Publications by authors named "Molly Dreher"

Background: Acute kidney injury after pediatric cardiac surgery is a common complication with few established modifiable risk factors. We sought to characterize whether indexed oxygen delivery during cardiopulmonary bypass was associated with postoperative acute kidney injury in a large pediatric cohort.

Methods: This was a retrospective analysis of patients under 1 year old undergoing cardiac surgery with cardiopulmonary bypass between January 1, 2013, and January 1, 2020.

View Article and Find Full Text PDF
Article Synopsis
  • Cardiopulmonary bypass practices in pediatric patients are evolving, driven by new technologies and techniques, with a focus on gathering updated international data since 2016.
  • A recent survey in July 2021 garnered responses from 153 of 284 pediatric cardiac surgery centers worldwide, reflecting a diverse range of practices in equipment and techniques.
  • Key findings include widespread use of roller head pumps (93%), hollow fiber oxygenators (86%), and selective antegrade cerebral perfusion (92%), indicating significant trends and variations in pediatric perfusion practices globally.
View Article and Find Full Text PDF

Background: Ultrafiltration (UF) is used for fluid removal during and after infant cardiopulmonary bypass (CPB) surgery to reduce fluid overload. Excessive UF may have the opposite of its intended effect, resulting in acute kidney injury (AKI), oliganuria, and fluid retention.

Methods: This is a single-center, retrospective review of infants treated with conventional and/or modified UF during CPB surgery.

View Article and Find Full Text PDF

Objectives: Neurodevelopmental injury after cardiac surgery using cardiopulmonary bypass (CPB) for congenital heart defects is common, but the mechanism behind this injury is unclear. This study examines the impact of CPB on cerebral mitochondrial reactive oxygen species (ROS) generation and mitochondrial bioenergetics.

Methods: Twenty-three piglets (mean weight 4.

View Article and Find Full Text PDF

Introduction: A device that may help attenuate the amount of homologous blood product given to pediatric cardiac surgical patients is the autotransfusion device. Three separate autotransfusion devices were selected for evaluation. The Sorin Xtra, Fresenius Continuous Autotransfusion System Plus (CATS), and the Fresenius Continuous Autotransfusion System Smart (CATSmart) were evaluated based on the mechanical processes of each device, hematocrit value of the salvaged packed red cell product, time of processing, and the advantageous accessories with each device.

View Article and Find Full Text PDF

Cardiac surgery with the use of cardiopulmonary bypass (CPB) is known to induce an inflammatory response in patients. This response may be even more pronounced in pediatric patients given their small body size compared to adults. Several interventions have been instituted in an effort to attenuate this response, including the use of corticosteroids in the pump prime.

View Article and Find Full Text PDF