHS is now well founded, there is significant variation among centers. In this white paper, we present the current state of the art in our understanding and treatment of HLHS during the stages of care: 1) pre-Stage I: fetal and neonatal assessment and management; 2) Stage I: perioperative care, interstage monitoring, and management strategies; 3) Stage II: surgeries; 4) Stage III: Fontan surgery; and 5) long-term follow-up...
January 3, 2012: Journal of the American College of Cardiology
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