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Paediatric cardiac surgery

Shoahaib Karimi, Victor M Lu, Mithun Nambiar, Kevin Phan, Anuruthran Ambikaipalan, Ralph J Mobbs
STUDY DESIGN: Systematic review and meta-analysis of randomised controlled trials. OBJECTIVE: The purpose of this study is to perform a systematic review and meta-analysis of antifibrinolytic agents for paediatric spine surgery. BACKGROUND: Bleeding is an important consideration in paediatric scoliosis surgery; blood loss leads directly to higher morbidity and mortality. Antifibrinolytics are an attractive non-invasive method of reducing bleeding as evidenced in arthroplasty, cardiac surgery and adult scoliosis surgery...
February 9, 2019: European Spine Journal
Mustafa Cagdas Cayir, Ahmet Yuksel
BACKGROUND: The del Nido (DN) cardioplegia solution has been widely used in paediatric open-heart surgery for years; however, its application in adult open-heart surgery has not yet gained sufficient popularity. We investigated the safety and efficiency of the DN cardioplegia solution versus the traditional crystalloid cardioplegia solution [St. Thomas' Hospital (STH) cardioplegia solution] in adult patients undergoing coronary artery bypass grafting (CABG). METHODS: A retrospective comparative analysis of 200 consecutive patients undergoing isolated on-pump CABG between April 2016 and September 2017 was performed...
January 18, 2019: Heart, Lung & Circulation
Andrea S Christoff, David S Winlaw, Julie Curtin, Elizabeth H Barnes, Jonathan R Egan
OBJECTIVES: The aim of this study is to determine whether recombinant activated factor VII (rVIIa) was associated with thrombus formation in neonates undergoing cardiac surgery. METHODS: This is a retrospective study of neonates undergoing surgical repair of congenital cardiac lesions during a 9-year period. RESULTS: In our study, 416 cardiac operations requiring cardiopulmonary bypass (CPB) were performed on 414 neonates. The overall intravascular thrombus (thrombus) frequency for all operations was 45 of 416 (11%)...
January 31, 2019: European Journal of Cardio-thoracic Surgery
Jeffrey J Cies, Wayne S Moore, Jason Parker, Randy Stevens, Yasir Al-Qaqaa, Adela Enache, Arun Chopra
Objectives: Our aim was to describe the pharmacokinetics of cefazolin in paediatric patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) who received cefazolin for peri-operative surgical prophylaxis in addition to having cefazolin added to the CPB circuit priming solution. Secondary aims were to determine the pharmacodynamic exposure associated with the addition of cefazolin to the CPB priming solution and to assess whether a target cefazolin concentration range for the CPB priming solution could be identified...
January 25, 2019: Journal of Antimicrobial Chemotherapy
Justin J Skowno
Every day, hundreds of children around the world undergo some form of heart surgery. Safely seeing a patient through the complexities of paediatric cardiac surgery requires a range of skills, many of which are based on use and interpretation of standard clinical monitoring. However, these monitors are unable to tell us about absolute cardiac output, or whether the current cardiovascular state is adequate to the patient's needs. This article is protected by copyright. All rights reserved.
January 22, 2019: Paediatric Anaesthesia
Chunxiang Li, Limin Zhu, Xiaolei Gong, Zhuoming Xu, Yujie Liu, Mingjie Zhang, Qing Cao
The present study aimed to assess the usefulness of soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) in the diagnosis of ventilator-associated pneumonia (VAP) in paediatric patients with congenital heart disease (CHD) following cardiac surgery. The current prospective study enrolled 48 patients with congenital heart diseases who were suspected of having VAP; these patients were undergoing cardiac surgery between August 2016 and October 2017 in the Cardiac Intensive Care Unit of Shanghai Children's Medical Center (Shanghai, China)...
January 2019: Experimental and Therapeutic Medicine
Misha Dagan, Warwick Butt, Johnny Millar, Yves d'Udekem, Jenny Thompson, Siva P Namachivayam
BACKGROUND: Reported incidence of in hospital cardiac arrest (IHCA) after paediatric cardiac surgery varies between 3-4% in high income countries and this risk may have changed over time. We sought to examine this trend in detail. METHODS: A retrospective observational study of 3781 children who underwent 4938 cardiac surgeries between 1 January 2007 and 31 December 2016 in a tertiary children's hospital. IHCA was defined as cessation of cardiac mechanical activity requiring cardiac massage for ≥1minute...
