scholarly journals Reappraisal of the Subtropical Guidelines on Palivizumab Prophylaxis in Congenital Heart Disease

2022 ◽  
Vol 9 ◽  
Author(s):  
Shuenn-Nan Chiu ◽  
Ching-Chia Wang ◽  
Ming-Tai Lin ◽  
Chun-An Chen ◽  
Chun-Wei Lu ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Care Center ◽  
Tertiary Care ◽  
The Novel ◽  
Genetic Syndromes ◽  
Syncytial Virus ◽  
The Impact ◽  
Associated Abnormalities

Objective: To define the impact of associated abnormalities on the efficacy of the novel subtropical guidelines for palivizumab prophylaxis on respiratory syncytial virus (RSV)-related hospitalizations in patients with hemodynamically significant congenital heart disease (hsCHD).Method: This prospective study enrolled every patient seen at a tertiary care center for hsCHD, who was born between 2014 and 2018 and received at least 1 dose of palivizumab, according to the subtropical guidelines. The patients were followed until the age of 2 years.Results: A total of 772 patients (49% male) were enrolled. Cyanotic CHD was seen in 46% of patients, of whom 23% had associated abnormalities. Lung/airway abnormalities (14%) were the most common followed by the genetic syndromes associated with CHD (7.3%). Among the 772 patients, RSV-related hospitalizations occurred in 3.2 and 2.2% children aged ≤ 12 and 13–24 months, respectively. Most of the RSV infections occurred in patients no longer satisfying the criteria for palivizumab prophylaxis. The patients with associated abnormalities but not the type of CHD, patient age, and patient sex were risk factors for RSV-related hospitalizations. The rates of RSV-related hospitalizations, admission to the intensive care unit, and endotracheal intubation were higher for patients with associated anomalies than for other patients before 24 months of age (10.2 vs. 4.0%, 67 vs. 33%, and 39 vs. 4.2%, p = 0.004, 0.06, 0.013, respectively).Conclusion: Children with abnormalities, especially genetic syndromes and lung/airway problems associated with CHD, are at high risk for RSV-related hospitalization. Our current subtropical guidelines for palivizumab prophylaxis in patients with hsCHD, should be revised to include the results of this study.

scholarly journals Cyanotic congenital heart disease: Impact on growth and endocrine functions.

2021 ◽  
Vol 28 (10) ◽  
pp. 1477-1483
Author(s):  
Muhammad Sohail Arshad ◽  
Waqas Imran Khan ◽  
Arif Zulqarnain ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Mudasser Adnan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pulmonary Stenosis ◽  
Tertiary Care ◽  
Cyanotic Congenital Heart Disease ◽  
P Value ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Objective: To find out the impact of Cyanotic Congenital Heart Disease (CCHD) on growth and endocrine functions at a tertiary care child healthcare facility of South Punjab. Study Design: Case Control study. Setting: Department of Pediatric Cardiology and Department of Pediatric Endocrinology, Institute of Child’s Health (ICH), Multan, Pakistan. Period: December 2018 to March 2020. Material & Methods: During the study period, a total of 53 cases of Echocardiography confirmed CCHD were registered. Along with 53 cases, 50 controls during the study period were also enrolled. Height, weight, body mass index (BMI) along with hormonal and biochemical laboratory investigations were done. Results: There was no significant difference between gender and age among cases and controls (p value>0.05). Most common diagnosis of CCHD among cases, 24 (45.3%) were Tetralogy of Fallot (TOF) followed by 9 (17.0%) transposition of the great arteries (TGA) with Ventricular Septal Defect (VSD) with Pulmonary Stenosis (PS). Mean weight of CCHD cases was significantly lower in comparison to controls (21.19+6.24 kg vs. 26.48+8.1 kg, p value=0.0003). Blood glucose was significantly lower among cases in comparison to controls (77.58+14.58 mg/dl vs. 87.25+11.82 mg/dl, p value=0.0004). No significant difference was found in between cases and controls in terms of various hormone levels studied (p value>0.05) except Insulin-like Growth Factor-1 (IGF-1) levels (p value<0.0001). Conclusion: Children with cyanotic congenital heart disease seem to have negative effects on nutrition and growth. Change in pituitary-adrenal axis is suspected while pituitary-thyroid axis seemed to be working fine among CCHD cases. Serum glucose and IGF-1 levels were significantly decreased among CCHD cases.

