Pulse oximetry home monitoring in infants with single-ventricle physiology and a surgical shunt as the only source of pulmonary blood flow

AbstractBackgroundShunt occlusion is a major cause of death in children with single ventricle. We evaluated whether one daily measurement of oxygen saturation at home could detect life-threatening shunt dysfunction.MethodsA total of 28 infants were included. Parents were instructed to measure saturation once daily and if less than or equal to 70% repeat the measurement. Home monitoring was defined as positive when a patient was admitted to Queen Silvia Children's Hospital because of saturation less than or equal to 70% on repeated measurement at home. A shunt complication was defined as arterial desaturation and a narrowing of the shunt that resulted in an intervention to relieve the obstruction or in death. Parents’ attitude towards the method was investigated using a questionnaire.ResultsA shunt complication occurred out of hospital eight times in eight patients. Home monitoring was positive in five out of eight patients. In two patients, home monitoring was probably life saving; in one of them, the shunt was replaced the same day and the other had an emergency balloon dilatation of the shunt. In three out of eight patients, home monitoring was negative; one had an earlier stage II and survived, but two died suddenly at home from thrombotic shunt occlusion. On seven occasions in three patients home monitoring was positive but there was no shunt complication. The method was well accepted by the parents according to the results of the questionnaire.ConclusionHome monitoring of oxygen saturation has the potential to detect some of the life-threatening shunt obstructions between stages I and II in infants with single-ventricle physiology.

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THE IMPACT OF A DESIGNATED CARDIOLOGY TEAM INVOLVING HOME MONITORING ON THE CARE OF CHILDREN WITH SINGLE-VENTRICLE PHYSIOLOGY AFTER NORWOOD PALLIATION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(16)30941-x ◽

2016 ◽

Vol 67 (13) ◽

pp. 940

Author(s):

Ashraf Harahsheh ◽

Lisa Hom ◽

Sarah Clauss ◽

Amy Curtis ◽

Russell Cross ◽

...

Keyword(s):

Single Ventricle ◽

Home Monitoring ◽

Single Ventricle Physiology ◽

The Impact

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Urgent bronchoscopy for foreign body aspiration: 48 children among 1096 patients

Acta Medica ◽

10.32552/2019.actamedica.359 ◽

2019 ◽

Vol 50 (3) ◽

pp. 38-43

Author(s):

Alper Avcı ◽

Onder Ozden ◽

Zehra Hatipoglu ◽

Serdar Onat

Keyword(s):

Foreign Body ◽

Postoperative Complications ◽

Oxygen Saturation ◽

English Literature ◽

Length Of Hospital Stay ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Peripheral Oxygen Saturation ◽

Life Saving ◽

Life Threatening

Objective: Foreign body aspiration (FBA) is a potentially life-threatening emergency in children. Urgent rigid bronchoscopy (URB) should be performed when presentation includes severe respiratory failure with suspicion for FBA. To the best of the knowledge, this is the first study that evaluates URB in English literature. Methods: Forty-eight patients who underwent URB were included in this study. From the medical records, the patients’ demographic characters, endotracheal intubation status, peripheral oxygen saturation, bronchoscopy results, type and location of foreign body (FB), intra- and postoperative complications and mortality, X-ray, length of hospital stay were evaluated. Results: Twenty-four of the 48 patients were non-intubated. Peripheral oxygen saturation values were 60 ± 14.40 in the preoperative period. No statistical differences were found between intubated and non-intubated patients in terms of intra- and postoperative complications. There were no statistical differences between patients with negative and positive results for bronchoscopy in terms of intra- and postoperative complications. Conclusions: Bronchoscopy is not without risk; however, it is a life-saving procedure. Despite negative FB results, urgent bronchoscopy should be performed in suspicious cases.

