Malnutrition on admission to the paediatric cardiac intensive care unit increases the risk of mortality and adverse outcomes following paediatric congenital heart surgery: A prospective cohort study

2021 ◽  
Author(s):  
Sibel Yilmaz Ferhatoglu ◽  
Okan Yurdakok ◽  
Nurgul Yurtseven
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Adverse Outcomes ◽  
Cardiac Intensive Care Unit ◽  
Risk Of Mortality ◽  
Cardiac Intensive Care

EFFECT OF CBT ON DEPRESSION AMONG PARENTS WITH CHILDREN UNDERGOING COMPLEX CONGENITAL HEART SURGERY & PROLONG ICU STAY

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Bhanu Pratap Singh ◽  
Abhimanyu Singh
Keyword(s):  
Intensive Care Unit ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Complex Congenital Heart Disease ◽  
State Trait Anxiety Inventory ◽  
Cardiac Intensive Care Unit ◽  
Biological Mothers ◽  
Cardiac Intensive Care ◽  
Stressor Scale

Background: Mothers whose children are born with complex congenital heart disease (CCHD) experience stress during their children’s hospitalization in a cardiac intensive care unit (CICU). Method: This descriptive correlational study included 30 biological mothers of childrens admitted to a PICU who had undergone cardiac surgery for CCHD. Maternal and children demographics and responses to the Parental Stressor Scale: children Hospitalization and the State-Trait Anxiety Inventory were collected. Results: The association between hospital stay and depression was found significant. Conclusions: Parents feel more stress when the child admission duration is more. Keywords: PICU., CCHD

Hyperoxia is associated with adverse outcomes in the cardiac intensive care unit: insights from the Medical Information Mart for Intensive Care (MIMI-III) database

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.Y Lui ◽  
L Garber ◽  
M Vincent ◽  
L Celi ◽  
J Masip ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Logistic Regression ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Adverse Outcomes ◽  
Rank Test ◽  
Positive Pressure ◽  
Cardiac Intensive Care Unit ◽  
Multivariable Logistic Regression ◽  
Cardiac Intensive Care

Abstract Background Hyperoxia produces reactive oxygen species, apoptosis, and vasoconstriction, and is associated with adverse outcomes in patients with heart failure and cardiac arrest. Our aim was to evaluate the association between hyperoxia and mortality in patients (pts) receiving positive pressure ventilation (PPV) in the cardiac intensive care unit (CICU). Methods Patients admitted to our medical center CICU who received any PPV (invasive or non-invasive) from 2001 through 2012 were included. Hyperoxia was defined as time-weighted mean of PaO2 >120mmHg and non-hyperoxia as PaO2 ≤120mmHg during CICU admission. Primary outcome was in-hospital mortality. Multivariable logistic regression was used to assess the association between hyperoxia and in-hospital mortality adjusted for age, female sex, Oxford Acute Severity of Illness Score, creatinine, lactate, pH, PaO2/FiO2 ratio, PCO2, PEEP, and estimated time spent on PEEP. Results Among 1493 patients, hyperoxia (median PaO2 147mmHg) during the CICU admission was observed in 702 (47.0%) pts. In-hospital mortality was 29.7% in the non-hyperoxia group and 33.9% in the hyperoxia group ((log rank test, p=0.0282, see figure). Using multivariable logistic regression, hyperoxia was independently associated with in-hospital mortality (OR 1.507, 95% CI 1.311–2.001, p=0.00508). Post-hoc analysis with PaO2 as a continuous variable was consistent with the primary analysis (OR 1.053 per 10mmHg increase in PaO2, 95% CI 1.024–1.082, p=0.0002). Conclusions In a large CICU cohort, hyperoxia was associated with increased mortality. Trials of titration of supplemental oxygen across the full spectrum of critically ill cardiac patients are warranted. Funding Acknowledgement Type of funding source: None

Cardiac Arrest in Infants After Congenital Heart Surgery

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
John F. Rhodes ◽  
Andrew D. Blaufox ◽  
Howard S. Seiden ◽  
Jeremy D. Asnes ◽  
Ronda P. Gross ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Pediatric Intensive Care ◽  
Congenital Heart Surgery ◽  
Inotropic Support