Impact of pulmonary hypertension and congenital heart disease with hemodynamic repercussion on the severity of acute respiratory infections in children under 5 years of age at a pediatric referral center in Colombia, South America

2020 ◽  
Vol 30 (12) ◽  
pp. 1866-1873
Author(s):  
Diego A. Lozano-Espinosa ◽  
Victor M. Huertas-Quiñones ◽  
Carlos E. Rodríguez-Martínez
Keyword(s):  
Congenital Heart Disease ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Respiratory Infection ◽  
Acute Respiratory Infection ◽  
Congenital Heart ◽  
Respiratory Infections ◽  
Syncytial Virus ◽  
The Impact ◽  
Children Under 5

AbstractBackground:Acute respiratory infection is one of the main causes of morbidity in children. Some studies have suggested that pulmonary hypertension and congenital heart disease with haemodynamic repercussion increase the severity of respiratory infections, but there are few publications in developing countries.Methods:This was a prospective cohort study evaluating the impact of pulmonary hypertension and congenital heart disease (CHD) with haemodynamic repercussion as predictors of severity in children under 5 years of age hospitalised for acute respiratory infection.Results:Altogether, 217 children hospitalised for a respiratory infection who underwent an echocardiogram were evaluated; 62 children were diagnosed with CHD with haemodynamic repercussion or pulmonary hypertension. Independent predictors of admission to intensive care included: pulmonary hypertension (RR 2.14; 95% CI 1.06–4.35, p = 0.034), respiratory syncytial virus (RR 2.52; 95% CI 1.29–4.92, p = 0.006), and bacterial pneumonia (RR 3.09; 95% CI 1.65–5.81, p = 0.000). A significant difference was found in average length of hospital stay in children with the cardiovascular conditions studied (p = 0.000).Conclusions:Pulmonary hypertension and CHD with haemodynamic repercussion as well as respiratory syncytial virus and bacterial pneumonia were predictors of severity in children with respiratory infections in this study. Early recognition of cardiovascular risks in paediatric populations is necessary to lessen the impact on respiratory infections.

Impact of Anesthesia and Surgery for Congenital Heart Disease on the Vitamin D Status of Infants and Children

2013 ◽  
Vol 119 (1) ◽  
pp. 71-80 ◽  
Author(s):  
J. Dayre McNally ◽  
Kusum Menon ◽  
Pranesh Chakraborty ◽  
Lawrence Fisher ◽  
Kathryn A. Williams ◽  
...  
Keyword(s):  
Vitamin D ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Clinical Course ◽  
Tertiary Care ◽  
Vitamin D Status ◽  
Organ Systems ◽  
Vitamin D Levels ◽  
The Impact

Abstract Background: Vitamin D is recognized as a pleiotropic hormone important for the functioning of organ systems, including those central to critical illness pathophysiology. Recent studies have reported associations between vitamin D status and outcome among critically ill adults and children. Preoperative vitamin D status, impact of operative techniques, and relationship between immediate postoperative vitamin D levels and clinical course have not been described in the pediatric congenital heart disease (CHD) population. The objective of this study was to describe the impact of CHD surgery on vitamin D status and relationship between postoperative levels and clinical course. Methods: A prospective cohort study was conducted from 2009 to 2011 at a single tertiary care pediatric hospital. A total of 58 children with CHD were enrolled and blood collected preoperatively, intraoperatively, and postoperatively. Serum 25-hydroxyvitamin D (25OHD) was measured using liquid chromatography–mass spectrometry. Results: The mean preoperative 25OHD was 58.0 nm (SD, 22.4), with 42% being deficient (&lt;50 nm). Postoperatively, we identified a 40% decline in 25OHD to 34.2 nm (SD, 14.5) with 86% being deficient. Intraoperative measurements determined that initiation of cardiopulmonary bypass coincided with abrupt decline. CHD patients requiring catecholamines had lower postoperative 25OHD (38.2 vs. 26.5 nm, P = 0.007), findings confirmed through multivariate logistic regression. Lower postoperative 25OHD was associated with increased fluid requirements and intubation duration. Conclusions: Most CHD patients are vitamin-D deficient postoperatively due to low preoperative levels and a significant intraoperative decline. Interventional studies will be required to determine whether prevention of postoperative vitamin D deficiency improves outcome.

