scholarly journals The brain protective effect of dexmedetomidine during surgery for paediatric patients with congenital heart disease

2019 ◽  
Vol 47 (4) ◽  
pp. 1677-1684 ◽  
Author(s):  
Jin Gong ◽  
Rufang Zhang ◽  
Li Shen ◽  
Yewei Xie ◽  
Xiaobing Li

Objective To study the brain protective effect of dexmedetomidine (DEX) during surgery in paediatric patients with congenital heart disease (CHD). Methods This randomized single-blind controlled study enrolled paediatric patients aged 0–3 years with CHD who underwent surgery and randomized them into two groups: one group received DEX and the control group received 0.9% NaCl during anaesthesia. Demographic data, heart rate (HR), mean arterial pressure (MAP) and central venous pressure (CVP) were recorded. Levels of neuron specific enolase (NES) and S-100β protein were determined using enzyme-linked immunosorbent assays. Results The study enrolled 80 paediatric patients with CHD. Compared with the control group, HR, MAP and CVP were significantly lower in the DEX group at all time-points except for T0. At all time-points except for T0, the levels of jugular venous oxygen saturation in the DEX group were significantly higher compared with the control group. At all time-points except for T0, the levels of arterial venous difference and cerebral extraction of oxygen were significantly lower in the DEX group compared with the control group. Levels of NES and S-100β protein in the DEX group were significantly lower compared with the control group at all time-points except for T0. Conclusion DEX treatment during surgery for CHD improved oxygen metabolism in brain tissues and reduced the levels of NES and S-100β protein.

2008 ◽  
Vol 28 (S 01) ◽  
pp. S61-S66 ◽  
Author(s):  
G. Cvirn ◽  
A. Rosenkranz ◽  
B. Leschnik ◽  
W. Raith ◽  
W. Muntean ◽  
...  

SummaryThrombin generation was studied in paediatric patients with congenital heart disease (CHD) undergoing cardiac surgery using the calibrated automated thrombography (CAT) in terms of the lag time until the onset of thrombin formation, time to thrombin peak maximum (TTP), endogenous thrombin potential (ETP), and thrombin peak height. The suitability to determine the coagulation status of these patients was investigated. Patients, material, methods: CAT data of 40 patients with CHD (age range from newborn to 18 years) were compared to data using standard coagulation parameters such as prothrombin (FII), antithrombin (AT), tissue factor pathway inhibitor (TFPI), prothrombin fragment 1.2 (F 1.2), thrombin-antithrombin (TAT), activated partial thromboplastin time (aPTT), and prothrombin time (PT). Results: A significant positive correlation was seen between ETP and FII (p < 0.01; r = 0.369), as well as between peak height and F II (p < 0.01; r = 0.483). A significant negative correlation was seen between ETP and TFPI values (p < 0.05; r = –0.225) while no significant correlation was seen between peak height and TFPI. A significant negative correlation was seen between F 1.2 generation and ETP (p < 0.05; r = –0.254) and between F 1.2 generation and peak height (p < 0.05; r = –0.236). No correlation was seen between AT and ETP or peak. Conclusions: CAT is a good global test reflecting procoagulatory and inhibitory factors of the haemostatic system in paediatric patients with CHD.


2014 ◽  
Vol 69 (6) ◽  
pp. 574-580 ◽  
Author(s):  
A. Adibi ◽  
K. Mohajer ◽  
A. Plotnik ◽  
A. Tognolini ◽  
R. Biniwale ◽  
...  

2013 ◽  
Vol 36 (3) ◽  
pp. 372-380 ◽  
Author(s):  
ANTHONY C. McCANTA ◽  
MELISSA H. KONG ◽  
MICHAEL P. CARBONI ◽  
RUTH A. GREENFIELD ◽  
PATRICK M. HRANITZKY ◽  
...  

Author(s):  
Qi-Liang Zhang ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Hua Cao ◽  
Qiang Chen

Abstract Background The purpose of this study was to investigate the effect of using telemedicine to improve the quality of life of parents of infants with congenital heart disease surgery after discharge. Methods A prospective randomized controlled study was conducted in a provincial hospital in China from November 2020 to April 2021 to compare the quality of life of parents of infants with congenital heart disease surgery after discharge between the WeChat follow-up group and the outpatient follow-up group. A total of 84 patients (42 in each group) and 168 parents (84 in each group) participated in this study. Results One month after discharge, the SAS and SDS scores of parents in the intervention group were significantly lower than those in the control group (P&lt;0.05). Compared with the SAS and SDS scores at discharge, the scores of parents in the intervention group were significantly lower at one month after discharge (P&lt;0.05), while the scores of parents in the control group were similar at one month after discharge (P&gt;0.05). At discharge, in both the intervention group and the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P&lt;0.05). One month after discharge, in the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P&lt;0.05). One month after discharge, in the intervention group, the SAS and SDS scores of the mothers were similar to those of the fathers (P&gt;0.05). The comparison of the SAS and SDS scores of parents with different education levels showed that in both the intervention group and control group, the lower the parents’ educational levels were, the higher their SAS and SDS scores were (P&lt;0.05). One month after discharge, in the control group, the lower the parents’ education levels were, the higher their SAS and SDS scores (P&lt;0.05). One month after discharge, in the intervention group, the SAS and SDS scores were similar among parents with different educational levels. The results of the WHOQOL-BREF scale showed that the scores of the physiological, psychological, social and environmental fields at one month after discharge in the intervention group were significantly higher than those in the control group (P&lt;0.05). Conclusion Providing health education and medical support to the parents of infants with congenital heart disease surgery after discharge via telemedicine can effectively relieve the parents’ anxiety and depression and improve their quality of life.


