The Enhanced Recovery After Surgery protocol for the surgical management of craniosynostosis: Lausanne experience.

Objective: Over the past decade, the Enhanced Recovery After Surgery (ERAS) program has demonstrated its effectiveness and efficiency in improving postoperative care and enhancing recovery across various surgical fields. Preliminary results of ERAS protocol implementation in craniosynostosis surgery are presented.

Methods: An ERAS protocol was developed and implemented for cranial pediatric neurosurgery, focusing on craniosynostosis repair.

Outcome of humanitarian patients with late complete repair of tetralogy of Fallot: A 13-year long single-center experience.

Background: Surgical repair of tetralogy of Fallot is usually performed between 3 and 6 months of age with pulmonary valve-sparing repair promoted for the best long-term result. Through a humanitarian program from developing countries, late complete surgical repair of tetralogy of Fallot has been performed at our institution for many years.

Methods: Retrospective analysis of pre- and perioperative data, as well as 30-days outcome of patients older than one year with a confirmed diagnosis of tetralogy of Fallot who had a complete surgical repair between 2005 and 2018 at our institution.

Point-of-care HEMOstasis in children with congenital heart disease, the POCHEMO study: Rotational thromboelastometry and impedance aggregometry in children with cyanotic and non-cyanotic congenital heart disease.

Children with cyanotic congenital heart diseases have a higher risk of bleeding or thrombosis. Rotational thromboelastometry, using tissue factor (EXTEM), a contact activator (INTEM), or cytochalasin (FIBTEM), assesses coagulation by determining the time to initiation of clotting (CT) and clot firmness (MCF), including platelet-fibrin-interaction. This study aimed to evaluate rotational thromboelastometry and whole blood impedance aggregometry in cyanotic congenital heart diseases (CCHD) compared with a control group without chronic cyanosis (NCHD) in a pediatric cohort.

Point-of-care hemostasis in children with congenital heart disease, the POCHEMO study: baseline reference values of thromboelastometry and impedance aggregometry.

: Viscoelastic tests and impedance aggregometry allow coagulation evaluation at the bedside, but reference values are scarce in pediatrics. The aim of this study was to establish reference values of thromboelastometry and impedance aggregometry for this population and compare it between age groups. This prospective, single-center, observational study evaluates viscoelastic tests and impedance aggregometry in children with congenital heart disease.

Anesthetic Management for Concomitant Correction of Congenital Cardiac Defects and Long "O" Ring Tracheal Stenosis: A Role for Heliox?: Report of 2 Cases.

We present 2 infants with the rare association of long congenital tracheal stenosis, ventricular septal defect, and pulmonary hypertension. We describe a step-by-step assessment of the patients and the necessary procedures for a successful concomitant repair of both cardiac and tracheal malformations. The use of a helium-oxygen mixture (heliox) for the induction of anesthesia and pre-cardiopulmonary bypass is discussed.

Improvement in perioperative care in pediatric cardiac surgery by shifting the primary focus of treatment from cardiac output to perfusion pressure: Are beta stimulants still needed?

Objective: An important aspect of perioperative care in pediatric cardiac surgery is maintenance of optimal hemodynamic status using vasoactive/inotropic agents. Conventionally, this has focused on maintenance of cardiac output rather than perfusion pressure. However, this approach has been abandoned in our center in favor of one focusing primarily on perfusion pressure, which is presented here and compared to the conventional approach.

Levosimendan in a neonate with severe coarctation of aorta and low cardiac output syndrome.

We report successful use of levosimendan after failed balloon angioplasty in a critically ill neonate with coarctation of aorta (CoA) and severe low cardiac output syndrome (LCOS). Treatment with levosimendan improved left heart function, and decreased lactate and brain natriuretic peptide levels. To our knowledge, this is the first report on the safe and successful use of levosimendan in the management of LCOS due to severe CoA in a neonate awaiting surgical repair.

Endurance training enhances vasodilation induced by nitric oxide in human skin.

Endurance training modifies the thermoregulatory control of skin blood flow, as manifested by a greater augmentation of skin perfusion for the same increase in core temperature in athletes, in comparison with sedentary subjects. In this study, we tested the hypothesis that a component of this adaptation might reside in a higher ability of cutaneous blood vessels to respond to vasodilatory stimuli. We recruited healthy nonsmoking males, either endurance trained or sedentary, in two different age ranges (18-35 y and >50 y).

Endothelium-dependent vasodilation in the skin microcirculation of patients with septic shock.

The evidence for endothelial dysfunction in sepsis is mostly restricted to animal models. We investigated endothelial function in the skin microcirculation of eight patients hospitalized for septic shock in an intensive care unit (ICU). All patients required adrenergic support.