Pre-Hospital Discharge Car Safety Seat Testing in Infants Following Congenital Heart Surgery

2007 ◽  
Vol 29 (2) ◽  
pp. 313-316 ◽  
Author(s):  
J. M. Simsic ◽  
K. Masterson ◽  
B. E. Kogon ◽  
P. M. Kirshbom ◽  
K. R. Kanter
Keyword(s):  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Car Safety ◽  
Safety Seat

Prehospital Discharge Car Safety Seat Testing of Infants After Congenital Heart Surgery

2007 ◽  
Vol 29 (1) ◽  
pp. 142-145 ◽  
Author(s):  
J. M. Simsic ◽  
K. Masterson ◽  
B. E. Kogon ◽  
P. M. Kirshbom ◽  
K. Kanter
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Car Safety ◽  
Safety Seat

Standardizing Discharge Furosemide Duration Following Congenital Heart Surgery

2021 ◽  
pp. 215013512110493
Author(s):  
Mira Trivedi ◽  
Carlos Eduardo Diaz-Castrillon ◽  
Evonne Morell
Keyword(s):  
Quality Improvement ◽  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Average Duration ◽  
Diuretic Therapy ◽  
Total Duration ◽  
Congenital Heart Surgery ◽  
Practice Change ◽  
Improvement Project

Background: Pediatric cardiothoracic surgery has evolved over the last several decades with shorter bypass times and less need for hypothermic arrest. Diuretics have been commonly used in the post-operative period with no guidelines on duration following cardiopulmonary bypass. As a result, we conducted a single-center quality improvement project to reduce overuse of diuretics in post-operative patients without causing an increase in complications. We devised an early diuretic wean protocol that was implemented upon patient discharge. Methods: All patients who underwent uncomplicated congenital heart surgery after November 2018 were considered for the protocol. We defined an early diuretic wean protocol with a total duration of ten days of single diuretic therapy following hospital discharge. Patients were evaluated in clinic two weeks following discharge, after completion of diuretic therapy, to assess for clinical symptoms and development of effusions. Results: Retrospective pre-protocol data found the average duration a patient was on diuretics was 32 days following hospital discharge from uncomplicated congenital heart surgery. Following implementation of the protocol, there was a decrease in the total duration to 14 days, demonstrating a 56% decrease. With this practice change, there was no notable increase in adverse events. Conclusions: With implementation of the protocol, practice variability was minimized and the average post-operative diuretic duration was decreased without an increase in pleural and/or pericardial effusions or readmissiosn rates. Future directions and ongoing changes include expanding to a multicenter quality improvement collaborative focusing on decreasing the average duration of furosemide to less than five days after hospital discharge.

scholarly journals Pediatric Cardiac Surgical Patterns of Practice and Outcomes in Japan and Europe

2021 ◽  
Vol 12 (3) ◽  
pp. 312-319
Author(s):  
Jürgen Hörer ◽  
Yasutaka Hirata ◽  
Hisateru Tachimori ◽  
Masamichi Ono ◽  
Vladimiro Vida ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Septal Defect ◽  
Congenital Heart Surgery ◽  
Atrioventricular Septal Defect ◽  
Postoperative Length ◽  
Surgery Mortality ◽  
Patterns Of Practice

Objectives: The Japan Cardiovascular Surgery Database–Congenital section (JCVSD-Congenital) and the European Congenital Heart Surgeons Association (ECHSA) Congenital Heart Surgery Database (CHSD) share the same nomenclature. We aimed at comparing congenital cardiac surgical patterns of practice and outcomes in Japan and Europe using the JCVSD-Congenital and ECHSA-CHSD. Methods and Results: We examined Japanese (120 units, 63,365 operations) and European (96 units, 90,098 operations) data in JCVSD-Congenital and ECHSA-CHSD from 2011 to 2017. Patients’ age and weight, periprocedural times, mortality at hospital discharge, and postoperative length of stay were calculated for ten benchmark operations. There was a significantly higher proportion of ventricular septal defect closures and Glenn operations and a significantly lower proportion of coarctation repairs, tetralogy of Fallot repairs, atrioventricular septal defect repairs, arterial switch operations, truncus repairs, Norwood operations, and Fontan operations in JCVSD-Congenital compared to ECHSA-CHSD. Postoperative length of stay was significantly longer following all benchmark operations in JCVSD-Congenital compared to ECHSA-CHSD. Mean STAT mortality score (Society of Thoracic Surgeons European Association for Cardio-Thoracic Surgery mortality score) was significantly higher in JCVSD-Congenital (0.78) compared to ECHSA-CHSD (0.71). Mortality at hospital discharge was significantly lower in JCVSD-Congenital (4.2%) compared to ECHSA-CHSD (6.0%, P < .001). Conclusions: The distribution of the benchmark procedures and age at the time of surgery differ between Japan and Europe. Postoperative length of stay is longer, and the mean complexity is higher in Japan compared to European data. These comparisons of patterns of practice and outcomes demonstrate opportunities for continuing bidirectional transcontinental collaboration and quality improvement.