2019 ◽  
Vol 95 (1128) ◽  
pp. 547-551
Author(s):  
Jun Pan ◽  
Jiang Hu ◽  
Xusheng Qi ◽  
Liqin Xu

BackgroundCongenital heart disease (CHD) is among the leading causes of infant death worldwide. Although shortage of folate has been found potentially to contribute to CHD in the embryo, the aetiology of CHD was not completely understood. Inflammation and altered immune processes are involved in all forms of cardiac malformation, including CHD. Tumour necrosis factor-α (TNF-α), was involved in the pathogenesis of multiple kinds of heart diseases. However, no studies have systematically evaluated the associations of genetic variants of TNF-α with susceptibility of CHD.MethodsA case-control study was conducted to evaluate the associations between tagSNPs of TNF-α and CHD susceptibility. Serum level of TNF-α was assessed using ELISA. The dual luciferase reporter assay was used to evaluate the functional significance of variant rs1800629 on TNF-α transcriptional activity.ResultsWe found rs1800629 was significantly correlated with increased CHD susceptibility (OR: 1.72, 95% CI 1.26 to 2.36, p=0.001). Serum levels of TNF-α were significantly higher in CHD group (9.09±1.90 pg/mL) than that in control group (6.12±1.56 pg/mL, p<0.001). The AA genotype and AG genotype of rs1800629 was associated with higher serum TNF-α level, compared with GG genotype. The dual luciferase reporter assay showed that promoter activity was significantly increased by 57% and 76% for plasmids containing the minor A allele compared with the major G allele in H9c2 and HEK 293T, respectively.ConclusionThese results indicate that higher level of serum TNF-α increases risk of CHD, while TNF-α rs1800629 A allele might contribute to higher risk for CHD due to the increase in TNF-α expression.


1968 ◽  
Vol 17 (3) ◽  
pp. 523-539 ◽  
Author(s):  
I. Emerit ◽  
P. Vernant ◽  
P. Corone

SUMMARYPalm-print and finger-print patterns were studied in a series of 330 patients with congenital heart disease and compared to a control group of 200 patients with acquired heart disease.156 patiens had associated malformations, while 174 other patients had isolated heart disease. Both groups were studied separately.Simian creases are more frequent in the malformed patients than in the controls, but the difference is only significant in patients with multiple malformations.A triradius in the positions t' is seen with a higher frequency in patients with multiple malformations and in patients with isolated heart disease than in the controls. The position t” however is only more frequent in the group of patients with multiple malformations, and tends to be associated more often with a ventricular septal defect and Fallot's tetralogy than with an atrial septum defect, aortic stenosis, coarctation and patent ductus.Hypothenar patterns are more frequent in patients than in controls.The results concerning finger-print patterns show a diminished frequency of arches in patients with isolated heart disease compared with controls and patients with multiple malformations. Variations between the different types of congenital heart disease were not important. They are partly in agreement, partly in disagreement with the results of other authors.21 patients with familial congenital heart disease show an increased frequency of ulnar loops and a low frequency of whorls compared to the rest of patients.This study does not include classical chromosomal aberrations and no malformation syndromes besides the Holt-Oram syndrome and the supravalvular aortic stenosis syndrome. The first one is characterised by an increased frequency of axial triradius in the t” position and of simian creases, while the second one seems to be without any dermatoglyphic particularity.


2015 ◽  
Vol 41 (4) ◽  
pp. S52
Author(s):  
Reem Abu-Rustum ◽  
M. Fouad Ziade ◽  
Assaad Kesrouani ◽  
Sameer Abu-Rustum ◽  
Linda Daou

Author(s):  
Gülben İrem Kanberoğlu ◽  
Önder Doksöz ◽  
Özlem Bağ ◽  
Serpil Ece Aras Öztürk

OBJECTIVE: Congenital heart disease is one of the most common childhood diseases that affect both the children's and their families social life, quality of life and the children's academic achievement. The aim of this study is to evaluate the school performance of children suffering from congenital heart disease who underwent surgical or catheter based interventions. METHODS: The study group included 50 patients with congenital heart disease underwent surgical or catheter based interventions attending to secondary school (aged 12-15 years old) and 50 healthy controls. The academic success validation from official school grades of lessons Turkish, Mathematics, Science, Social Sciences lessons and behavioral attitudes were obtained from the Ministry of Education ‘’e-school’’ parent information system printouts. The patient group consisted of both cyanotic and acyanotic patients and each groups were compared with controls. RESULTS: Turkish, mathematics, physical education classes and behavioral attitudes note in the patient group was significantly lower than in the control group. The school success in Cyanotic group was significantly lower than the control group in Turkish, mathematics, education lessons and behavioral attitudes grades. Significant difference was not determined in science and social science lessons. CONCLUSION: Cyanotic group's success in mathematic and turkish lessons are lower in children with congenital heart disease especially in cyanotic group. We suggest that providing supportive teaching pragrammes for children with congenital hearth disease are needed in order to maintain academic success.


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