Lipo-PGE1 treatment of the neonate with critical congenital heart disease and ductus-arteriosus dependent circulation

1996 ◽  
Vol 20 (2-3) ◽  
pp. 177-180 ◽  
Author(s):  
Kazuo Momma
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Critical Congenital Heart Disease

A retrospective analysis of a pediatric tele-echocardiography service to treat, triage, and reduce trans-Pacific transport

2017 ◽  
Vol 24 (3) ◽  
pp. 224-229 ◽  
Author(s):  
Christopher A Rouse ◽  
Brandon T Woods ◽  
C Becket Mahnke
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
The United States ◽  
Critical Congenital Heart Disease ◽  
Medical Centers ◽  
Prompt Diagnosis ◽  
Patent Ductus

Introduction Tele-echocardiography can ensure prompt diagnosis and prevent the unnecessary transport of infants without critical congenital heart disease, particularly at isolated locations lacking access to tertiary care medical centers. Methods We retrospectively reviewed all infants who underwent tele-echocardiography at a remote 16-bed level IIIB NICU from June 2005 to March 2014. Tele-echocardiograms were completed by cardiac sonographers in Okinawa, Japan, and transmitted asynchronously for review by pediatric cardiologists in Hawaii. Results During the study period 100 infants received 192 tele-echocardiograms: 46% of infants had tele-echocardiograms completed for suspected patent ductus arteriosus, 28% for suspected congenital heart disease, 12% for possible congenital heart disease in the setting of likely pulmonary hypertension, and 10% for possible congenital heart disease in the setting of other congenital anomalies. Of these, 17 patients were aeromedically evacuated for cardiac reasons; 12 patients were transported to Hawaii, while five patients with complex heart disease were transported directly to the United States mainland for interventional cardiac capabilities not available in Hawaii. Discussion This study demonstrates the use of tele-echocardiography to guide treatment, reduce long and potentially risky trans-Pacific transports, and triage transports to destination centers with the most appropriate cardiac capabilities.

Critical congenital heart disease screening with a pulse oximetry in neonates

2018 ◽  
Vol 46 (2) ◽  
pp. 203-207 ◽  
Author(s):  
Şahin Hamilçıkan ◽  
Emrah Can
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
Newborn Infants ◽  
Added Value ◽  
Critical Congenital Heart Disease ◽  
Pulse Oximetry Screening

AbstractObjective:To compare the results of pulse oximetry screening for critical congenital heart disease (CCHD) in newborn infants performed at <24 h and >24 h following.Method:Measurements were taken for each group at <24 h and >24 h following birth. Echocardiography was performed if the SpO2 readings remained abnormal results.Results:A total of 4518 newborns were included in this prospective descriptive study. Of these, 2484 (60.3%) were delivered vaginally and 1685 (39.7%) by cesarean section. Median time points of the screening were 25.4 (25.3–25.5) vs. 17.3 (12.2–22.4) hours after birth. In 4109 infants screened 24 h after birth, the mean pre- and postductal oxygen saturations (SpO2) were 96.5±1.99 and 97.7±1.98, while 127 infants screened within 24 h of mean preductal and postductal SpO2 were 91.33±2.64 and 94.0±4.44. No CCHD was detected during the study period. Pulse oximetry screening was false positive for CCHD in 9 of 4109 infants (0.02%); of these, six infants were referred to pediatric cardiology and three cases were diagnosed as other significant, non-cardiac pathology. There were two cases with AVSD (atrioventricular septal defect, three cases with ventricular septal defect (VSD), and one case with patent ductus arteriosus (PDA).Conclusions:Saturation values are different between <24-h and >24-h neonates in pulse oximetry screening. The screening in this study identified infants with other important pathologies, this forms an added value as an assessment tool for newborn infants.

scholarly journals Congenital Heart Disease Requiring Maintenance of Ductus Arteriosus in Critically Ill Newborns Admitted at A Tertiary Neonatal Intensive Care Unit

