The impact of viral respiratory infection on surgical outcome of cavopulmonary shunt.

Undetected respiratory infections may adversely affect the intrapulmonary resistance after Stage 2 or Stage 3 Fontan palliation. A few studies describe a higher risk for viral pneumonia during respiratory virus season, but none of them have focused on the effect of symptomatic viral pneumonia on in-hospital clinical course after bidirectional Glenn shunt. We analysed 77 patients who underwent bidirectional Glenn shunt surgery.

Impact of Inhaled Nitric Oxide (iNO) on the Outcome of COVID-19 Associated ARDS.

Inhaled nitric oxide (iNO) can improve oxygenation in acute respiratory syndrome (ARDS), has anti-inflammatory and antithrombotic effects, and can inhibit coronavirus- replication. The study aim was to investigate the impact of iNO in COVID-19 associated ARDS (CARDS) on oxygenation, the length of mechanical ventilation (MV), the level of inflammatory markers and the rate of thrombotic events during ICU stay. This was a retrospective, observational, monocentric study analyzing the effect of INO (15 parts per million) vs.

Laryngeal Mask Airway Versus Endotracheal Intubation during Lacrimal Duct Stenosis Surgery in Children-A Retrospective Analysis.

The use of laryngeal masks in the surgical treatment of infantile lacrimal duct stenosis is controversial due to the potential risk of aspiration. This study investigates airway procedures in children aged <6 years for surgery of lacrimal duct stenosis in a tertiary care university hospital. After institutional approval, airway procedures, duration of anesthesiological measures, and airway-related complications were retrospectively analyzed.

Evaluation of a modified paediatric early warning score for children with congenital heart disease.

Background: Paediatric early warning score systems are used for early detection of clinical deterioration of patients in paediatric wards. Several paediatric early warning scores have been developed, but most of them are not suitable for children with cyanotic CHD who are adapted to lower arterial oxygen saturation.

Aim: The present study compared the original paediatric early warning system of the Royal College of Physicians of Ireland with a modification for children with cyanotic CHD.

3D-printed facet-attached optical elements for beam shaping in optical phased arrays.

We demonstrate an optical phased-array equipped with a 3D-printed facet-attached element for shaping and deflection of the emitted beam. The beam shaper combines freeform refractive surfaces with total-internal-reflection mirrors and is in-situ printed to edge-emitting waveguide facets using high-resolution multi-photon lithography, thereby ensuring precise alignment with respect to on-chip waveguide structures. In a proof-of-concept experiment, we achieve a grating-lobe free steering range of ±30 and a full-width-half-maximum beam divergence of approximately 2.

Human metapneumovirus infection in the cardiac paediatric ICU before and during COVID-19 pandemic: a retrospective cohort analysis.

Introduction: This study investigates the hygiene standards in the context of the COVID-19 pandemic and their impact on the perioperative incidence of human metapneumovirus as well as the typical symptom burden of human metapneumovirus-infected children with CHDs.

Materials And Methods: Between March 2018 and July 2021, all patients of a cardiac paediatric ICU of a German university hospital were included in this retrospective cohort analysis.

Results: A total of 589 patients with CHD were included in the analysis.

Nalbuphine as analgesic in preschool children undergoing ophthalmic surgery and the occurrence of emergence delirium.

Background/aims: Perioperative pain in children is often inadequately treated, and emergence agitation is common. The purpose of this analysis was to determine whether nalbuphine is suitable for perioperative eye pain and to analyse if it influences the occurrence of emergence delirium/agitation (EDA) in children undergoing ophthalmic surgery in general anaesthesia.

Methods: Retrospective cohort analysis of 50 children in preschool age undergoing general anaesthesia for ophthalmic surgery receiving nalbuphine as a postoperative analgesic in a German university hospital from June 2020 to February 2021.

Dexmedetomidine as a sole sedative for procedural sedation in preterm and neonate infants: A retrospective analysis.

Background: Many different sedation concepts for magnetic resonance imaging have been described for prematurely and term-born infants, ranging from "no sedation" to general anesthesia. Dexmedetomidine is an alpha-2 receptor agonist that is frequently used to sedate older children, because the anesthesiologist can easily adjust sedation depth, the patient maintains spontaneous breathing, and awakens rapidly afterwards.

Aims: The present study evaluates whether dexmedetomidine could safely be used as the sole sedative for prematurely and term-born infants less than 60 weeks postconceptional age undergoing diagnostic procedures.

Impact of Lactate Clearance on Early Outcomes in Pediatric ECMO Patients.

Pediatric extracorporeal membrane oxygenation (ECMO) support is often the ultimate therapy for neonatal and pediatric patients with congenital heart defects after cardiac surgery. The impact of lactate clearance in pediatric patients during ECMO therapy on outcomes has been analyzed. Materials We retrospectively analyzed data from 41 pediatric vaECMO patients between January 2006 and December 2016.

Severe Hyponatraemia Associated with the Use of Arginine-Vasopressin in Two Neonates with Complex Congenital Heart Disease.

We report two cases of neonates with complex congenital heart disease and volume, catecholamine, and corticosteroid refractory shock treated with arginine-vasopressin. Arginine-vasopressin was able to reverse critical hypotension, but both patients developed severe hyponatremia, which recovered after discontinuation of arginine-vasopressin. Close control and prompt substitution of serum sodium is required in neonates with advanced heart failure on high-dose vasopressin therapy.

RACHS-1 score as predictive factor for postoperative ventilation time in children with congenital heart disease.

Background: Congenital heart disease is the most frequent malformation in newborns. The postoperative mortality of these patients can be assessed with the Risk Adjustment in Congenital Heart Surgery-1 (RACHS-1) score. This study evaluates whether the RACHS-1 score can also be used as a predictor for the length of postoperative ventilation and what is the influence of age.

