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Pediatric catheterization

Sezen Atik Ugan, Selman Gökalp, Betül Çınar, İrfan Levent Saltık
OBJECTIVE: Right-heart catheterization using the antecubital veins has recently regained attention, and studies demonstrating the feasibility and safety of antecubital access in adults have been published. However, no changes have been observed in the preferred entrance sites in right-heart catheterizations in children with congenital heart diseases. This article is a description of the technique and features of the antecubital venous approach in pediatric patients with complex congenital heart defects and a Glenn anastomosis...
March 2019: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Albert Holvast, Gursah Kats-Ugurlu, Frank A J A Bodewes, Ruben H J de Kleine, Robert J Porte, Adrienne H Brouwers, Hubert P J van der Doef
Secondary protein-losing enteropathy (PLE) is a rare complication following pediatric liver transplantation (LT), mostly related to venous outflow obstruction of the liver. Here, we discuss a thus far unknown cause of secondary PLE following pediatric LT. A 7-months old boy underwent LT with biliary anastomosis using a Roux-en-Y jejunal loop. Eleven months later he developed PLE. Routine diagnostic work-up was negative. No hepatic outflow obstruction was detected during catheterization. Although the hepatic venous pressure gradient was slightly increased (10 mmHg), there were no clinical signs of portal hypertension...
March 14, 2019: American Journal of Transplantation
Ashleigh Xie, Paul Forrest, Antonio Loforte
Background: Despite the survival benefit of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for treatment of refractory cardiogenic shock, it can also have potentially deleterious effects of left ventricular overload and pulmonary edema. The objective of this review was to investigate the current evidence on the incidence, diagnosis, risk factors, prevention, and interventions for left ventricular overload in adult and pediatric VA-ECMO patients. Methods: Five electronic databases, including MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews, were searched for original published studies from their dates of inception to January 2018...
January 2019: Annals of Cardiothoracic Surgery
Ravi S Samraj, Maria Kerrigan, Maria Mejia, Laura Wilson, James C Fudge, Himesh V Vyas, Dipankar Gupta
PURPOSE: Shock is associated with increased tissue oxygen extraction. Near-infrared spectroscopy-derived thenar muscle tissue oxygenation (StO2 ) levels can provide an estimate of the oxygen supply-demand balance at the tissue level. We hypothesized that thenar StO2 levels would correlate with central venous oxygen saturation (ScvO2 ) levels, the gold standard for global tissue oxygen extraction in the body. METHODS: We prospectively enrolled 60 pediatric subjects admitted to pediatric intensive care unit or who underwent cardiac catheterization from September 2015 to March 2018...
March 6, 2019: Clinical Pediatrics
Ban Al-Sayyed, Jeremy Le, Mohammad Mousbah Al-Tabbaa, Brian Barnacle, Jinma Ren, Richard Tapping, Meenakshy Aiyer
OBJECTIVES: Antimicrobial stewardship programs target antimicrobial use within the inpatient care setting. However, most antimicrobials are prescribed at ambulatory sites. We aim to determine the appropriateness of the diagnosis and treatment of uncomplicated urinary tract infection (UTI) in children within the outpatient setting at our institution, and to evaluate the cost of antibiotic treatment in our patient cohort. METHODS: This retrospective study was conducted by reviewing electronic records of patients aged 2 to 18 years diagnosed with uncomplicated UTI and treated with antibiotics in the outpatient setting from January 1, 2016, to April 30, 2016...
January 2019: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Adam J Rensing, Konrad M Szymanski, Rosalia Misseri, Joshua D Roth, Shelly King, Katherine Chan, Benjamin M Whittam, Martin Kaefer, Richard C Rink, Mark P Cain
BACKGROUND: Spina bifida (SB) patients are at increased risk for hydronephrosis, bladder storage and emptying problems, and renal failure that may require multiple bladder surgeries. METHODS: We retrospectively reviewed patients born with SB 2005-2009, presenting to our institution within 1 year of birth. Outcomes at 8-11 years old included final renal/bladder ultrasound (RBUS) results, clean intermittent catheterization (CIC) use, anticholinergic use, surgical interventions, and final renal function...
March 3, 2019: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Nobuyuki Tsujii, Tamaki Hayashi, Hiroyuki Yoshizawa, Ryohei Fukuba, Shinya Yokoyama, Midori Shima
No abstract text is available yet for this article.