scholarly journals The effect of pre-hospital discharge care program on mothers’ knowledge and reported practice for children with congenital heart surgery

2018 ◽  
Vol 8 (9) ◽  
pp. 122
Author(s):  
Fatma Ahmed Elsobky ◽  
Samah Abdalha Mohamed Amer ◽  
Ahlam Elahmady Mohamed Sarhan
Keyword(s):  
Hospital Discharge ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Heart Diseases ◽  
Heart Defects ◽  
Care Program ◽  
Congenital Heart Surgery ◽  
Care Practice ◽  
Discharge Care ◽  
Significant Difference

Heart surgery in children is done to repair heart defects for a child born with congenital heart defects and heart diseases. The aim of the study was to evaluate the effect of pre-hospital discharge care program on mothers’ knowledge and reported practice regarding discharge care of children with congenital heart surgery. The study was conducted in the Heart Surgery Department at Abo-EL Riesh University Children Hospital. The sample included 30 mothers and their children that were available during the period of data collection. Three tools were used to collect data including: Tool I: Interviewing questioner sheet of the participants categorized into two parts. Part I and part II: Personal characteristics of the children and their mothers. Tool II: Assessment of mothers’ knowledge regarding care of children after congenital heart surgery. Tool III: Mother’s reported care practice checklist. Results: The results of the present study revealed that there was a highly significant difference in all items of care knowledge (activity, food, medication and follow-up) before, after immediately and after one month from discharge program with highly significant statistically (p < .001). Discharge program improve mothers’ knowledge and practice regarding care of their children after congenital heart surgery. Recommendations: Comprehensive, multidisciplinary discharge planning should deign early and should include the mothers and children contain education regarding congenital heart surgery care.

Care Models and Associated Outcomes in Congenital Heart Surgery

PEDIATRICS ◽  
2011 ◽  
Vol 127 (6) ◽  
pp. peds.2010-2796d-peds.2010-2796d
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Care Models

scholarly journals LONG-TERM TRANSPLANT-FREE SURVIVAL AFTER CONGENITAL HEART SURGERY

2021 ◽  
Vol 77 (18) ◽  
pp. 481
Author(s):  
Lazaros Kochilas ◽  
Amanda Thomas ◽  
Chao Zhang ◽  
J’Neka Claxton ◽  
Courtney McCracken ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Free Survival

Early Extubation in a Pediatric Cardiac Surgery Program Located at High Altitude

2021 ◽  
Vol 12 (4) ◽  
pp. 473-479
Author(s):  
Orlando José Tamariz-Cruz ◽  
Luis Antonio García-Benítez ◽  
Hector Díliz-Nava ◽  
Felipa Acosta-Garduño ◽  
Marcela Barrera-Fuentes ◽  
...  
Keyword(s):  
Down Syndrome ◽  
Operating Room ◽  
Sea Level ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Anesthetic Management ◽  
Fontan Procedure ◽  
Congenital Heart Surgery ◽  
Serum Lactate ◽  
Early Extubation

Background: Early extubation is performed either in the operating room or in the cardiovascular intensive care unit during the first 24 postoperative hours; however, altitude might possibly affect the process. The aim of this study is the evaluation of early extubation feasibility of patients undergoing congenital heart surgery in a center located at 2,691 m (8,828 ft.) above sea level. Material and Methods: Patients undergoing congenital heart surgery, from August 2012 through December 2018, were considered for early extubation. The following variables were recorded: weight, serum lactate, presence or not of Down syndrome, optimal oxygenation and acid–base status according to individual physiological condition (biventricular or univentricular), age, bypass time, and ventricular function. Standardized anesthetic management with dexmedetomidine–fentanyl–rocuronium and sevoflurane was used. If extubation in the operating room was considered, 0.08 mL/kg of 0.5% ropivacaine was injected into the parasternal intercostal spaces bilaterally before closing the sternum. Results: Four hundred seventy-eight patients were operated and 81% were early extubated. Mean pre- and postoperative SaO2 was 92% and 98%; postoperative SaO2 for Glenn and Fontan procedures patients was 82% and 91%, respectively. Seventy-three percent of patients who underwent Glenn procedure, 89% of those who underwent Fontan procedure (all nonfenestrated), and 85% with Down syndrome were extubated in the operating room. Reintubation rate in early extubated patients was 3.6%. Conclusion: Early extubation is feasible, with low reintubation rates, at 2,691 m (8,828 ft.) above sea level, even in patients with single ventricle physiology.

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