2016 ◽  
Vol 2 (4) ◽  
pp. 185-191 ◽  
Author(s):  
Manuela Cucerea ◽  
Marta Simon ◽  
Elena Moldovan ◽  
Marcela Ungureanu ◽  
Raluca Marian ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Pulmonary Circulation ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Ductus Arteriosus ◽  
Prostaglandin E ◽  
Critical Congenital Heart Disease ◽  
The Mean

AbstractIntroduction: Congenital heart diseases (CHD) have been reported to be responsible for 30 to 50% of infant mortality caused by congenital disabilities. In critical cases, survival of newborns with CHD depends on the patency of the ductus arteriosus (PDA), for maintaining the systemic or pulmonary circulation. The aim of the study was to assess the efficacy and side effects of PGE (prostaglandin E) administration in newborns with critical congenital heart disease requiring maintenance of the ductus arteriosus.Material and method: All clinical and paraclinical data of 66 infants admitted to one referral tertiary level academic center and treated with Alprostadil were analyzed. Patients were divided into three groups: Group 1: PDA dependent pulmonary circulation (n=11) Group 2: PDA dependent systemic circulation (n=31) Group 3: PDA depending mixed circulation (n=24)Results: The mean age of starting PGE1 treatment was 2.06 days, 1.91 (+/−1.44) days for PDA depending pulmonary flow, 2.39 (+/−1.62) days for PDA depending systemic flow and 1.71 (+/1.12) for PDA depending mixing circulation. PEG1 initiation was commenced 48 hours after admission for 72%, between 48-72 hours for 6%, and after 72 to 120 hours for 21% of newborns detected with PDA dependent circulation. Before PEG1 initiation the mean initial SpO2 was 77.89 (+/− 9.2)% and mean initial oxygen pressure (PaO2) was 26.96(+/−6.45) mmHg. At the point when stable wide open PDA was achieved their mean SpO2increased to 89.73 (+/−8.4)%, and PaO2 rose to 49 (+/−7.2) mmHg. During PGE1 treatment, eleven infants (16.7%) had apnea attacks, five children (7.5%) had convulsions, 33 (50%) had fever, 47 (71.2%) had leukocytosis, 52 (78.8%) had edema, 25.8% had gastrointestinal intolerance, 45.5% had hypokalemia, and 63.6% had irritability.Conclusions: For those infants with severe cyanosis or shock caused by PDA dependent heart lesions, the initiation and maintenance of PGE1 infusion is imperative. The side effects of this beneficial therapy were transient and treatable.

scholarly journals Critical Congenital Heart Disease in Newborn: Early Detection, Diagnosis, and Management

2020 ◽  
Vol 5 (1) ◽  
pp. 107-116
Author(s):  
Herick Alvenus Willim ◽  
Cristianto ◽  
Alice Inda Supit
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Early Detection ◽  
Congenital Heart ◽  
Care Center ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Critical Congenital Heart Disease ◽  
Diagnosis And Management ◽  
Discharge From Hospital

Critical congenital heart disease (CHD) is a type of CHD that requires early intervention in the first year of life to survive. Morbidity and mortality increases significantly if newborns with critical CHD experience delay in the initial diagnosis and management. The infants may develop cyanosis, systemic hypoperfusion, or respiratory distress as the main manifestations of critical CHD. Pulse oximetry screening for early detection of critical CHD must be performed in newborns after 24 hours of age or before discharge from hospital. Generally, infants with critical CHD require patency of the ductus arteriosus with infusion of prostaglandin to maintain pulmonary or systemic blood flow. After initial management, the infants must be immediately referred to tertiary care center for definitive intervention. Keywords: congenital heart disease, duct-dependent circulation, ductus arteriosus, prostaglandin

scholarly journals Pulse Oximetry Screening Has Not Changed Timing of Diagnosis or Mortality of Critical Congenital Heart Disease

2020 ◽  
Vol 41 (5) ◽  
pp. 899-904 ◽  
Author(s):  
Matthew J. Campbell ◽  
William O. Quarshie ◽  
Jennifer Faerber ◽  
David J. Goldberg ◽  
Christopher E. Mascio ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Pulse Oximetry ◽  
Congenital Heart ◽  
Critical Congenital Heart Disease ◽  
Pulse Oximetry Screening