February 2019: Pediatrics International: Official Journal of the Japan Pediatric Society
Gerard R Martin, Jeffrey B Anderson, Robert N Vincent
The IMproving Pediatric and Adult Congenital Treatments (IMPACT) Registry and the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) are two efforts initiated to improve outcomes in the congenital heart disease field. The IMPACT Registry is focused on evaluating the use, risks, adverse events (AEs), and outcomes associated with diagnostic and common interventional catheterization procedures in all children and adults with congenital heart disease. Utilizing a modular approach, the common procedures include diagnostic cardiac catheterization, atrial septal defect device closure, patent ductus arteriosus device closure, pulmonary valvuloplasty, aortic valvuloplasty, balloon and stent angioplasty of coarctation of the aorta, pulmonary artery balloon stent angioplasty, transcatheter pulmonary valve replacement, and electrophysiology procedures including radiofrequency ablation...
January 2019: World Journal for Pediatric & Congenital Heart Surgery
Shi-Bing Xi, Shu-Shui Wang, Ming-Yang Qian, Yu-Mei Xie, Jun-Jie Li, Zhi-Wei Zhang
BACKGROUND: Pulmonary artery hypertension associated with congenital heart disease (PAH-CHD) occurs predominantly among patients with uncorrected CHD. Treatment of severe pediatric PAH-CHD remains a major intractability. This study evaluated the predictors and prognoses of children with PAH-CHD who underwent surgical correction. METHODS: The data for 59 children with severe PAH-CHD who underwent surgical correction, with or without postoperative medication between May 2011 and June 2015 at the Guangdong Provincial People's Hospital were analyzed retrospectively...
February 15, 2019: Chinese Medical Journal
Jess T Randall, Osamah Aldoss, Asra Khan, Melissa Challman, Gurumurthy Hiremath, Athar M Qureshi, Manish Bansal
BACKGROUND: Traditional approaches to pediatric cardiac catheterization have relied on femoral venous access. Upper- extremity venous access may enable cardiac catheterization procedures to be performed safely for diagnostic and interventional catheterizations. The objective of this multicenter study was to demonstrate the feasibility and safety of upper-extremity venous access in a pediatric cardiac catheterization laboratory. METHODS: A retrospective chart review of all patients who underwent cardiac catheterization via upper-extremity vascular access was performed...
February 15, 2019: Journal of Invasive Cardiology
Jin Hee Ahn, Jiyeon Park, In Sun Song, Keoung Ah Kim, Jungchan Park, Jeong Jin Min, Chung Su Kim, Jong-Hwan Lee
BACKGROUND: Since the femoral artery frequently overlaps the femoral vein, femoral central venous catheterization carries the risk of arterial puncture in pediatric patients. AIM: We evaluated the angle range of leg abduction with external hip rotation to minimize the overlap between the femoral artery and vein in pediatric patients undergoing general anesthesia. METHODS: Eighty-two pediatric patients who underwent elective surgery with general anesthesia were enrolled in this study...
February 8, 2019: Paediatric Anaesthesia
Ronald A Ligon, Christopher J Petit
We describe a patient with chronic thromboembolic pulmonary hypertension who presented to the pediatric cardiac catheterization laboratory for peripheral pulmonary artery recanalization and angioplasty. This case report outlines serial pulmonary arterial rehabilitation via a retrograde approach through intrapulmonary collateral arterial connections.
February 5, 2019: Catheterization and Cardiovascular Interventions
D S Giraldo Gutiérrez, J Bautista Sánchez, R D Reyes Patiño
The insertion of a central venous catheter is a procedure frequently performed in paediatric anaesthesia. The most frequent approach for this procedure is the internal jugular vein. However, some specific factors in children, such as the short neck and the easy collapse of this vein, which is accentuated in situations such as hypovolaemia and changes in the respiratory pattern, can lead to greater difficulty. The supraclavicular approach of the subclavian vein was described more than 50 years ago. However, it is not often considered nowadays, even after the introduction of ultrasound, and despite the obvious advantages with respect to the internal jugular approach due to the lower incidence of thrombosis and infection...
February 1, 2019: Revista Española de Anestesiología y Reanimación
J Jiménez Gómez, M Gómez Cervantes, V Núñez Cerezo, V Amesty Morello, M D Ponce Dorrego, F B Nava Hurtado de Saracho, L Martínez Martínez, J C López Gutiérrez
INTRODUCTION: High morbidity has been described in secondary chylothorax. Thoracic duct embolization (TDE) after intranodal lymphangiography (IL) is one of the treatments in adults but there is poor experience in children. We aim to describe our experience with this technique for refractory pediatric chylothorax. METHODS: A retrospective study of patients with refractory chylothorax treated with thoracic duct embolization at our Institution in the last 4 years was performed...
