Postoperative Atrioventricular Block in Pediatric Patients: Impact of Congenital Cardiac Malformations and Medications.

Postoperative atrioventricular block may occur after pediatric cardiac surgery. A small proportion of those who develop atrioventricular block will require pacemaker placement. The primary aim of this study was to determine factors associated with postoperative atrioventricular block.

The utility of a structured, interactive cardiac anatomy teaching session for resident education.

Background: Paediatric residents are often taught cardiac anatomy with two-dimensional images of heart specimens, or via imaging such as echocardiography or computed tomography. This study aimed to determine if the use of a structured, interactive, teaching session using heart specimens with CHD would be effective in teaching the concepts of cardiac anatomy.

Methods: The interest amongst paediatric residents of a cardiac anatomy session using heart specimens was assessed initially by circulating a survey.

Impact of Medical Interventions and Comorbidities on Norwood Admission for Patients with Hypoplastic Left Heart Syndrome.

The purpose of these analyses was to determine how specific comorbidities and medical interventions impact risk of inpatient mortality in those with hypoplastic left heart syndrome undergoing Norwood procedure. The secondary aims were to determine the impact of these on billed charges, postoperative length of stay, and risk of cardiac arrest. Admissions from 2004 to 2015 in the Pediatric Health Information System database with hypoplastic left heart syndrome and Norwood procedure were identified.

Alpha-blockade during congenital heart surgery admissions: analysis from national database.

Introduction: The effects of alpha-blockade on haemodynamics during and following congenital heart surgery are well documented, but data on patient outcomes, mortality, and hospital charges are limited. The purpose of this study was to characterise the use of alpha-blockade during congenital heart surgery admissions and to determine its association with common clinical outcomes.

Materials And Methods: A cross-sectional study was conducted using the Pediatric Health Information System database.

Venous blood gases in pediatric patients: a lost art?

Blood oximetry provides a fundamental approach to blood gases for inpatients. Arterial blood gases (ABG) have been considered the gold standard for blood oximetry assessment. Venous blood gas (VBG) evaluation is frequently available and provides a source of a more comfortable method for the assessment of blood oximetry in pediatric patients.

The effect of dexmedetomidine on renal function after surgery: A systematic review and meta-analysis.

What Is Known And Objective: Acute kidney injury (AKI) is a complication following surgery and has been associated with worsened patient outcomes. Providers have used agents that may confer a degree of renal protection in the perioperative stage. Such is the case of dexmedetomidine, a selective alpha-2 adrenergic agonist used in the intensive care unit (ICU) as a sedative agent.

Correlation of Near-Infrared Spectroscopy Oximetry and Corresponding Venous Oxygen Saturations in Children with Congenital Heart Disease.

Invasive and non-invasive monitoring allow for early detection of hemodynamic compromise, facilitating timely intervention and avoidance of further decline. While venous oximetry is useful for assessing the adequacy of systemic oxygen delivery (DO), it is most often intermittent, invasive, and costly. Near-infrared spectroscopy (NIRS) oximetry allows for the non-invasive estimation of the adequacy of DO.

Effects of Fenoldopam in the Pediatric Population: Fluid Status, Serum Biomarkers, and Hemodynamics: A Systematic Review and Meta-Analysis.

Fluid overload is a frequent complication in children during critical illness. Fluid restriction and diuretic agents have been the mainstay therapies so far. Fenoldopam, a selective dopamine-1 receptor agonist, is a diuretic agent with promising effects in the pediatric population.

Technical Modifications That Might Improve Long-term Outcomes of the Ross Procedure in Children.

Background: Failure of the pulmonary valve autograft (PVA) after the Ross procedure (RP) has discouraged its widespread use and has led to modifications or alternatives to the procedure. We sought to analyze whether certain technical modifications could improve results of the RP in children.

Methods: Sixty-nine patients (median age, 12 years; range, 0.

Use of Fenoldopam in Children with Congenital Heart Disease to Decrease Fluid Balance: A Retrospective, Descriptive Study and Insights into Predictors of Decreased Fluid Balance.

This retrospective study aimed to determine if fenoldopam is associated with a decrease in fluid balance and to define the factors that may promote this in children with a history of congenital heart disease at the cardiac intensive care unit (CICU). Patients cared from January 2014 to December 2018 in the CICU were reviewed, and those on fenoldopam infusion were identified. Patient cohort data included demographics, clinical information, laboratory results, hemodynamic and urine output measurements, and information regarding fenoldopam infusion were compared between those with and without decrease in fluid balance.

The impact of medical interventions on admission characteristics in children with congenital heart disease and cardiomyopathy.

Introduction: Children with congenital heart disease and cardiomyopathy are a unique patient population. Different therapies continue to be introduced with large practice variability and questionable outcomes. The purpose of this study is to determine the impact of various medications on intensive care unit length of stay, total length of stay, billed charges, and mortality for admissions with congenital heart disease and cardiomyopathy.

Troponin elevation in the setting of exercise-induced rhabdomyolysis in an athletic teenager.

Troponin levels are often obtained when chest pain is evaluated in the paediatric emergency department. Elevations in troponin levels can be due to different causes, and it is important to fully understand all of these possible causes to help streamline further evaluation and therapy. We present the case of a teenager who had two episodes of troponin elevation in the setting of rhabdomyolysis.

Neurally adjusted ventilatory assist versus conventional ventilation in the pediatric population: Are there benefits?

Introduction: Neurally-adjusted ventilator assist (NAVA) is a relatively new form of ventilation in which the electrical activity of the diaphragm is sensed by a catheter. The amplitude of this electrical signal is then used to deliver an appropriately proportioned pressure supported breath to the patient. Due to the synchronous nature of the breaths and the patient-adjusted nature of the support, NAVA has been shown to have benefits over conventional ventilation.