Rapid advancement to more concentrated formula in infants after surgery for congenital heart disease reduces duration of hospital stay: A randomized clinical trial

2004 ◽  
Vol 145 (6) ◽  
pp. 761-766 ◽  
Author(s):  
Francy Pillo-Blocka ◽  
Ian Adatia ◽  
Waseem Sharieff ◽  
Brian W. McCrindle ◽  
Stanley Zlotkin
2021 ◽  
Vol 73 (12) ◽  
pp. 808-814
Author(s):  
Atipotsawee Tungsupreechameth ◽  
Klaita Srisingh

Objective: To determine the factors associated with severe ALRTI from RSV in children.Materials and Methods: A retrospective study of children aged 1-60 months were conducted from 2014 to 2018. Out of 269 patients diagnosed with RSV ALRTI, 100 children were enrolled in the study, 20 had severe RSV ALRTI, while 80 had non-severe RSV ALRTI as identified by the ReSVinet scale. A multivariable logistic model was conducted to select significant variables.Results: During the study period, 269 patients were diagnosed with RSV ALRTI. Mean age was 10.45 ± 3.53 months. Clinical manifestations of severe RSV ALRTI group had significant difference in abnormal general condition (P < 0.001), tachypnea (P < 0.001), SpO2 < 85% (P < 0.001), poor air entry in lungs (P < 0.001), and retraction (P < 0.001). The factors associated with severe RSV ALRTI group, were underlying congenital heart disease [aOR32.45; 95% CI 3.38-311.87, P = 0.003] and duration of hospital stay >5 days [aOR 19.56; 95% CI 1.81-212.05, P = 0.014].Conclusion: Factors associated with severe RSV ALRTI in children were underlying congenital heart disease andduration of hospital stay >5 days.


2016 ◽  
Vol 221 ◽  
pp. 1100-1106 ◽  
Author(s):  
Susanne Hwiid Klausen ◽  
Lars L. Andersen ◽  
Lars Søndergaard ◽  
Janus Christian Jakobsen ◽  
Vibeke Zoffmann ◽  
...  

1970 ◽  
Vol 21 (1) ◽  
pp. 58-62 ◽  
Author(s):  
L Shamima Sharmin ◽  
M Azizul Haque ◽  
M Iqbal Bari ◽  
M Ayub Ali

Objectives: To see the (a) type of congenital heart disease, (b) Clinical presentation of the cases, (c) association with extra-cardiac anomalies and disease, (d) complications of different CHD, (e) outcome of patients during hospital stay. Methodology: it was a prospective study conducted in the department of pediatrics of Rajshahi Medical College & Hospital over a period of one year.115 children from birth to 12 years of age who had congenital heart disease confirmed by echocardiography were included. All patients were treated conservatively and observed for immediate out come during the hospital stay. Result: major types of CHD were VSD (42.6%), TOF (18.3%), ASD (14.8%), PDA (7.8%). Male outnumbers female child. Common symptoms were breathlessness (60%), fatigue (54.8%), cough (43.5%), poor weight gain (41.7%), recurrent chest infection (34.8%), fever (28.7%), feeding problems (26.1%), palpitation (21.7%) and bluish discoloration of lips and fingertips (20%). Murmur with or without thrill and cardiomegaly was the most important cardiac finding. Frequently observed complications were heart failure, pulmonary hypertension and growth failure.   doi: 10.3329/taj.v21i1.3221 TAJ 2008; 21(1): 58-62


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Anna L Harbison ◽  
Jodie K Votava-Smith ◽  
Sylvia Del Castillo ◽  
S Ram Kumar ◽  
Vincent K Lee ◽  
...  

Objectives: Term congenital heart disease (CHD) neonates demonstrate pre-operative (op) abnormal brain metabolism (reduced N-acetylaspartate (NAA), elevated lactate) on long echo MR spectroscopy (MRS). We sought to delineate associations between serial brain metabolism and patient and perioperative clinical factors in term neonates with CHD using short echo MRS. We measured NAA and lactate as well as other metabolites important for brain connectivity such as neurotransmitters glutamate/glutamine and GABA. Methods: Subjects were prospectively enrolled to undergo pre and post-op 3T short echo single voxel MRS of parietal white matter with absolute quantitation of 15 metabolites using LCModel. Neurodevelopment (ND) was assessed via 18 month Battelle Developmental Inventory. Linear and logistic regression with false discovery rate correction was used for statistical analysis. Results: Eighty subjects were enrolled 2009-2015 and 21 term CHD infants underwent both pre and post-op MRS. Eight infants had at least one MRS and ND. NAA and glutamate were significantly decreased post-op compared to pre-op (p<0.0001), with no significant difference in other metabolites. Pre-op factors including lower Apgar score, birth weight, head circumference and PaO2 and higher arterial pH and serum lactate were associated with lower NAA (p<0.002). Single ventricle anatomy was associated with low NAA, high myo-inositol and low glutamine/glutamate compared to two ventricles (p<0.01). Longer cardipulmonary bypass time, but not deep hypothermic circulatory arrest, was associated with reduced NAA (p<0.001). Post-op, global alteration in multiple serial brain metabolites (NAA, lactate, glutamate/glutamine, GABA, myo-inostol) were associated with longer ICU and hospital stay (p<0.03). In those with ND testing, high GABA correlated with low cognitive domain score, while high glutamine correlated with low motor score (p<0.03). Conclusion: In term CHD neonates, serial brain metabolism by MRS demonstrates alterations beyond NAA, including neurotransmitters GABA and glutamate/glutamine. These abnormalities are associated with multiple clinical pre and post-op factors and also predict prolonged hospital stay and 18 month ND.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jing Xu ◽  
Guanghua Zhou ◽  
Yanpei Li ◽  
Na Li

