Perioperative ischemic stroke in children undergoing cardiac surgery for congenital heart diseases (CHD) with cardiopulmonary bypass(CPB)

Background This study evaluated thiamine levels in Indonesian children with congenital heart diseases before and after cardiopulmonary bypass and their relationship with clinical and surgical outcomes. Method A prospective, single center cross-sectional study was conducted to evaluate thiamine levels in 25 children undergoing congenital heart diseases surgery with cardiopulmonary bypass procedure. Thiamine levels were quantified using a high-performance liquid chromatography method. Result Preoperative thiamine deficiency was observed in one subject. Thiamine levels did not differ statistically between nutritional status and clinical outcomes categories. There were no significant changes in thiamine levels before and after cardiopulmonary bypass (median pre versus post (P25–75): 50 ng/mL (59.00–116.00) and 83.00 ng/mL (70.00–101.00), p = 0.84), although a significant reduction in thiamine levels were observed with longer cardiopulmonary bypass duration ( p = 0.017, R = −0.472). Conclusion Thiamine levels were not significantly impacted by cardiac surgery except in patients undergoing extremely long cardiopulmonary bypass duration. However, clinical outcome was not affected by thiamine levels.

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Variation in clinical usefulness of biomarkers of acute kidney injury in young children undergoing cardiac surgery

Clinical and Experimental Pediatrics ◽

10.3345/cep.2019.00913 ◽

2020 ◽

Vol 63 (4) ◽

pp. 151-156

Author(s):

Hee Sun Baek ◽

Youngok Lee ◽

Hea Min Jang ◽

Joonyong Cho ◽

Myung Chul Hyun ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Young Children ◽

Serum Creatinine ◽

Congenital Heart ◽

Heart Diseases ◽

Kidney Injury ◽

Clinical Usefulness ◽

Congenital Heart Diseases ◽

Significant Difference

Background: Acute kidney injury (AKI) is one of the most significant postoperative complications of pediatric cardiac surgery. Because serum creatinine has limitations as a diagnostic marker of AKI, new biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are being evaluated to overcome these limitations and detect AKI at an early stage after cardiac surgery.Purpose: This study aimed to investigate the clinical usefulness of these biomarkers in young children.Methods: Thirty patients with congenital heart diseases who underwent cardiac surgery using cardiopulmonary bypass (CPB) were selected, and their urine and blood samples were collected at baseline and 6, 24, and 48 hours after surgery. Serum creatinine and blood urea nitrogen levels as well as NGAL, KIM-1, and IL-18 levels in urine samples were measured, and clinical parameters were evaluated.Results: Of the 30 patients, 12 developed AKI within 48 hours after cardiac surgery. In the AKI group, 8 of 12 (66.6%) met AKI criteria after 24 hours, and urine KIM-1/creatinine (Cr) level (with adjustment of urine creatinine) peaked at 24 hours with significant difference from baseline level. Additionally, urine KIM-1/Cr level in the AKI group was significantly higher than in the non-AKI group at 6 hours. However, urine NGAL/Cr and IL-18/Cr levels showed no specific trend with time for 48 hours after cardiac surgery.Conclusion: It is suggested that urine KIM-1/Cr concentration could be considered a good biomarker for early AKI prediction after open cardiac surgery using CPB in young children with congenital heart diseases.

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Peculiarities of hemostasis in infants with congenital heart diseases in the first 12 hours of their life

Pediatric Hematology/Oncology and Immunopathology ◽

10.24287/1726-1708-2019-18-3-29-34 ◽

2019 ◽

Vol 18 (3) ◽

pp. 29-34

Author(s):

O. V. Shumakova ◽

N. Ya. Morozova ◽

A. A. Burov ◽

Yu. L. Podurovskaya ◽

E. L. Bockeriya ◽

...

Keyword(s):

Cardiac Surgery ◽

Platelet Count ◽

Drug Therapy ◽

Congenital Heart ◽

Clinical Case ◽

Heart Diseases ◽

Ethics Committee ◽

Research Centre ◽

Congenital Heart Diseases ◽

Thrombotic Complications

The article is focused on the main parameters hemostasis and platelet count of newborns with congenital heart diseases who could require an early cardiac surgery during the first 12 hours of their life. Some known disorders of hemostasis in children with congenital heart diseases are described. A clinical case of the thrombotic complications in the child after cardiac surgery are presented, the tactic of drug therapy is described. The study was approved by the Independent Ethics Committee of the V.I. Kulakov Obstetrics, Gynecology and Perinatology Research Centre.

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