scholarly journals Pulmonary Hypertension Following Cardiac Surgery in Children with Down Syndrome: A Review

2019 ◽  
Vol 5 (2) ◽  
pp. 26
Author(s):  
Abubakar Umar
Keyword(s):  
Pulmonary Hypertension ◽  
Down Syndrome ◽  
Cardiac Surgery ◽  
Children With Down Syndrome

scholarly journals Down syndrome and congenital heart disease: perioperative planning and management

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Dennis R. Delany ◽  
Stephanie S. Gaydos ◽  
Deborah A. Romeo ◽  
Heather T. Henderson ◽  
Kristi L. Fogg ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Down Syndrome ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Single Ventricle ◽  
Heart Defects ◽  
Careful Consideration ◽  
Children With Down Syndrome ◽  
Perioperative Planning

AbstractApproximately 50% of newborns with Down syndrome have congenital heart disease. Non-cardiac comorbidities may also be present. Many of the principles and strategies of perioperative evaluation and management for patients with congenital heart disease apply to those with Down syndrome. Nevertheless, careful planning for cardiac surgery is required, evaluating for both cardiac and noncardiac disease, with careful consideration of the risk for pulmonary hypertension. In this manuscript, for children with Down syndrome and hemodynamically significant congenital heart disease, we will summarize the epidemiology of heart defects that warrant intervention. We will review perioperative planning for this unique population, including anesthetic considerations, common postoperative issues, nutritional strategies, and discharge planning. Special considerations for single ventricle palliation and heart transplantation evaluation will also be discussed. Overall, the risk of mortality with cardiac surgery in pediatric patients with Down syndrome is no more than the general population, except for those with functional single ventricle heart defects. Underlying comorbidities may contribute to postoperative complications and increased length of stay. A strong understanding of cardiac and non-cardiac considerations in children with Down syndrome will help clinicians optimize perioperative care and long-term outcomes.

scholarly journals Congenital Heart Defect and Pulmonary Hypertension in Children With Down Syndrome: Clinical Profile Over Two Decades

Cureus ◽  
2021 ◽  
Author(s):  
Abdullah N Alhuzaimi ◽  
Najoud M Alotaibi ◽  
Ghadah I Alsuhaibani ◽  
Reem K Alanazi ◽  
Mohamad-Hani Temsah
Keyword(s):  
Pulmonary Hypertension ◽  
Down Syndrome ◽  
Congenital Heart Defect ◽  
Congenital Heart ◽  
Clinical Profile ◽  
Children With Down Syndrome ◽  
Heart Defect ◽  
Hypertension In Children

Pulmonary hypertension in children with Down syndrome

2020 ◽  
Author(s):  
Douglas Bush ◽  
Csaba Galambos ◽  
David Dunbar Ivy
Keyword(s):  
Pulmonary Hypertension ◽  
Down Syndrome ◽  
Children With Down Syndrome ◽  
Hypertension In Children

scholarly journals Angiogenic profile identifies pulmonary hypertension in children with Down syndrome

2019 ◽  
Vol 9 (3) ◽  
pp. 204589401986654 ◽  
Author(s):  
Douglas Bush ◽  
Kristine Wolter-Warmerdam ◽  
Brandie D. Wagner ◽  
Csaba Galambos ◽  
D.Dunbar Ivy ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Down Syndrome ◽  
Classification Tree ◽  
Children With Down Syndrome ◽  
Angiogenic Proteins ◽  
Peptide Signals ◽  
Low Levels ◽  
Cardiac Catheterizations ◽  
A Prospective Study ◽  
Hypertension In Children