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To be a surgeon may be life saving

Trauma ◽

10.1177/1460408620933202 ◽

2020 ◽

Vol 22 (4) ◽

pp. 320-323

Author(s):

Erhan Aysan

Keyword(s):

Hemodynamic Instability ◽

Rib Fractures ◽

General Surgeon ◽

Late Development ◽

Multiple Rib Fractures ◽

Motorcycle Accident ◽

Life Saving ◽

Massive Hemothorax ◽

Life Threatening ◽

At Home

In the first 24 h after multiple rib fractures, a life-threatening massive hemothorax is very rare but can cause death at home in cases who have been discharged. A 50-year-old male general surgeon, was admitted to the emergency unit after a motorcycle accident. Multiple rib fractures were diagnosed but no hemopneumothorax or hemodynamic instability were observed. After 24 h of observation, he was discharged. On the fifth day at home he was woken by symptoms of acute massive hemothorax. With the assistance of his wife he commenced intravenous fluid resuscitation to treat his own hemodynamic instability and transferred himself to his own hospital via ambulance where he subsequently underwent thoracotomy for arrest of haemorrhage. Late development of a massive hemopneumothorax after multiple rib fractures is rare, but may be a life-threatening risk. Such patients should be more closely followed up and informed about symptoms and treatment.

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Near-infrared spectroscopy to monitor cerebral oxygen saturation in single-ventricle physiology

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2005.07.039 ◽

2006 ◽

Vol 131 (2) ◽

pp. 395-402 ◽

Cited By ~ 12

Author(s):

Marco Ricci ◽

Pierluca Lombardi ◽

Steven Schultz ◽

Alvaro Galindo ◽

Ernesto Coscarella ◽

...

Keyword(s):

Infrared Spectroscopy ◽

Oxygen Saturation ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Single Ventricle ◽

Cerebral Oxygen Saturation ◽

Cerebral Oxygen ◽

Single Ventricle Physiology

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Percutaneous upsizing of a Blalock–Taussig shunt

Cardiology in the Young ◽

10.1017/s1047951111001247 ◽

2011 ◽

Vol 22 (2) ◽

pp. 219-222 ◽

Cited By ~ 1

Author(s):

Aphrodite Tzifa ◽

Eric Rosenthal ◽

Shakeel Qureshi

Keyword(s):

Oxygen Saturation ◽

Single Ventricle ◽

Single Ventricle Physiology ◽

Blalock Taussig Shunt

AbstractPercutaneous upsizing of surgically placed Blalock–Taussig shunts is an uncommon practice. We report the case of an 8-month-old infant with single-ventricle physiology, who – due to comorbidities – was deemed unsuitable to proceed with Glenn operation. The 3.5-millimetre Blalock–Taussig shunt was stented successfully with a 5-millimetre pre-mounted stent, resulting in an increase in shunt diameter and oxygen saturation by nearly 30% and 10%, respectively.

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Efficacy of Telemedicine and Telemonitoring in At-Home Monitoring of Patients with COVID-19

Journal of Clinical Medicine ◽

10.3390/jcm10132893 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2893

Author(s):

Emilio Casariego-Vales ◽

Rosa Blanco-López ◽

Benigno Rosón-Calvo ◽

Roi Suárez-Gil ◽

Fernando Santos-Guerra ◽

...

Keyword(s):

Mortality Rate ◽

Home Monitoring ◽

Lower Mortality ◽

Reduced Pressure ◽

Home Life ◽

Life Threatening ◽

Northwestern Spain ◽

Hospital Stays ◽

Proactive Monitoring ◽

At Home

Aim: this work aims to assess if telemedicine and telemonitoring are clinically useful and safe for at-home monitoring of Coronavirus disease 2019 (COVID-19) patients. Methods: This is a retrospective cohort study of all patients diagnosed with COVID-19 in Galicia (Northwestern Spain) between 26 December 2020 and 15 February 2021. The structured, proactive monitoring via telemonitoring (TELEA) of patients considered to be high-risk in the Lugo, A Mariña, and Monforte Healthcare Area (ASLAM) was evaluated compared to other models in the remaining healthcare areas of Galicia. Results: Of the 47,053 COVID-19 patients, 4384 (9.3%) were in ASLAM. Of them, 1187 (27.1%) were monitored via TELEA, and the rest (3197 in ASLAM and 42,669 in the rest of Galicia) were monitored via other methods. Patients monitored in ASLAM via TELEA were older, consulted in the emergency department less frequently (p = 0.05), were hospitalized less frequently (p < 0.01), had shorter hospital stays (p < 0.0001), and had a lower mortality rate in their first hospitalization (p = 0.03). No at-home life-threatening emergencies were recorded. Conclusions: these data suggest that, for COVID-19 patients, a care model involving proactive at-home monitoring with telemedicine and telemonitoring is associated with reduced pressure on hospital services and a lower mortality rate.

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