Background —The survival rate to discharge after a cardiac arrest in a patient in the pediatric intensive care unit is reported to be as low as 7%. The survival rates and markers for survival strictly regarding infants with cardiac arrest after congenital heart surgery are unknown. Methods and Results —Infants in our pediatric cardiac intensive care unit database were identified who had a postoperative cardiac arrest between January 1994 and June 1998. Parameters from the perioperative, prearrest, and resuscitation periods were analyzed for these patients. Comparisons were made between survivors and nonsurvivors. Of 575 infants who underwent congenital heart surgery, 34 (6%) sustained a documented cardiac arrest; of these, 14 (41%) survived to discharge. Perioperative parameters, ventricular physiology, and primary rhythm at the time of arrest did not influence outcome. Prearrest blood pressure was lower in nonsurvivors than in survivors ( P <0.001). A high level of inotropic support prearrest was associated with death ( P =0.06). Survivors had a shorter duration of resuscitation ( P <0.001) and higher minimal arterial pH ( P <0.02) and received a smaller total dose of medication during the resuscitation. Although survivors had an overall shorter duration of resuscitation, 5 of 22 patients (23%) survived to discharge despite resuscitation of >30 minutes. Conclusions —The outcome of cardiac arrest in infants after congenital heart surgery was better than that for pediatric intensive care unit populations as a whole. Univentricular physiology did not increase the risk of death after cardiac arrest. Infants with more hemodynamic compromise before the arrest as demonstrated with lower mean arterial blood pressure and higher inotropic support were less likely to survive. The use of predetermined resuscitation end points in this subpopulation may not be justified.

Prospective cohort study on noise levels in a pediatric cardiac intensive care unit

2018 ◽  
Vol 44 ◽  
pp. 318-322 ◽  
Author(s):  
Gonzalo Garcia Guerra ◽  
Ari R. Joffe ◽  
Cathy Sheppard ◽  
Jodie Pugh ◽  
Elham Khodayari Moez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Noise Levels ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Intensive Care

Comparison of Cisatracurium and Vecuronium by Infusion in Neonates and Small Infants after Congenital Heart Surgery

2004 ◽  
Vol 101 (5) ◽  
pp. 1122-1127 ◽  
Author(s):  
David L. Reich ◽  
Ingrid Hollinger ◽  
Donna J. Harrington ◽  
Howard S. Seiden ◽  
Sephali Chakravorti ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neuromuscular Blockade ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Spontaneous Recovery ◽  
Congenital Heart Surgery ◽  
Pharmacokinetic Analysis ◽  
Train Of Four ◽  
Neonates And Infants

Background Neonates and infants often require extended periods of mechanical ventilation facilitated by sedation and neuromuscular blockade. Methods Twenty-three patients aged younger than 2 yr were randomly assigned to receive either cisatracurium or vecuronium infusions postoperatively in a double-blinded fashion after undergoing congenital heart surgery. The infusion was titrated to maintain one twitch of a train-of-four. The times to full spontaneous recovery of train-of-four without fade, extubation, intensive care unit discharge, and hospital discharge were documented after drug discontinuation. Sparse sampling after termination of the infusion and a one-compartment model were used for pharmacokinetic analysis. The Mann-Whitney U test and Student t test were used to compare data between groups. Results There were no significant differences between groups with respect to demographic data or duration of postoperative neuromuscular blockade infusion. The median recovery time for train-of-four for cisatracurium (30 min) was less than that for vecuronium (180 min) (P &lt; 0.05). Three patients in the vecuronium group had prolonged train-of-four recovery: Two had long elimination half-lives for vecuronium, and one had a high concentration of 3-OH vecuronium. There were no differences in extubation times, intensive care unit stays, or hospital stays between groups. Conclusions Our results parallel data from adults demonstrating a markedly shorter recovery of neuromuscular transmission after cisatracurium compared with vecuronium. Decreased clearance of vecuronium and the accumulation of 3-OH vecuronium may contribute to prolonged spontaneous recovery times. Cisatracurium is associated with faster spontaneous recovery of neuromuscular function compared with vecuronium but not with any differences in intermediate outcome measures in neonates and infants.

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