The evolution of cardiac care for children in Washington, DC

2021 ◽  
Vol 31 (8) ◽  
pp. 1220-1227
Author(s):  
Richard A. Jonas ◽  
Gerard R. Martin
Keyword(s):  
Cardiac Surgery ◽  
Circulatory Arrest ◽  
Washington Dc ◽  
Full Time ◽  
Surface Cooling ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The 1960S ◽  
Hospital Staffing ◽  
Surgery Department

AbstractCardiac surgery for CHD was pioneered in Washington, DC by Charles Hufnagel and Edgar Davis working at Georgetown University and Children’s Hospital of the District of Columbia. Children’s Hospital, now Children’s National Hospital, had been established just 5 years after the end of the Civil War. In the 1950s, Davis and Hufnagel undertook many open-heart operations using the technique of surface cooling, hypothermia, and circulatory arrest. Hufnagel and Lewis Scott, who founded the cardiology department at Children’s, were trained in Boston by Gross and Nadas. Judson Randolph, also a trainee of Gross, introduced cardiac surgery using cardiopulmonary bypass and established the General Pediatric Surgery department at Children’s in the 1960s. The transition of hospital staffing from community-based private physicians to full-time hospital employees was often controversial but was complete by the turn of the millennium. The 21st century has seen continuing growth of the new Children’s National Heart Institute and consolidation of several congenital cardiac programmes in Washington, DC.

scholarly journals Introduction: Highlights of HeartWeek 2013 at the Sixth World Congress of Paediatric Cardiology and Cardiac Surgery in Cape Town South Africa

2013 ◽  
Vol 23 (6) ◽  
pp. 784-800 ◽  
Author(s):  
Jeffrey Phillip Jacobs
Keyword(s):  
South Africa ◽  
Cardiac Surgery ◽  
Nursing Education ◽  
Cape Town ◽  
World Congress ◽  
Collaborative Project ◽  
Saint Petersburg ◽  
Paediatric Cardiology ◽  
Children's Hospital ◽  
Children’S Hospital

AbstractThis December issue of Cardiology in the Young represents the 11th annual publication generated from the two meetings that compose “HeartWeek in Florida”. “HeartWeek in Florida”, the joint collaborative project sponsored by the Cardiac Center at the Children's Hospital of Philadelphia, Pennsylvania, together with Johns Hopkins All Children's Heart Institute of Saint Petersburg, Florida, averages over 1000 attendees every year and is now recognised as one of the major planks of continuing medical and nursing education for those working in the fields of diagnosis and treatment of cardiac disease in the foetus, neonate, infant, child, and adult. “HeartWeek in Florida” combines the International Symposium on Congenital Heart Disease, organised by All Children's Hospital and Johns Hopkins Medicine and entering its 14th year, with the Annual Postgraduate Course in Pediatric Cardiovascular Disease, organised by The Children's Hospital of Philadelphia and entering its 17th year.This December, 2013 issue of Cardiology in the Young highlights the sessions from HeartWeek 2013 that were held at The Sixth World Congress of Paediatric Cardiology and Cardiac Surgery in Cape Town, South Africa. We would like to acknowledge the tremendous contributions made to medicine by John Brown, and therefore we dedicate this HeartWeek 2013 issue of Cardiology in the Young to him.

Malignant Hyperthermia

2013 ◽  
Author(s):  
Philip Ragg
Keyword(s):  
Malignant Hyperthermia ◽  
Full Time ◽  
General Anesthetics ◽  
Malignant Hyperpyrexia ◽  
Children's Hospital ◽  
Children’S Hospital

Malignant hyperthermia, or malignant hyperpyrexia (MH), is a rare but frightening condition that occurs with an incidence of between 1:6,000 and 1:50,000 general anesthetics. To put this in context, a full-time anesthesiologist is likely to see one case in his or her working lifetime, and a major children's hospital may expect to see one case every 2 to 3 years. Its presentation is nonspecific and the course of MH can be insidious or rapidly progressive.