Orbit in a Box: A Simplified Technique for Patient-Specific Virtually Planned Orbital Floor Reconstruction.

Purpose: Possibilities for the reconstruction of orbital floor fractures have been extensive for years with regard to materials, methods and differential indications and are inconsistent worldwide. With the spread of CAD/CAM techniques, new and mostly time-consuming possibilities for orbital floor reconstructions have been added.

Methods: The simple and time-efficient CT-to-patient-specific implant workflow presented here shows that a "form-box" can be created from a patient's computer tomography data set using planning software and a 3D printer.

Endoscopic ultrasound-guided tissue sampling of small subepithelial tumors of the upper gastrointestinal tract with a 22-gauge core biopsy needle.

 The optimal approach to small subepithelial tumors (SETs) of the upper gastrointestinal tract remains inconclusive. The aim of this study was to evaluate endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for less invasive tissue sampling of small SETs of the upper gastrointestinal tract.  In this prospective observational study patients with small ( ≤ 3 cm) SETs of the upper gastrointestinal tract were eligible and underwent EUS-FNB with a 22-gauge core biopsy needle.

Bottom-Up Fabrication of Hybrid Plasmonic Sensors: Gold-Capped Hydrogel Microspheres Embedded in Periodic Metal Hole Arrays.

The high potential of bottom-up fabrication strategies for realizing sophisticated optical sensors combining the high sensitivity of a surface plasmon resonance with the exceptional properties of stimuli-responsive hydrogel is demonstrated. The sensor is composed of a periodic hole array in a gold film whose holes are filled with gold-capped poly(N-isoproyl-acrylamide) (polyNIPAM) microspheres. The production of this sensor relies on a pure chemical approach enabling simple, time-efficient, and cost-efficient preparation of sensor platforms covering areas of cm.

A Cross-Sectional Survey of Near-Infrared Spectroscopy Use in Pediatric Cardiac ICUs in the United Kingdom, Ireland, Italy, and Germany.

Objectives: Despite the increasing use of near-infrared spectroscopy across pediatric cardiac ICUs, there is significant variability and equipoise with no universally accepted management algorithms. We aimed to explore the use of near-infrared spectroscopy in pediatric cardiac ICUs in the United Kingdom, Ireland, Italy, and Germany.

Design: A cross-sectional multicenter, multinational electronic survey of one consultant in each pediatric cardiac ICU.

Controversies in arrhythmias and arrhythmic syndromes of active children and young adults.

Important advances in the diagnosis and therapy of various arrhythmic disorders have been made in the last two decades. These, in turn, have necessitated a re-examination of current practice guidelines, with a view to deciding on optimal management of young patients with suspected or proven arrhythmia syndromes and in assessing the risk of adverse arrhythmic events during sport participation. There has also been a concomitant emphasis on identifying individuals at risk by nationwide screening programs using the ECG and excluding them from competitive sport.

Enhancing second harmonic generation in gold nanoring resonators filled with lithium niobate.

Plasmonic nanorings provide the unique advantage of a pronounced plasmonic field enhancement inside their core. If filled with a polarizable medium, it may significantly enhance its optical effects. Here, we demonstrate this proposition by filling gold nanorings with lithium niobate.

Emergency video capsule endoscopy in patients with acute severe GI bleeding and negative upper endoscopy results.

Background: In mid-GI bleeding, video capsule endoscopy (VCE) shows the best diagnostic yield for ongoing overt bleeding. To date, the utility of VCE in acute severe GI bleeding has been analyzed rarely.

Objective: To evaluate the impact of VCE when performed on patients with acute severe GI bleeding immediately after an initial negative upper endoscopy result.

The spectral shift between near- and far-field resonances of optical nano-antennas.

Within the past several years a tremendous progress regarding optical nano-antennas could be witnessed. It is one purpose of optical nano-antennas to resonantly enhance light-matter interactions at the nanoscale, e.g.

Deep-subwavelength plasmonic nanoresonators exploiting extreme coupling.

A metal-insulator-metal (MIM) waveguide is a canonical structure used in many functional plasmonic devices. Recently, research on nanoresonantors made from finite, that is, truncated, MIM waveguides attracted a considerable deal of interest motivated by the promise for many applications. However, most suggested nanoresonators do not reach a deep-subwavelength domain.

Phase anomalies in Talbot light carpets of self-images.

An interesting feature of light fields is a phase anomaly, which occurs on the optical axis when light is converging as in a focal spot. Since in Talbot images the light is periodically confined in both transverse and axial directions, it remains an open question whether at all and to which extent the phase in the Talbot images sustains an analogous phase anomaly. Here, we investigate experimentally and theoretically the anomalous phase behavior of Talbot images that emerge from a 1D amplitude grating with a period only slightly larger than the illumination wavelength.

Inducible nitric oxide synthase contributes to immune dysfunction following trauma.

Trauma results in a persistent depression in adaptive immunity, which contributes to patient morbidity and mortality. This state of immune paralysis following trauma is characterized by a change in cell-mediated immunity, specifically a depression in T-cell function and a shift toward TH2 T-cell phenotype. Upregulation of inducible nitric oxide synthase (iNOS) is well recognized after injury and contributes to the inflammatory response and organ damage early after trauma.

Perfect absorbers on curved surfaces and their potential applications.

Recently perfect metamaterial absorbers triggered some fascination since they permit the observation of an extreme interaction of light with a nanostructured thin film. For the first time we evaluate here the functionality of such perfect absorbers if they are applied on curved surfaces. We probe their optical response and discuss potential novel applications.