DIAGNOSIS AND TREATMENT: THE SALVAGE OF CRITICALLY ILL NEWBORN INFANTS WITH CONGENITAL HEART DISEASE

The natural course of congenital heart disease in the newborn infant may last only a few days or weeks; yet, many of these babies are salvageable through surgery. The clinician's problems include the necessity for early detection through recognition of persistant cyanosis or respiratory symptoms, exclusion of primary lung disease through chest x-rays and blood gas determinations, and establishing an accurate diagnosis as rapidly as possible through cardiac catheterization. An aggressive surgical approach to these critically ill infants can then result ill many survivors.

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PS-032a Perfusion Index And Pulse Oximetry Screening For Severe Congenital Heart Disease In Newborn Infants. Results From A Collaborative Italian Study

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-307384.328 ◽

2014 ◽

Vol 99 (Suppl 2) ◽

pp. A123.1-A123 ◽

Cited By ~ 1

Author(s):

F Schena ◽

I Picciolli ◽

F Mosca

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Pulse Oximetry ◽

Congenital Heart ◽

Newborn Infants ◽

Perfusion Index ◽

Italian Study ◽

Severe Congenital Heart Disease ◽

Pulse Oximetry Screening

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Abstract 2344: Cumulative Radiation Dose Estimate From Medical Testing in Grown-Up Patients With Congenital Heart Disease

Circulation ◽

10.1161/circ.116.suppl_16.ii_513-a ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Lamia Ait-Ali ◽

Nicoletta Botto ◽

Maria Grazia Andreassi ◽

Pierluigi Festa ◽

Eugenio Picano

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Effective Dose ◽

Cumulative Dose ◽

Congenital Heart ◽

Cumulative Exposure ◽

X Rays ◽

Dose Estimate ◽

Risk Of Cancer ◽

Beir Vii

Background: The “Biological effects of Ionizing Radiation” (BEIR VII,2005) underlines “the need of studies of infants who are exposed to diagnostic radiation”. Aim: to assess the individual cumulative lifetime radiological dose in grown up congenital heart disease (GUCH) patients. Methods: In 41 consecutive operated GUCH patient (24 males, age= 27 ± 9 years old), followed in our outpatient clinic, a cumulative radiological history was collected with a structured questionnaire and access to lifetime hospital records. All patient underwent at least one surgical intervention during the infancy for Tetralogy of Fallot (n=18), aortic coarctation (n=10), anatomical/functional univentricular heart (n=8), other congenital heart disease (n=5) The cumulative exposure was expressed in milliSievert (mSv) and derived from average effective dose estimates of individual examinations proposed by the European Commission Medical Imaging Guidelines (2001). The attributable cancer risk was estimated from BEIR VII, 2005 document. Results: On average, cumulative dose estimate was 22.3 ± 12.4 (mean ± SD) mSv per patient, equivalent to about 1115 ± 620 chest x-rays. Diagnostic and interventional catheterization accounted for the most important sources of exposure (see figure ). The median cumulative dose gave an average extra-risk of cancer of about 1 out of 200 patients (range, 1 in 448 to 1 out of 58). Conclusion: the average contemporary GUCH patient is exposed to a significant cumulative radiological effective dose. Every effort should be done to justify the indications and to optimise dose delivery during ionizing testing.

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GASTRIC RESPONSE TO SPECIFIC DISEASE IN INFANTS

PEDIATRICS ◽

10.1542/peds.38.5.874 ◽

1966 ◽

Vol 38 (5) ◽

pp. 874-878

Author(s):

Gordon B. Avery ◽

Judson G. Randolph ◽

Thomas Weaver

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Congenital Heart ◽

Newborn Infants ◽

Chloride Concentration ◽

Acid Formation ◽

Total Acidity ◽

Pepsin Activity ◽

Specific Disease ◽

Normal Acidity

1. A method of gastric analysis has been developed for the study of newborn infants. Results obtained with this method have shown it to reflect more accurately the ongoing secretory activity of the stomach. Previous methods of sampling left significant and varying amounts of acidity behind in the stomach rendering much of the available data inconclusive. 2. For the first time, gastric function has been correlated with specific disease states in the infant. 3. The volume, pH, total acidity, chloride content, and pepsin activity have been found to vary independently of one another. 4. Pneumonia and bronchiolitis, two conditions producing compromised respiratory function, were characterized by decreased total acidity, a more alkaline pH, and decreased pepsin activity. 5. Infants with short gut after bowel resection displayed highly significant increases in total gastric acidity and rate of acid formation, and a lower gastric pH. 6. Infants with acyanotic congenital heart disease showed significantly decreased pepsin content and increased chloride concentration despite normal acidity. Conversely, the few infants with cyanotic congenital heart disease studied had decreased volume of gastric juice and rate of acid formation.

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Generalized Bone Changes and Thrombocytopenic Purpura in Association with Intrauterine Rubella

PEDIATRICS ◽

10.1542/peds.36.2.264 ◽

1965 ◽

Vol 36 (2) ◽

pp. 264-268

Author(s):

AARON R. RAUSEN ◽

ROBERT D. LONDON ◽

ABRAHAM MIZRAHI ◽

LOUIS Z. COOPER

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Rubella Virus ◽

Congenital Heart ◽

Newborn Infants ◽

First Trimester ◽

Long Bones ◽

Thrombocytopenic Purpura ◽

Bone Changes ◽

First Trimester Of Pregnancy

Two newborn infants are presented whose mothers had rubella in the first trimester of pregnancy. Both infants were born with thrombocytopenic purpura and suggestive evidence of a hemolytic disorder. The second infant had congenital heart disease as well. Roentgenographic changes in the metaphyseal ends of several long bones, observed in the first infant at 3 days of age, regressed completely by 2 months of age. The second infant had roentgenographic evidence of metaphyseal changes of a lesser degree, limited to the distal ends of the femora. These changes were no longer present at 6 weeks of age. Both infants were shown to be harboring an interfering agent with the characteristics of the rubella virus.

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

PEDIATRICS ◽

10.1542/peds.28.3.388 ◽

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.

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