scholarly journals The Comparison of Direct Laryngoscopy and Video Laryngoscopy in Pediatric Airways Management for Congenital Heart Surgery: A Randomized Clinical Trial

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Fatemeh Javaherforooshzadeh ◽  
Laleh Gharacheh
Keyword(s):  
Clinical Trial ◽  
Heart Disease ◽  
Randomized Clinical Trial ◽  
Direct Laryngoscopy ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Congenital Heart Surgery ◽  
Video Laryngoscopy ◽  
The Third ◽  
Time Required

Background: Airway management in patients with hereditary heart disease is an important therapeutic intervention. Objectives: The purpose of this study was to compare direct laryngoscopy (DL) with video laryngoscopy (VL) in pediatric airways management for congenital heart surgery. Methods: This study was designed as a prospective randomized clinical trial. Two consecutive groups of 30 patients undergoing elective noncyanotic congenital heart surgery. The patients were divided into direct laryngoscopy versus video laryngoscopy for intubation of the trachea. The main outcomes were the number of success rate in the first attempt, and the secondary outcomes were the duration of successful intubation and complications, such as desaturation and bradycardia. Results: Intubation procedure time was measured as 51.13 ± 17.88 seconds for the group with direct laryngoscopy and 59.66 ± 45.91 seconds for group with VL that was significant (P = 0.006). In DL group, 22 patients were intubated on the first attempt, 8 patients on the second attempt, and 6 patients on the third attempt, compared to 24, 6, and 2 respectively, in VL group. The differences were significant only in the third attempt between groups (P = 0.033). The important difference established in heart rate (HR) and SpaO2 amounts between the two groups at any time (P < 0.05). Conclusions: VL can produce better visualization for intubation of trachea in congenital heart disease, but this is time-consuming. Indeed, training in the use of the VL should be increased to reduce the time required for performance. Moreover, further studies are recommended to approve these helpful findings.

scholarly journals The effect of sevoflurane versus propofol anesthesia on troponin I after congenital heart surgery, a randomized clinical trial

2015 ◽  
Vol 4 (1) ◽  
pp. 86 ◽  
Author(s):  
Ahmad Entezari ◽  
Habibollah Hosseini ◽  
SyedHossein Moshtaghioon ◽  
Ehsan Salehi ◽  
Azam Rafie ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Troponin I ◽  
Congenital Heart Surgery

The elephant in the room: ethical issues associated with rare and expensive medical conditions

2015 ◽  
Vol 25 (8) ◽  
pp. 1621-1625 ◽  
Author(s):  
Constantine D. Mavroudis ◽  
Constantine Mavroudis ◽  
Jeffrey P. Jacobs
Keyword(s):  
Resource Allocation ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Ethical Issues ◽  
Healthcare Resource ◽  
Congenital Heart Surgery ◽  
Medical Conditions ◽  
Economic Perspectives

AbstractThe treatment of rare and expensive medical conditions is one of the defining qualities of paediatric cardiology and congenital heart surgery. Increasing concerns over healthcare resource allocation are challenging the merits of treating more expensive forms of congenital heart disease, and this trend will almost certainly continue. In this manuscript, the problems of resource allocation for rare and expensive medical conditions are described from philosophical and economic perspectives. The argument is made that current economic models are limited in the ability to assess the value of treating expensive and rare forms of congenital heart disease. Further, multi-disciplinary approaches are necessary to best determine the merits of treating a patient population such as those with significant congenital heart disease that sometimes requires enormous healthcare resources.

scholarly journals Evaluation of Complications of Heart Surgery in Children With Congenital Heart Disease at Dena Hospital of Shiraz

2015 ◽  
Vol 8 (5) ◽  
pp. 33 ◽  
Author(s):  
Maryam Mirzaei ◽  
Samaneh Mirzaei ◽  
Elham Sepahvand ◽  
Afifeh Rahmanian Koshkaki ◽  
Marzieh Kargar Jahromi
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Vascular Complications ◽  
Congenital Heart Surgery ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Cross Sectional

<p><strong>INTRODUCTION:</strong> Today, with progress in the field of congenital heart surgery, different complicated actions are done in children. These actions may be associated with several complications, especially open heart surgery in which the cardiopulmonary bypass (CPB) is used. Serious complications can be caused high morbidity and mortality rates. Present study has been performed to determine the incidence of morbidity and mortality in cardiac surgery in children.</p> <p><strong>METHOD:</strong> In a cross-sectional retrospective, records of 203 patients undergoing surgery for congenital heart disease in Dena hospital during 2013-2015 were reviewed for incidence of complications. Data was analyzed by using descriptive and analytical statistics and using SPSS version 18.</p> <p><strong>RESULTS:</strong> The mean age of samples was 3/65±4/47 years. The majority of samples (73/8%) were undergoing open surgery. The overall adverse cardiovascular complications were respectively, renal complications (44/3%), lung (40/3%), anemia (35/9%), heart (34/4%), gastrointestinal (17/2%), brain (14/2%), need for re-intubation of the trachea 11/3%), infection (7/8%) required reoperation (5/9%) and vascular complications (1/4%).</p> <p><strong>CONCLUSION:</strong> High incidence of complications after congenital heart surgery makes necessary attention to complications and their treatment after surgery. It is necessary to apply the measures and careful monitoring of patients to minimize these effects.</p>

scholarly journals Early extubation after congenital heart surgery

2014 ◽  
Vol 4 (3) ◽  
pp. 156-161 ◽  
Author(s):  
Mirza Halimić ◽  
Senka Mesihović Dinarević ◽  
Zijo Begić ◽  
Almira Kadić ◽  
Sanko Pandur ◽  
...  
Keyword(s):  
Heart Disease ◽  
Blood Transfusion ◽  
Odds Ratio ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Prolonged Mechanical Ventilation ◽  
Surgical Techniques ◽  
Congenital Heart Surgery ◽  
Early Extubation ◽  
Group I

Introduction: Despite recent advances in anesthesia, cardiopulmonary bypass and surgical techniques, children undergoing congenital heart surgery require postoperativemechanical ventilation. Early extubation was definedas ventilation shorter than 12 hours. Aim of this study is to identify factors associated with successful early extubation after pediatric cardiac surgery.Methods: The study was performed during period from January 2006 to January 2011 at Pediatric Clinic and Heart Center University Clinical center Sarajevo. One hundred children up to 5 years of age, who have had congenital heart disease, with left–right shunt and obstructive heart disease were included in the study. Patients were divided into two groups: Group I - patients extubated within 12 hours after surgery and Group II - patients extubated 12 or more hours after surgery. Results: The most frequently encountered preoperative variables were age with odds ratio 4% 95%CI (1-7%), Down's syndrome 8.5 95%CI (1.6-43.15), failure to thrive 4.3 95%CI( 1-18). Statistically significant postoperative data included lung disease (reactive airways, pneumonia, atelectasis, pneumothorax) and with odds ratio 35.1 95 %CI (4-286) and blood transfusion with odds ratio 4.6 95%CI (2-12). Blood transfusion (p=0.002) (Wald=9.2) 95%CI (2-12), during as well as after operation procedure has statistically significant influence on prediction time of extubation. Proven markers were age with cut of 21.5 months (sensitivity 74% and specificity 70%) and extracorporeal circulation (ECC) with cut-of 45.5 minutes (sensitivity 71% and specificity 65%).Conclusion: Early extubation is possible in many children undergoing congenital heart surgery. Younger age and prolonged ECC time are markers associated with prolonged mechanical ventilation.

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