January 21, 2019: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Daryl J McLeod, Konrad M Szymanski, Edward Gong, Candace Granberg, Pramod Reddy, Yuri Sebastião, Molly Fuchs, Patricio Gargollo, Benjamin Whittam, Brian A VanderBrink
OBJECTIVES: Posterior urethral valves predispose children to renal replacement therapy (RRT) and bladder dysfunction. Researchers of single-institutional series were unable to refine risk stratification because of rarity of the disease. We aimed to identify clinical variables associated with the risk of RRT and clean intermittent catheterization (CIC) in a large multicenter cohort study. METHODS: Children with posterior urethral valves born between 1995 and 2005 who were treated before 90 days of life at 5 children's hospitals were retrospectively reviewed...
March 2019: Pediatrics
Clifford L Cua, Melissa Moore-Clingenpeel, Nazia Husain, Ralf Holzer, John P Cheatham, Janaki Gokhale
BACKGROUND: Increased ventricular end-diastolic pressure (VEDP) is a known risk factor for morbidity and mortality in patients with single right ventricle (RV) physiology. Previous studies have shown mixed results correlating echocardiographic measurements with catheter-derived VEDP in this population. Goal of this study was to evaluate if echocardiographic systolic/diastolic ratio (S/D) correlated with VEDP. METHODS: Patients with single RV physiology who underwent simultaneous echocardiography and catheterization were evaluated...
January 30, 2019: Congenital Heart Disease
Jason R Buckley, Venu Amula, Peter Sassalos, John M Costello, Arthur J Smerling, Lias Iliopoulos, Aimee Jennings, Christine M Riley, Katherine Cashen, Sukumar Suguna Narasimhulu, Keshava Murthy Narayana Gowda, Adnan M Bakar, Michael Wilhelm, Aditya Badheka, Elizabeth A S Moser, Christopher W Mastropietro
BACKGROUND: Literature describing morbidity and mortality after truncus arteriosus repair is predominated by single-center reports. We created and analyzed a multicenter dataset to identify risk factors for late mortality and right ventricle-to-pulmonary artery (RV-PA) conduit reintervention for this patient population. METHODS: We retrospectively collected data on children who underwent repair of truncus arteriosus without concomitant arch obstruction at 15 centers between 2009 and 2016...
February 2019: Annals of Thoracic Surgery
Femke van der Stelt, Sebastiaan N Siegerink, Gregor J Krings, Mirella M C Molenschot, Johannes M P J Breur
Cardiac catheterization is a commonly used form of imaging and treatment in pediatric patients with congenital heart disease. Traditionally, two-dimensional conventional angiography was the method used, but since 2000 three-dimensional rotational angiography (3DRA) is increasingly used in the field of cardiology in both adult and pediatric patients. To investigate the use and applications of 3DRA in pediatric congenital cardiology, literature was systematically reviewed and 29 eligible articles were found. Those showed that 3DRA is already a greatly valued diagnostic and therapeutic technique in pediatric cardiology...
January 24, 2019: Pediatric Cardiology
Balagangadhar R Totapally, Andre Raszynski, Danyal Khan, Ibrahim Amjad, Jefry Biehler
OBJECTIVES: The purpose of this study was to evaluate the prevalence, demographics, predisposing conditions, therapeutic interventions, and outcomes of extremity arterial thrombosis in hospitalized children. DESIGN: Retrospective cohort study. PATIENTS: National discharge database analysis. MEASUREMENTS AND MAIN RESULTS: Cases of extremity arterial thrombosis in children and neonates were extracted from the Kids' Inpatient Database 2012...
January 11, 2019: Pediatric Critical Care Medicine
Jun Takeshita, Takayuki Yoshida, Yasufumi Nakajima, Yoshinobu Nakayama, Kei Nishiyama, Yukie Ito, Yoshiyuki Shimizu, Muneyuki Takeuchi, Nobuaki Shime
OBJECTIVE: Arterial catheterization for infants and small children is technically challenging. This study evaluated whether the dynamic needle tip positioning (DNTP) technique improved the success rate of ultrasound-guided radial artery catheterization in patients with a radial artery depth ≥4 mm compared with the conventional ultrasound-guided technique. DESIGN: Randomized controlled study. SETTING: Single institution, Osaka Women's and Children's Hospital...
December 4, 2018: Journal of Cardiothoracic and Vascular Anesthesia
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