Abstract Background To compare the outcomes of ultra-fast-track anesthesia (UFTA) and conventional anesthesia in cardiac surgery for children with congenital heart disease (CHD) and low birth weight. Methods One hundred and ninety-four CHD children, aged 6 months to 2 years, weighting 5 to 10 kg, were selected for this study. The 94 boys and 100 girls with the American Society of Anesthesiologists (ASA) physical status III and IV were randomly divided into two groups each consisting of 97 patients, and were subjected to ultra-fast-track and conventional anesthesia for cardiac surgery. For children in UFTA group, sevoflurane was stopped when cardiopulmonary bypass (CPB) started and cis-atracurium was stopped at the beginning of rewarming, and remifentanil (0.3 μg/kg/mim) was then infused. Propofol and remifentanil were discontinued at skin closure. 10 min after surgery, extubation was performed in operating room. For children in conventional anesthesia group, anesthesia was given routinely and they were directly sent to ICU with a tracheal tube. Extubation time, ICU stay and hospital stay after operation were recorded. Sedation-agitation scores (SAS) were assessed and adverse reactions as well as other anesthesia –related events were recorded. Results The extubation time, ICU stay and hospital stay were significantly shorter in UFTA group (P < 0.05) and SAS at extubation was lower in UFTA group than in conventional anesthesia group, but similar in other time points. For both groups, no airway obstruction and other serious complications occurred, and incidence of other anesthesia –related events were low. Conclusions UFTA shortens extubation time, ICU stay and hospital stay for children with CHD and does not increase SAS and incidence of adverse reactions.


2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Vural Polat ◽  
Sahin Iscan ◽  
Mustafa Etli ◽  
Helin El Kılıc ◽  
Özgür Gürsu ◽  
...  

Background. Red cell distribution width (RDW) is an important marker which reflects inflammatory activity in many chronic diseases. The objective of this study is to investigate the impact of RDW on morbidity and mortality before and after pediatric congenital heart surgery.Methods. 107 patients with congenital heart disease, cardiac case group, and 70 patients, control group, without heart disease were retrospectively analyzed. Pre-, and postoperative and at discharge RDW of the cardiac patients were determined. Lengths of hospital and intensive care unit (ICU) stay and exited patients were determined.Results. Mean lengths of ICU and hospital stay were3.3±2.7and7.3±2.9days. In control group, mean preoperative RDW was12.6±1.4, while in cardiac case group it was significantly higher (15.1±3.5). In cardiac case group, postoperative RDW were significantly higher than preoperative period, while RDW at discharge were significantly lower than postoperative estimates. A significant and a positive correlation was detected between lengths of ICU and hospital stay and RDW. RDW of the exited patients were significantly higher than the survivors.Conclusions. This study demonstrates that RDW can be used as an important indicator in the prediction of morbidity and mortality during pre-, and postoperative period of the pediatric congenital heart disease surgery.


2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Fatemeh Javaherforooshzadeh ◽  
Laleh Gharacheh

Background: Airway management in patients with hereditary heart disease is an important therapeutic intervention. Objectives: The purpose of this study was to compare direct laryngoscopy (DL) with video laryngoscopy (VL) in pediatric airways management for congenital heart surgery. Methods: This study was designed as a prospective randomized clinical trial. Two consecutive groups of 30 patients undergoing elective noncyanotic congenital heart surgery. The patients were divided into direct laryngoscopy versus video laryngoscopy for intubation of the trachea. The main outcomes were the number of success rate in the first attempt, and the secondary outcomes were the duration of successful intubation and complications, such as desaturation and bradycardia. Results: Intubation procedure time was measured as 51.13 ± 17.88 seconds for the group with direct laryngoscopy and 59.66 ± 45.91 seconds for group with VL that was significant (P = 0.006). In DL group, 22 patients were intubated on the first attempt, 8 patients on the second attempt, and 6 patients on the third attempt, compared to 24, 6, and 2 respectively, in VL group. The differences were significant only in the third attempt between groups (P = 0.033). The important difference established in heart rate (HR) and SpaO2 amounts between the two groups at any time (P < 0.05). Conclusions: VL can produce better visualization for intubation of trachea in congenital heart disease, but this is time-consuming. Indeed, training in the use of the VL should be increased to reduce the time required for performance. Moreover, further studies are recommended to approve these helpful findings.


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