Persistent left superior vena cava accompanying congenital heart disease in children: Experience of a tertiary care center

2017 ◽  
Vol 34 (3) ◽  
pp. 436-440 ◽  
Author(s):  
Mehmet Emre Ari ◽  
Vehbi Doğan ◽  
Senem Özgür ◽  
Özben Ceylan ◽  
İlker Ertuğrul ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Superior Vena ◽  
Care Center ◽  
Tertiary Care ◽  
Vena Cava ◽  
Tertiary Care Center ◽  
Left Superior Vena Cava ◽  
Persistent Left Superior Vena

scholarly journals Clinical suspicion of congenital heart diseases during well-baby follow-up and echocardiographic correlation

2017 ◽  
Vol 4 (6) ◽  
pp. 2046
Author(s):  
K. M. Adhikari ◽  
Sandeep Dhingra
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Suspicion ◽  
Tertiary Care Center ◽  
Monthly Basis ◽  
Septal Defects

Background: Congenital heart disease (CHD), the most common cardiac malformation in the fetal and neonatal period, represents a heterogeneous group of defects with little known cause. Despite advances in detection and treatment, CHD accounts for 3% of all infant deaths and 46% of death from congenital malformations. CHD patients with minimum or no symptoms are frequently under diagnosed in areas with inadequate health services. The aim of this study was to investigate the role of clinical suspicion of congenital heart disease in babies who presented for well-baby follow-up against echocardiographic findings and to study the clinical spectrum of all the CHD that were diagnosed. Methods: The study involved analysis of data collected by the authors while working in a tertiary care center at Mumbai, India, during 2009 to 2010. All the babies born from April 2009 to August 2010 (17 months) and those who came for well-baby visits (with or without symptoms) were examined carefully for findings on cardiac examination including abnormalities of heart sound and presence of murmur on auscultation. Findings of the echocardiography were recorded for follow up and all the babies were followed up on at least three-monthly basis. Echocardiography was repeated on a quarterly basis in symptomatic babies and six-monthly basis in asymptomatic babies with small septal defects. All the babies on follow up were closely monitored clinically and on echocardiography for ascertaining the natural course of the observed defects. Results: A total of 1856 babies were born at the tertiary care center out of which 1688 were seen at the well-baby clinic. A total of 42 cases were referred for echocardiography on clinical suspicion of CHD and out of these 21 (50%) were positive for some form of CHD. Most common CHD diagnosed was atrial septal defect (ASD). There was no spontaneous closure of ventricular septal defects (VSD), though, 02 cases of ASD less than 3 mm closed during the during the follow up period.Conclusions: This study demonstrated that clinical experience is a valuable tool in early diagnosis of CHD, even if they are asymptomatic. Early echocardiography is justified to diagnose the cases so that appropriate follow-up and management decisions could be planned. Though majority of the cases were moderate to small ASD and VSD, there is a need to diagnose them early and follow them up till closure.

scholarly journals What do adult patients with congenital heart disease know about their disease, treatment, and prevention of complications? A call for structured patient education

Heart ◽  
2001 ◽  
Vol 86 (1) ◽  
pp. 74-80
Author(s):  
P Moons ◽  
E De Volder ◽  
W Budts ◽  
S De Geest ◽  
J Elen ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Adult Congenital Heart Disease ◽  
Tertiary Care ◽  
Educational Interventions ◽  
Heart Defect ◽  
The Impact

OBJECTIVETo assess how much adults with congenital heart disease understand about their heart defect, its treatment, and the preventive measures necessary to avoid complications.DESIGNDescriptive, cross sectional study.SETTINGAdult congenital heart disease programme in one tertiary care centre in Belgium.PATIENTS62 adults with congenital heart disease (47 men; 15 women), median age 23 years.MAIN OUTCOME MEASURESPatients' knowledge was assessed during an outpatient visit using the Leuven knowledge questionnaire for congenital heart diseases, a 33 item instrument developed for this study.RESULTSPatients had adequate knowledge (> 80% correct answers) about their treatment, frequency of follow up, dental practices, occupational choices, appropriateness of oral contraceptives, and the risks of pregnancy. Knowledge about the name and anatomy of the heart defect, the possibility of recurrent episodes of endocarditis during their lifetime, and the appropriateness of different physical activities was moderate (50–80% correct answers). There was poor understanding (< 50% correct answers) about the reasons for follow up, the symptoms of deterioration of the heart disease, the definition, characteristics, and risk factors of endocarditis, the impact of smoking and alcohol on the heart disease, the hereditary nature of the condition, and the suitability of intrauterine devices as contraceptives.CONCLUSIONSAdults with congenital heart disease have important gaps in their knowledge about their condition. The results of this study can be used as a basis for developing or optimising structured educational interventions to enhance patients' health behaviour.

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