Past studies have shown that lung angiogenic signaling may be abnormal in children with Down syndrome, but whether differences in circulating angiogenic proteins can identify pulmonary hypertension in children with Down syndrome is unknown. A prospective study of 78 children from birth to 21 years of age was conducted to evaluate clinical data, echocardiograms, and cardiac catheterizations. Four patient populations were enrolled, including children with Down syndrome who have pulmonary hypertension (Down syndrome + pulmonary hypertension, n = 12); control children without Down syndrome who have pulmonary hypertension (C + pulmonary hypertension, n = 15); children with Down syndrome without a known diagnosis of pulmonary hypertension (Down syndrome − pulmonary hypertension, n = 26); and children without Down syndrome or a known diagnosis of pulmonary hypertension (C − pulmonary hypertension, n = 25). Blood samples were collected at enrollment and concentrations for 11 proteins were evaluated. A classification tree was created to identify angiogenic peptide signals that may be associated with pulmonary hypertension in children with Down syndrome compared with controls. Findings identified elevated endostatin levels (>4.98 log10 pg/ml) were associated with Down syndrome. Platelet-derived growth factor AA levels (>2.51 log10 pg/ml) were higher in non-Down syndrome patients with pulmonary hypertension (C + pulmonary hypertension), whereas lower angiogenin (<5.428 log10 pg/ml) or lower angiogenin with elevated angiopoietin-1 levels (>3.59 log10 pg/ml) distinguished pulmonary hypertension in those with Down syndrome from the other groups. This study suggests that children with Down syndrome have high endostatin levels, but low levels of angiogenin levels in children with Down syndrome more often identified pulmonary hypertension than Down syndrome subjects without pulmonary hypertension or non-Down syndrome children. We speculate that these changes in circulating peptides support the concept of dysregulated angiogenesis in children with Down syndrome and pulmonary hypertension, which may further support potential utility as biomarkers for identifying subjects with Down syndrome at risk for pulmonary hypertension in this population.

232: DO CHILDREN WITH DOWN SYNDROME REALLY NEED HIGHER SEDATION AND ANALGESIA AFTER CARDIAC SURGERY?

2018 ◽  
Vol 46 (1) ◽  
pp. 98-98
Author(s):  
Parag Jain ◽  
Barbara-Jo Achuff ◽  
Karla Resendiz ◽  
Lauren Kane ◽  
Paul Checchia
Keyword(s):  
Down Syndrome ◽  
Cardiac Surgery ◽  
Children With Down Syndrome ◽  
Sedation And Analgesia

scholarly journals Nutritional Status and Pulmonary Hypertension in Children with Down Syndrome Presenting with Congenital Heart Disease: Retrospective Study

2020 ◽  
pp. 12-18
Author(s):  
J. M. Chinawa ◽  
O. C. Duru ◽  
B. F. Chukwu ◽  
A. T. Chinawa
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Down Syndrome ◽  
Heart Disease ◽  
Retrospective Study ◽  
Nutritional Status ◽  
Congenital Heart ◽  
Children With Down Syndrome ◽  
Increased Risk ◽  
Hypertension In Children

Introduction: Children with Down syndrome are predisposed to having congenital heart defect. Objectives: This study is aimed to describe the clinical correlates, nutritional status and pulmonary hypertension in children with Down syndrome who presented with congenital heart disease. Patients and Methods: A retrospective study of children with Down syndrome who presented with congenital heart disease from 2016 to 2020 was carried out. Nutritional status was assessed with WHO Anthro software while pulmonary hypertension was assessed with standard procedures. Results: Out of 758 echocardiography done over the period of 5 years for children suspected of having cardiac disease, three hundred and eight one had confirmed congenital heart disease of which twenty-eight of them had Down syndrome 7.34% (28/381).  Ten 10/28 (35.7%) of them had pulmonary hypertension. This is commonly noted among infants than older ages. Among 28 children with Down syndrome, twenty-three had complete information for weight and height which was used to assess their nutritional status, 47.8% (11/28) presented with wasting and stunted, 8.7% (2/28) of those with Down syndrome were wasted and 8.7% (2/28) with stunting. Down syndrome is commoner in children with AV canal defect 50% (14/28) followed by PDA 21.4% (6/14). Fast breathing 86.7% (13/15) as the most common symptom followed by cough 64.3% (9/14) Conclusion: Children with Down syndrome who had congenital heart disease are at increased risk of malnutrition and pulmonary hypertension.

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