Oxygen Saturation and Perfusion Index-Based Enhanced Critical Congenital Heart Disease Screening

2019 ◽  
Vol 37 (02) ◽  
pp. 158-165 ◽  
Author(s):  
Heather Siefkes ◽  
Laura Kair ◽  
Daniel J. Tancredi ◽  
Brian Vasquez ◽  
Lorena Garcia ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Oxygen Saturation ◽  
Congenital Heart ◽  
Perfusion Index ◽  
Outflow Obstruction ◽  
Critical Congenital Heart Disease ◽  
Healthy Infants ◽  
Optimal Screening ◽  
To Come

Objective To determine if addition of perfusion index (PIx) to oxygen saturation (SpO2) screening improves detection of critical congenital heart disease (CCHD) with systemic outflow obstruction. Study Design We determined screening thresholds for PIx and applied these to a cohort of newborns with and without congenital heart disease (CHD). Results A total of 123 normal and 21 CHD newborns (including five with critical systemic outflow obstruction) were enrolled. Four of these five critical systemic obstruction subjects passed SpO2-based screen. Four out of these five subjects failed PIx-based screen. The sensitivity for detection of systemic obstruction CCHD when compared with healthy infants increased from 20% (95% confidence interval [CI]: 1–72%) with SpO2 screening alone to 80% (95% CI: 28–100%) with combined SpO2-PIx screen. However, 2.44% of normal infants failed PIx screen. Conclusion Addition of PIx to SpO2 screening may detect additional cases of CCHD and further research is necessary to come up with optimal screening thresholds.

scholarly journals Brain Injury in Infants with Critical Congenital Heart Disease: Insights from Two Clinical Cohorts with Different Practice Approaches

2019 ◽  
Vol 215 ◽  
pp. 75-82.e2 ◽  
Author(s):  
Nathalie H.P. Claessens ◽  
Vann Chau ◽  
Linda S. de Vries ◽  
Nicolaas J.G. Jansen ◽  
Stephanie H. Au-Young ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Brain Injury ◽  
Congenital Heart ◽  
Critical Congenital Heart Disease

scholarly journals Perfusion index in healthy newborns during critical congenital heart disease screening at 24 hours: retrospective observational study from the USA

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017580 ◽  
Author(s):  
Priya Jegatheesan ◽  
Matthew Nudelman ◽  
Keshav Goel ◽  
Dongli Song ◽  
Balaji Govindaswami
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Observational Study ◽  
Oxygen Saturation ◽  
Congenital Heart ◽  
Selection Method ◽  
Perfusion Index ◽  
Data Selection ◽  
Retrospective Observational Study ◽  
Critical Congenital Heart Disease

ObjectiveTo describe the distribution of perfusion index (PI) in asymptomatic newborns at 24 hours of life when screening for critical congenital heart disease (CCHD) using an automated data selection method.DesignThis is a retrospective observational study.SettingNewborn nursery in a California public hospital with ~3500 deliveries annually.MethodsWe developed an automated programme to select the PI values from CCHD screens. Included were term and late preterm infants who were screened for CCHD from November 2013 to January 2014 and from May 2015 to July 2015. PI measurements were downloaded every 2 s from the pulse oximeter and median PI were calculated for each oxygen saturation screen in our cohort.ResultsWe included data from 2768 oxygen saturation screens. Each screen had a median of 29 data points (IQR 17 to 49). The median PI in our study cohort was 1.8 (95% CI 1.8 to 1.9) with IQR 1.2 to 2.7. The median preductal PI was significantly higher than the median postductal (1.9 vs 1.8, p=0.03) although this difference may not be clinically significant.ConclusionUsing an automated data selection method, the median PI in asymptomatic newborns at 24 hours of life is 1.8 with a narrow IQR of 1.2 to 2.7. This automated data selection method may improve accuracy and precision compared with manual data collection method. Further studies are needed to establish external validity of this automated data selection method and its clinical application for CCHD screening.

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