November 23, 2018: Heart, Lung & Circulation
Huiwen Zhang, Ying Gu, YaPing Mi, Yun Jin, Weijia Fu, Jos M Latour
BACKGROUND: Previous studies have shown that feeding a high-energy formula (HF) to infants after cardiac surgery increases energy intake, with fewer side effects on cardiopulmonary function. However, impacts on weight gain and gastrointestinal function remain unclear. AIMS AND OBJECTIVES: To determine the impact of HF compared with standard formula on weight gain and gastrointestinal tolerance in postoperative infants with congenital heart disease. DESIGN: This was a randomized controlled trial...
December 9, 2018: Nursing in Critical Care
H Brun, R A B Bugge, L K R Suther, S Birkeland, R Kumar, E Pelanis, O J Elle
Aims: Proof of concept and feasibility study for preoperative diagnostic use of mixed reality (MR) holograms of individual 3D heart models from standard cardiac computed tomography angiograms (CTA) images. Optimal repair for complex congenital heart disease poses high demands on 3D anatomical imagination. Three-dimensional printed heart models are increasingly used for improved morphological understanding during surgical and interventional planning. Holograms are a dynamic and interactive alternative, probably with wider applications...
December 6, 2018: European Heart Journal Cardiovascular Imaging
Louise Tofft, Martin Salö, Einar Arnbjörnsson, Pernilla Stenström
Aim of the Study: To assess the frequency of and identify contributing factors to wound dehiscence after posterior sagittal anorectoplasty (PSARP) in children born with anorectal malformations (ARM). Methods: Ethical approval was obtained (DNR 2017/191). Charts of all children with anorectal malformations (ARM) reconstructed with PSARP, limited PSARP, or PSARVUP at a tertiary centre of paediatric surgery between 2001 and 2016 were reviewed. Wound dehiscence within 30 days postoperatively was analysed regarding gender, prematurity, birth weight, type of ARM, other congenital malformations, single- or multistaged reconstruction, age and weight at reconstruction, postoperative antibiotics, and fasting...
2018: BioMed Research International
Sara Hussain, Osman Al-Radi, Tae-Jin Yun, Zhongdong Hua, Budi Rahmat, Suresh Rao, An Qi, Charles Fraser, Yves d'Udekem, Quazi Ibrahim, Ingrid Copland, Richard Whitlock, Glen Van Arsdell
BACKGROUND: A wide variety of surgical strategies are used in tetralogy of Fallot repair. We sought to describe the international contemporary practice patterns for surgical management of tetralogy of Fallot. METHODS: Surgeons from 18 international paediatric cardiac surgery centres (representing over 1800 tetralogy of Fallot cases/year) completed a Research Electronic Data Capture-based survey. Participating countries include: China (4), India (2), Nepal (1), Korea (1), Indonesia (1), Saudi Arabia (3), Japan (1), Turkey (1), Australia (1), United States of America (2), and Canada (1)...
January 2019: Cardiology in the Young
Jonathan R G Etnel, Willem A Helbing, Jolien W Roos-Hesselink, Regina The, Ad J J C Bogers, Johanna J M Takkenberg
Background: To assess the current state of patient information and decision-making in congenital aortic and pulmonary valve disease, we conducted a survey among patients, parents and physicians. Methods: A questionnaire was sent by ground mail to 157 adults and 32 parents of children who previously underwent surgery for congenital aortic or pulmonary valve disease at 0-40 years of age between January 2005 and February 2014 at the Erasmus University Medical Center and to all paediatric and adult congenital cardiologists and congenital cardiac surgeons in the Netherlands (n=88)...
2018: Open Heart
Emily Mary O'Brien, David Law, David Celermajer, Peter Watson Grant, Jon Waites
OBJECTIVE: The number of adults with congenital heart disease has increased with improvements in surgical and medical management, posing a challenge for regional and rural settings, which might have difficulties accessing specialised professionals with congenital heart disease services. This study aims to ascertain the demographics and management of adults with congenital heart disease seen by a cardiology practice in regional Australia to better understand the needs of regional adults with congenital heart disease...
