scholarly journals Management Of Cardiogenic Shock In Pediatric Patients

2020 ◽  
Vol 9 (2) ◽  
pp. 60
Author(s):  
Dyaris Koentartiwi ◽  
Naura Candini ◽  
Renny Suwarnianty
Keyword(s):  
Cardiogenic Shock ◽  
Cardiac Failure ◽  
Pediatric Patients ◽  
Comprehensive Approach ◽  
Unfavorable Outcome ◽  
Proper Management

Cardiogenic shock is an acute state of end-organ hypoperfusion following cardiac failure. Usually many children have good compensation if they suffered from cardiogenic shock and sometimes delay diagnosis leads to unfavorable outcome. Comprehensive approach in treatment following investigation about the cause of cardiogenic shock is very important and proper management will prevent complication and mortality. 

Extracorporeal membrane oxygenation outcomes in children with hemophagocytic lymphohistiocytosis

Perfusion ◽  
2016 ◽  
Vol 32 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Katherine Cashen ◽  
Roland L Chu ◽  
Justin Klein ◽  
Peter T Rycus ◽  
John M Costello
Keyword(s):  
Risk Factors ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiac Failure ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Pediatric Patients ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Hemorrhagic Complication ◽  
Membrane Oxygenation ◽  
Va Ecmo

Introduction: Pediatric patients with hemophagocytic lymphohistiocytosis (HLH) may develop refractory respiratory or cardiac failure that warrants consideration for extracorporeal membrane oxygenation (ECMO) support. The purposes of this study were to describe the use and outcomes of ECMO in pediatric HLH patients, to identify risk factors for hospital mortality and to compare their ECMO use and outcomes to the ECMO population as a whole. Methods: Pediatric patients (⩽ 18 years) with a diagnosis of HLH in the Extracorporeal Life Support Organization (ELSO) Registry were included. Results: Between 1983 and 2014, data for 30 children with HLH were available in the ELSO registry and all were included in this study. All cases occurred in the last decade. Of the 30 HLH patients, 24 (80%) had a respiratory indication for ECMO and six (20%) had a cardiac indication (of which 4 were E-CPR and 2 cardiac failure). Of the 24 respiratory ECMO patients, 63% were placed on VA ECMO. Compared with all pediatric patients in the ELSO registry during the study period (n=17,007), HLH patients had worse hospital survival (non-HLH 59% vs HLH 30%, p=0.001). In pediatric HLH patients, no pre-ECMO risk factors for mortality were identified. The development of a hemorrhagic complication on ECMO was associated with decreased mortality (p=0.01). Comparing HLH patients with respiratory failure to patients with other immune compromised conditions, the overall survival rate is similar (HLH 38% vs. non-HLH immune compromised 31%, p=0.64). Conclusions: HLH is an uncommon indication for ECMO and these patients have increased mortality compared to the overall pediatric ECMO population. These data should be factored into decision-making when considering ECMO for pediatric HLH patients.

Diagnosis and Management of Suspected Pediatric Autoimmune Encephalitis: A Comprehensive, Multidisciplinary Approach and Review of Literature

2021 ◽  
pp. 088307382110646
Author(s):  
Melissa A. Wright ◽  
Cristina C. Trandafir ◽  
Gary R. Nelson ◽  
Aimee O. Hersh ◽  
C. J. Inman ◽  
...  
Keyword(s):  
Iterative Process ◽  
Multidisciplinary Approach ◽  
Pediatric Patients ◽  
Treatment Initiation ◽  
Young Patients ◽  
Autoimmune Encephalitis ◽  
Comprehensive Approach ◽  
Review Of Literature ◽  
Duration Of Treatment ◽  
Diagnosis And Management

Autoimmune encephalitis is an increasingly recognized entity in children. When treated promptly, favorable outcomes are seen in a majority of pediatric patients. However, recognition of autoimmune encephalitis in young patients is challenging. Once autoimmune encephalitis is suspected, additional difficulties exist regarding timing of treatment initiation and duration of treatment, as evidence to guide management of these patients is emerging. Here, we review available literature regarding pediatric autoimmune encephalitis and present our institution's comprehensive approach to the evaluation and management of the disease. These guidelines were developed through an iterative process involving both pediatric neurologists and rheumatologists.

