scholarly journals Atrioventricular block after congenital heart surgery: Analysis from the Pediatric Cardiac Critical Care Consortium

2019 ◽  
Vol 157 (3) ◽  
pp. 1168-1177.e2 ◽  
Author(s):  
Amy J. Romer ◽  
Sarah Tabbutt ◽  
Susan P. Etheridge ◽  
Peter Fischbach ◽  
Nancy S. Ghanayem ◽  
...  
Keyword(s):  
Critical Care ◽  
Atrioventricular Block ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Cardiac Critical Care

scholarly journals Variation in extubation failure rates after neonatal congenital heart surgery across Pediatric Cardiac Critical Care Consortium hospitals

2017 ◽  
Vol 153 (6) ◽  
pp. 1519-1526 ◽  
Author(s):  
Brian D. Benneyworth ◽  
Christopher W. Mastropietro ◽  
Eric M. Graham ◽  
Darren Klugman ◽  
John M. Costello ◽  
...  
Keyword(s):  
Critical Care ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Extubation Failure ◽  
Congenital Heart Surgery ◽  
Failure Rates ◽  
Cardiac Critical Care

Abstract 16121: Wellness in Pediatric Cardiac Intensivists - How are We Doing?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
David K Werho ◽  
leslie rhodes ◽  
Robin Horak ◽  
Bradley S Marino ◽  
David S Cooper ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Critical Care ◽  
Heart Surgery ◽  
Well Being ◽  
Congenital Heart Surgery ◽  
Risk Category ◽  
Physician Wellness ◽  
Modifiable Factors ◽  
Cardiac Critical Care

Introduction: Poor physician wellness is associated with detrimental effects on patient outcomes. There are no data on physician wellness in pediatric cardiac critical care. We aimed to define the prevalence of and risk factors for impaired wellness using a targeted survey of the North American pediatric cardiac critical care workforce. Methods: We developed a survey to examine physician wellness and potential risk factors, incorporating the Expanded Physician Well Being Index. Unit directors at 120 congenital heart surgery centers were contacted to provide faculty emails. The survey was distributed to each faculty with targeted reminders from June - September 2019. Univariate and multivariable logistic regression analyses were performed comparing the at-risk respondents to those not at risk for poor wellness. Results: Of the 477 faculty, 294 completed the survey (62%). Faculty reported working a median of 83 hours on service weeks and 50 hours on non-service weeks. Based on Well-Being scores, 34% were in the “at risk” category; 56% reported feeling burned out in the past month and 46% reported feeling overwhelmed. However, 96% felt their work was meaningful. Faculty reported a high incidence of developing unhealthy habits including poor nutrition (50%), infrequent exercise (56%), and lack of self-care (46%). Factors associated with well-being risk are shown in Table 1. Poor interpersonal experiences, higher work hours, and being primarily trained in critical care with an additional cardiac year were associated with risk of poor wellness. Working >100 hours per service week had a significant increase in risk (odds ratio 2.3, 95% confidence interval 1.31-4.40). Availability of wellness services was associated with reduced risk. Conclusion: Burnout and risk of poor wellness are common in pediatric cardiac critical care faculty. Modifiable factors, including wellness service availability and reduced hours of clinical service may improve wellness in the workforce.

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.

Variables Prevalent Among Early Unplanned Readmissions in Infants Following Congenital Heart Surgery

2021 ◽  
Author(s):  
Anna E. Berry ◽  
Nancy S. Ghanayem ◽  
Danielle Guffey ◽  
Meghan Anderson ◽  
Jeffrey S. Heinle ◽  
...  
Keyword(s):  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery
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