November 19, 2018: Australian Journal of Rural Health
Nicholas Dufourq, Lara Nicole Goldstein, Martin Botha
Introduction: Despite the differences in exposure and experience in dealing with medical emergencies, all doctors should nevertheless be competent to assist a patient in need of resuscitation. The objective of this study was to describe the level of self-assessed emergency skill competence that specialist trainees in various disciplines possessed as well as to identify factors that may have contributed to their level of self-perceived competence. Methods: A prospective, cross-sectional, questionnaire study of various specialist trainees' self-perceived levels of competence in emergency skills was conducted across three academic hospitals in Johannesburg, South Africa...
December 2017: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Caroline Tumelo Bayebaye, Palesa Motshabi-Chakane, Michel Kasongo Muteba
BACKGROUND: Cardiac surgery is associated with peri-operative bleeding, which may result in the need for blood transfusion, particularly in paediatric congenital cardiac surgery on cardiopulmonary bypass (CPB). There is a necessity for regular auditing in order to improve practices. METHODS: Retrospective, contextual, descriptive data of 105 patients were collected for the period January to December 2014. RESULTS: The median age of patients was four (1-6) years, weight was 13 (8...
November 6, 2018: Cardiovascular Journal of Africa
Tariq M Wani, Mohammed Hakim, Archana Ramesh, Shabina Rehman, Yasser Majid, Rebecca Miller, Dmitry Tumin, Joseph D Tobias
BACKGROUND: Preoperative factors have been correlated with pre-incision hypotension (PIH) in children undergoing surgery, suggesting that PIH can be predicted through preoperative screening. We studied blood pressure (BP) changes in the 12 min following the induction of anesthesia to study the incidence of post-induction hypotension and to assess the feasibility of predicting PIH in low-risk children without preoperative hypotension or comorbid features. METHODS: We retrospectively evaluated 200 patients ranging in age from 2 to 8 years with American Society of Anesthesiologists' (ASA) physical status I or II, undergoing non-cardiac surgery...
December 2018: Pediatric Surgery International
Kathleen N Fenton, Marcelo Cardarelli, Frank Molloy, William M Novick
BACKGROUND: In countries with ample resources, no debate exists as to whether heart surgery should be provided. However, where funding is limited, what responsibility exists to care for children with congenital heart defects? If children have a "right" to surgical treatment, to whom is the "duty" to provide it assigned? These questions are subjected to ethical analysis. METHODS: Examination is initially based on the four principles of medical ethics: autonomy, beneficence, non-maleficence, and justice...
October 18, 2018: Cardiology in the Young
R D Eveleens, D K Dungen, S C A T Verbruggen, J M Hulst, K F M Joosten
BACKGROUND: Reaching an optimal nutritional intake is challenging in critically ill infants. One possible way to minimise nutritional deficits is the use of protein and energy-enriched (PE)-formulas. We aimed to describe weight achievement and gastrointestinal symptoms in infants admitted to the paediatric intensive care unit (PICU) while receiving PE-formula for a prolonged period. METHODS: Records from infants admitted to a multidisciplinary PICU and using PE-formula were analysed retrospectively...
October 14, 2018: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
Pascal Amedro, Arthur Gavotto, Delphine Gelibert, Virginie Fraysse, Gregoire De La Villeon, D'Arcy Vandenberghe, Charlene Bredy
BACKGROUND: The use of hypnosis in children has been described more than two centuries ago, with a more recent research and clinical application. There is currently a good level of evidence for the efficacy of clinical hypnosis in children for minor surgery, medical procedures or pain management. The use of clinical hypnosis, in paediatric cardiology, for invasive procedures such as transesophageal echocardiography, has not been reported. AIMS: This study evaluated the feasibility of clinical hypnosis in children undergoing transesophageal echocardiography...
September 19, 2018: European Journal of Cardiovascular Nursing
Anne C Taylor, Katherine E Bates, Alaina K Kipps
Limited evidence exists to guide chest tube management following cardiac surgery in children. We assessed chest tube practice variation by surveying paediatric heart centres to prepare for a multi-site quality improvement project. We summarised management strategies highlighting variability in criteria for chest tube removal between and within centres. This lack of standardisation provides an opportunity for quality improvement.
September 10, 2018: Cardiology in the Young
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