Pediatric patients in a disaster: Part of the all-hazard, comprehensive approach to disaster management

2012 ◽  
Vol 7 (2) ◽  
pp. 111-125 ◽  
Author(s):  
Sharon E. Mace, MD ◽  
Constance Doyle, MD ◽  
Susan Fuchs, MD ◽  
Marianne Gausche-Hill, MD ◽  
Kristi L. Koenig, MD ◽  
...  
Keyword(s):  
Emergency Management ◽  
Special Needs ◽  
Disaster Management ◽  
Pediatric Patients ◽  
Disaster Planning ◽  
The Elderly ◽  
Comprehensive Approach ◽  
Management Approach ◽  
Planning And Management ◽  
Response And Recovery

Disasters affect all ages of patients from the newborn to the elderly. Disaster emergency management includes all phases of comprehensive emergency management from preparedness to response and recovery. Disaster planning and management has frequently overlooked the unique issues involved in dealing with the pediatric victims of a disaster. The following will be addressed: disaster planning and management as related to pediatric patients and the integration of pediatric disaster management as part of an all-hazard, comprehensive emergency management approach. Key recommendations for dealing with children, infants, and special needs patients in a disaster are delineated.

scholarly journals Rethrombolysis for Restruck Prosthetic Valve

2004 ◽  
Vol 3 (3) ◽  
pp. 56
Author(s):  
J Ezhilan
Keyword(s):  
Pulmonary Embolism ◽  
Cardiogenic Shock ◽  
Valve Replacement ◽  
Cardiac Failure ◽  
Prosthetic Valve ◽  
Congestive Cardiac Failure ◽  
Thrombotic Occlusion ◽  
Mitral Position ◽  
Surgical Thrombectomy

One of the complications of prosthetic valve (PV) is thrombotic occlusion of the valve. The incidence is 5/100/yr overall and is more common in mitral position than in aortic position, PV thrombosis presentation can be acute due to thrombi (55%), Subacute due to thrombus and pannus (40%) and Chronic due to pannus alone (5%). It can manifest as congestive cardiac failure, Pulmonary embolism, cardiogenic shock, Thromboembolism or death. Conventionally it was treated with surgical thrombectomy and pannus excision or valve replacement. Later on thrombolysis was tried and various agents like Streplokinase, Urokinase and t- PA have been used successfully to lyse the thrombus.

scholarly journals Case Report: Pediatric Patient with COVID-19 and Multisystem Inflammatory Syndrome in Children

2020 ◽  
Vol 4 (4) ◽  
pp. 513-516
Author(s):  
MacKenzie Burger ◽  
Marcus Moore ◽  
John Wilburn
Keyword(s):  
Case Report ◽  
Risk Stratification ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
Pediatric Patient ◽  
Pediatric Patients ◽  
Signs And Symptoms ◽  
Unique Case ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Inflammatory Syndrome

Introduction: Coronavirus disease 2019 (COVID-19) rarely manifests with severe complications in pediatric patients. An association between COVID-19 and a Kawasaki-like inflammatory syndrome has recently presented in pediatric patients. Case Report: We report a unique case of multisystem inflammatory syndrome in children presenting with characteristic findings in a child who later developed cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation. Conclusion: Recognition of these early signs and symptoms facilitates screening and risk stratification of pediatric COVID-19 cases associated with increased morbidity.

scholarly journals Primary Intraventricular Hemorrhage in Pediatric Patients: Causes, Characteristics, and Outcomes

2019 ◽  
Author(s):  
Rui Guo ◽  
Chaofeng Fan ◽  
Ruiqi Chen ◽  
Zhiyuan Yu ◽  
Rui Tian ◽  
...  
Keyword(s):  
Intraventricular Hemorrhage ◽  
Arteriovenous Malformations ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Unfavorable Outcome ◽  
Rare Type ◽  
Long Time ◽  
The Mean ◽  
Short Time

Abstract Background: Primary intraventricular hemorrhage is a rare type of stroke and little is known its causes, characteristics and outcomes in children. Methods: We retrospectively analyzed the clinical characteristics of patients aged one month to 21 years during seven consecutive years with primary intraventricular hemorrhage. Primary intraventricular hemorrhage was defined as bleeding confined to the ventricular system without parenchymal or subarachnoid hemorrhage involved. Results: Of the included eighteen patients, 55.6% were female, and the mean age was 13.8 ± 6.0 years. The most common symptoms on presentation were headache (77.8%) and vomiting (33.3%). Fifteen patients (83.3%) were diagnosed with known etiologies, including arteriovenous malformations (66.7%), Moyamoya disease (11.1%), and aneurysms (5.6%). Idiopathic PIVH was diagnosed in only 3 patients (16.7%). Fifteen patients (83.3%) underwent surgical intervention, and 3 patients (16.7%) received conservative treatment. Four patients (28.6%) had an unfavorable outcome at discharge and unfavorable was observed in 3 patients (16.7%) at the 3-month follow-up. Higher Graeb score was associated with an unfavorable outcome both in short-time and long-time follow-up. Conclusions: Most primary intraventricular hemorrhage patients were diagnosed with arteriovenous malformations in the pediatric population. Specific surgical treatment of underlying etiologies should be required to increase clinical improvement. The children with higher Graeb score at admission tended to have poor early and late outcome. Keywords: Primary intraventricular hemorrhage; pediatric; surgery; vascular disorders.

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