Delayed extracorporeal membrane oxygenation in children after cardiac surgery: two-institution experience

2013 ◽  
Vol 25 (2) ◽  
pp. 248-254 ◽  
Author(s):  
Punkaj Gupta ◽  
Rahul DasGupta ◽  
Derek Best ◽  
Craig B. Chu ◽  
Hassan Elsalloukh ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Extracorporeal Membrane Oxygenation ◽  
Bleeding Complications ◽  
Study Cohort ◽  
Children's Hospital ◽  
Membrane Oxygenation ◽  
Included Patient ◽  
Children’S Hospital ◽  
Surgical History ◽  
Radiographic Data

AbstractObjective: There are limited data on the outcomes of children receiving delayed (≥7 days) extracorporeal membrane oxygenation after cardiac surgery. The primary aim of this project is to identify the aetiology and outcomes of extracorporeal membrane oxygenation in children receiving delayed (≥7 days) extracorporeal membrane oxygenation after cardiac surgery. Patients and methods: We conducted a retrospective review of all children ≤18 years supported with delayed extracorporeal membrane oxygenation after cardiac surgery between the period January, 2001 and March, 2012 at the Arkansas Children’s Hospital, United States of America, and Royal Children’s Hospital, Australia. The data collected in our study included patient demographic information, diagnoses, extracorporeal membrane oxygenation indication, extracorporeal membrane oxygenation support details, medical and surgical history, laboratory, microbiological, and radiographic data, information on organ dysfunction, complications, and patient outcomes. The outcome variables evaluated in this report included: survival to hospital discharge and current survival with emphasis on neurological, renal, pulmonary, and other end-organ function. Results: During the study period, 423 patients undergoing cardiac surgery were supported with extracorporeal membrane oxygenation at two institutions, with a survival of 232 patients (55%). Of these, 371 patients received extracorporeal membrane oxygenation <7 days after cardiac surgery, with a survival of 205 (55%) patients, and 52 patients received extracorporeal membrane oxygenation ≥7 days after cardiac surgery, with a survival of 27 (52%) patients. The median duration of extracorporeal membrane oxygenation run for the study cohort was 5 days (interquartile range: 3, 10). In all, 14 patients (25%) received extracorporeal membrane oxygenation during active cardiopulmonary resuscitation with chest compressions. There were 24 patients (44%) who received dialysis while being on extracorporeal membrane oxygenation. There were eight patients (15%) who had positive blood cultures and four patients (7%) who had positive urine cultures while being on extracorporeal membrane oxygenation. There were nine patients (16%) who had bleeding complications associated with extracorporeal membrane oxygenation runs. There were 10 patients (18%) who had cerebrovascular thromboembolic events associated with extracorporeal membrane oxygenation runs. Of these, 19 patients are still alive with significant comorbidities. Conclusions: This study demonstrates that mortality outcomes are comparable among children receiving extracorporeal membrane oxygenation ≥7 days and <7 days after cardiac surgery. The proportion of patients receiving extracorporeal membrane oxygenation ≥7 days is small and the aetiology diverse.

Adults Undergoing Cardiac Surgery at a Children’s Hospital: An Analysis of Perioperative Morbidity

2007 ◽  
Vol 83 (2) ◽  
pp. 606-612 ◽  
Author(s):  
Joseph W. Rossano ◽  
E.O.’Brian Smith ◽  
Charles D. Fraser ◽  
E. Dean McKenzie ◽  
Anthony C. Chang ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Perioperative Morbidity ◽  
Children's Hospital ◽  
Children’S Hospital

scholarly journals 89 The Unintended Consequences and Impact of the COVID-19 Pandemic on Patients, Families and Clinicians in a Children’s Hospital

