scholarly journals Feasibility and effectiveness of prone position ventilation technique for postoperative acute lung injury in infants with congenital heart disease: study protocol for a prospective randomized study

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yu-lu Xu ◽  
Ya-ping Mi ◽  
Meng-xin Zhu ◽  
Yue-hong Ren ◽  
Wei-juan Gong ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Prone Position ◽  
Congenital Heart ◽  
Controlled Trial ◽  
Randomized Study ◽  
Oxygenation Index ◽  
Control Group

Abstract Background Prone position ventilation is a widely used lung protection ventilation strategy. The strategy is more convenient to implement in children compared to adults. Due to the precise mechanism of improving oxygenation function, development of pediatric prone ventilation technology has been largely focused on children with acute respiratory distress syndrome. There is a paucity of high-quality studies investigating the effects of prone position ventilation after pediatric cardiac surgery. The purpose of this study is to evaluate the feasibility and effectiveness of prone position ventilation in infants who develop postoperative acute lung injury after surgery for congenital heart disease. Methods A single-center, randomized controlled trial of pediatric patients with acute lung injury after surgery for congenital heart disease who will receive prone position ventilation or usual care (control group). A total of 68 children will be enrolled according to the inclusion criteria. The main outcome measures will be lung compliance and oxygenation index. The secondary outcomes will be duration of mechanical ventilation, length of stay in cardiac intensive care unit, reintubation rate, and complication rate. Discussion This study will investigate the feasibility and effectiveness of prone position ventilation techniques in children who develop postoperative acute lung injury after surgery for congenital heart disease. The results may help inform strategies to improve airway management after surgery for congenital heart disease. Trial registration ClinicalTrials.gov NCT04607993. Initially registered on 29 October 2020.

RESPIRATORY RATE, TIDAL VOLUME AND VENTILATION OF NEWBORN INFANTS IN THE PRONE AND SUPINE POSITIONS

PEDIATRICS ◽  
1961 ◽  
Vol 28 (3) ◽  
pp. 388-393
Author(s):  
W. T. Bruns ◽  
K. O. Loken ◽  
A. A. Siebens
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Tidal Volume ◽  
Respiratory Rate ◽  
Prone Position ◽  
Congenital Heart ◽  
Newborn Infants ◽  
Periodic Breathing ◽  
Continuous Recording ◽  
Body Plethysmograph

The respiratory rate, tidal volume and ventilation were measured in newborn infants with a body plethysmograph. A continuous recording revealed that, with one exception, no significant change occurred in these parameters when seven mature infants were turned from supine to prone position or vice versa. Two mature infants with periodic breathing, one of whom had congenital heart disease, exhibited periods of apnea when placed from the supine into the prone position.

Using Telemedicine to Improve the Quality of Life of Parents of Infants With CHD Surgery After Discharge

2021 ◽  
Author(s):  
Qi-Liang Zhang ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Hua Cao ◽  
Qiang Chen
Keyword(s):  
Quality Of Life ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Intervention Group ◽  
Control Group ◽  
Educational Levels ◽  
Education Levels

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<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<0.05), while the scores of parents in the control group were similar at one month after discharge (P>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<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<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>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<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<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<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.

Association study of a functional variant of TNF-α gene and serum TNF-α level with the susceptibility of congenital heart disease in a Chinese population

2019 ◽  
Vol 95 (1128) ◽  
pp. 547-551
Author(s):  
Jun Pan ◽  
Jiang Hu ◽  
Xusheng Qi ◽  
Liqin Xu
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Luciferase Reporter Assay ◽  
Luciferase Reporter ◽  
Control Group ◽  
Reporter Assay ◽  
Tnf Α ◽  
Α Level ◽  
Dual Luciferase Reporter Assay

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.

scholarly journals CHIP-Family intervention to improve the psychosocial well-being of young children with congenital heart disease and their families: results of a randomised controlled trial

2019 ◽  
Vol 29 (09) ◽  
pp. 1172-1182 ◽  
Author(s):  
Malindi van der Mheen ◽  
Maya G. Meentken ◽  
Ingrid M. van Beynum ◽  
Jan van der Ende ◽  
Eugène van Galen ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Randomised Controlled Trial ◽  
Congenital Heart ◽  
Controlled Trial ◽  
Psychosocial Problems ◽  
School Functioning ◽  
Trial Registry ◽  
Randomised Controlled

AbstractObjective:Children with congenital heart disease and their families are at risk of psychosocial problems. Emotional and behavioural problems, impaired school functioning, and reduced exercise capacity often occur. To prevent and decrease these problems, we modified and extended the previously established Congenital Heart Disease Intervention Program (CHIP)–School, thereby creating CHIP-Family. CHIP-Family is the first psychosocial intervention with a module for children with congenital heart disease. Through a randomised controlled trial, we examined the effectiveness of CHIP-Family.Methods:Ninety-three children with congenital heart disease (age M = 5.34 years, SD = 1.27) were randomised to CHIP-Family (n = 49) or care as usual (no psychosocial care; n = 44). CHIP-Family consisted of a 1-day group workshop for parents, children, and siblings and an individual follow-up session for parents. CHIP-Family was delivered by psychologists, paediatric cardiologists, and physiotherapists. At baseline and 6-month follow-up, mothers, fathers, teachers, and the child completed questionnaires to assess psychosocial problems, school functioning, and sports enjoyment. Moreover, at 6-month follow-up, parents completed program satisfaction assessments.Results:Although small improvements in child outcomes were observed in the CHIP-Family group, no statistically significant differences were found between outcomes of the CHIP-Family and care-as-usual group. Mean parent satisfaction ratings ranged from 7.4 to 8.1 (range 0–10).Conclusions:CHIP-Family yielded high program acceptability ratings. However, compared to care as usual, CHIP-Family did not find the same extent of statistically significant outcomes as CHIP-School. Replication of promising psychological interventions, and examination of when different outcomes are found, is recommended for refining interventions in the future.Trial registryDutch Trial Registry number NTR6063, https://www.trialregister.nl/trial/5780.

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