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e64-e65
Author(s):  
Catherine Diskin ◽  
Julia Orkin ◽  
Blossom Dharmaraj ◽  
Tanvi Agarwal ◽  
Arpita Parmar ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Case Series ◽  
Unintended Consequences ◽  
Pediatric Care ◽  
Full Time ◽  
Negative Consequences ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract Primary Subject area Hospital Paediatrics Background The coronavirus (COVID-19) pandemic has broad implications for children and families. Healthcare experience and delivery has changed significantly, and changes will likely continue for some time. Particular attention has been paid to delays in accessing timely pediatric care leading to unintended morbidity. Objectives This study aimed (1) to describe the broader spectrum of unintended negative consequences by describing the courses of care altered by the COVID-19 pandemic from the clinician's perspectives and (2) to identify thematic similarities to inform clinical practice change. Design/Methods All full-time doctors, dentists, and nurse practitioners working at a tertiary care children’s hospital in Canada were surveyed every two weeks throughout the initial phase of the COVID-19 pandemic. We asked them to identify and describe clinical cases in which they perceived a negative outcome associated with hospital or societal changes due to the COVID-19 pandemic. Analysis followed a qualitative case series methodology using a narrative synthesis approach to determine similarities and associated themes. Results Two-hundred and twelve clinicians reported 116 cases. Several broad themes emerged, including (1) timeliness of care, (2) disruption of child and family-centred care, (3) new pressures in the provision of safe and efficient care and (4) inequity in the experience of the COVID-19 pandemic. Within each of these themes, subthemes emerged, highlighting its impact on (1) patients, (2) their families and (3) healthcare providers. Table 1 provides examples of cases within each theme. Conclusion The broad consequences of the COVID-19 pandemic impact patients, families, healthcare providers and the healthcare system. Understanding this breadth is necessary as we strive to deliver safe, high quality, family-centred pediatric care in this new era. As the pandemic continues, we need to consider carefully how to provide elective and ambulatory care, including surgery, in this era of social distancing. Particular attention is needed to understand particular aspects, including vulnerable children and the clinician experience of the COVID-19 pandemic.

Digital solution for follow-up in congenital cardiac surgery

2021 ◽  
pp. 1-9
Author(s):  
Laura Carlson ◽  
Jacqueline O’Brien ◽  
Nitin Gujral ◽  
Vincent Chiang ◽  
Pedro del Nido ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Health Status ◽  
Post Discharge ◽  
Web Based ◽  
Cardiac Anomalies ◽  
Children's Hospital ◽  
Congenital Cardiac Surgery ◽  
Phone Calls ◽  
Children’S Hospital

Abstract Background: In this era of public scrutiny, there is an ongoing need for innovative methods for patient follow-up. Objectives: As part of a quality initiative, we developed an automated post-operative follow-up system for patients following discharge after cardiac surgery at Boston Children’s Hospital. Methods: Discharge Communication (DisCo) is a web-based system developed at Boston Children’s Hospital. An automated text and e-mail with a link to a health status survey are sent at 30 days and 1 year post-discharge in English/Spanish. If there is no response, surveys are completed via phone calls to the patient/patient’s physician or chart review. Responses are stored in the DisCo database and the patient’s medical record. Patients who underwent cardiac surgery and survived to hospital discharge from October, 2016 received the surveys. Results: Overall, 3345 30-day and 2563 1-year surveys were sent between October, 2016 and June, 2020. Of 3345 30-day surveys, there were 3191 responses (95%). Of 2563 1-year surveys, there were 1807 responses (71%). Most patients/families responded directly to the link at 30 days (65% for paediatrics/75% for adults) and at 1 year (72% for paediatrics/78% for adults). Multi-variable logistic regression revealed that higher complexity of cardiac lesion, presence of major non-cardiac anomalies and presence of major residua were associated with readmission and catheter/surgical reinterventions. Non-cardiac anomalies were associated with increased need for services for learning, development or behaviour. Conclusions: DisCo provides a successful web-based health status assessment of patients following congenital cardiac surgery. It helps to identify high-risk patients who need closer follow-up.

scholarly journals Vital Design

2019 ◽  
Vol 141 (04) ◽  
pp. 30-35
Author(s):  
Kayt Sukel
Keyword(s):  
Cardiac Surgery ◽  
Children's Hospital ◽  
Research Department ◽  
Children’S Hospital ◽  
Long Time ◽  
Surgery Research ◽  
The Relationship

Engineering and medicine has been intertwined for a very long time and in the recent years the relationship has been getting stronger and more important to the advance of healthcare. Surgeons and engineers are collaborating are using 3-D models to plan complex procedures. To do that, engineers must speak a language surgeons can understand. This article looks at how Boston Children's Hospital has invested in the Cardiac Surgery Research department and wants engineers engaged “in the room where it happens.” Then they can observe, study, and communicate with surgeons to truly understand their problems and the type of solutions that they would want to use.

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