Mortality prediction in pediatric postcardiotomy veno-arterial extracorporeal membrane oxygenation: A comparison of scoring systems.

Background: Pediatric postcardiotomy veno-arterial extracorporeal membrane oxygenation (VA-ECMO) patients have high mortality and morbidity. There are currently three scoring systems available to predict mortality: the Pediatric Extracorporeal Membrane Oxygenation Prediction (PEP) model, Precannulation Pediatric Survival After VA-ECMO (Pedi-SAVE) score, and Postcannulation Pedi-SAVE score. These methods provide risk stratification scores for pediatric patients requiring ECMO for cardiac support.

Risk factors and outcomes associated with acute kidney injury following extracardiac total cavopulmonary connection: a retrospective observational study.

Background: Total cavopulmonary connection (TCPC) is an important operation for the treatment of complex congenital heart disease. Epidemiology and outcomes for pediatric patients with acute kidney injury (AKI) following extracardiac TCPC have not been well documented. This study investigates the prevalence, risk factors, and outcomes of AKI in children after extracardiac TCPC surgery.

Risk Factors and Long-Term Prognosis for Chylothorax After Total Cavopulmonary Connection in Children: A Retrospective Study From a Single Center.

Chylothorax is a severe complication after total cavopulmonary connection (TCPC) in children. This study was performed to evaluate the incidence, risk factors, and short- and long-term prognosis for chylothorax. We retrospectively reviewed the electronic records of patients who underwent TCPC between January 2008 and December 2020 in Fuwai Hospital.

The lower threshold of hypothermic oxygen delivery to prevent neonatal acute kidney injury.

Background: Oxygen delivery during cardiopulmonary bypass (CPB) is closely related to postoperative acute kidney injury (AKI). The value of critical indexed oxygen delivery (DOi) is a key indicator to reflect oxygen supply in cardiovascular surgery. However, the target DOi value for neonates undergoing hypothermic CPB remains unclear.

Investigation of myocardial protection during pediatric CPB: Practical experience in 100 Chinese hospitals.

Many measures have been proposed for myocardial protection in pediatric congenital heart surgeries, but little data is available for China. This study investigates myocardial protection strategies in pediatric cardiopulmonary bypass (CPB) throughout China. Online questionnaires were delivered to 100 hospitals in 27 provinces.

Outcomes and factors associated with early mortality in pediatric postcardiotomy veno-arterial extracorporeal membrane oxygenation.

Mortality and morbidity of children received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support after cardiac surgery remain high despite remarkable advances in medical management and devices. The purpose of this study was to describe outcomes and risk factors of applying VA-ECMO in the surgical pediatric population. We retrospectively analyzed 85 consecutive pediatric patients (aged <18 years) who received postcardiotomy VA-ECMO from January 2010 to December 2018.

Effect of two different colloid priming strategies in infants weighing less than 5 kg undergoing on-pump cardiac surgeries.

Our aim was to explore the effect of two different priming strategies (artificial colloid only vs. artificial colloid combined with human serum albumin) on the prognosis of children weighing less than 5 kg undergoing on-pump congenital heart disease (CHD) surgery. A total of 65 children weighing less than 5 kg who underwent on-pump CHD surgery in our hospital from September 2016 to December 2017 were enrolled in this study.

Perioperative blood product transfusion of two different perfusion strategies on pediatric patients undergoing aortic arch surgery.

Simple regional cerebral perfusion (SRCP) or cerebro-myocardial perfusion (CMP) is selectively used in one-stage complex aortic arch malformation repair. This analysis was performed to investigate the effect of CMP and SRCP on perioperative blood product consumption, and to evaluate whether these two strategies have different effects on the clinical outcomes. A retrospective analysis of 284 children with complicated aortic malformation from January 2010 to June 2018 was performed.

Perioperative Outcomes of Using Different Temperature Management Strategies on Pediatric Patients Undergoing Aortic Arch Surgery: A Single-Center, 8-Year Study.

With the widespread application of regional low-flow perfusion (RLFP), development of surgical techniques, and shortened circulatory arrest time, deep hypothermia is indispensable for organ protection. Clinicians have begun to increase the temperature to reduce hypothermia-related adverse outcomes. The aim of this study was to evaluate the safety and efficacy of elevated temperatures during aortic arch surgery with lower body circulatory arrest (LBCA) combined with RLFP.

The influence of cardiopulmonary bypass priming without FFP on postoperative coagulation and recovery in pediatric patients with cyanotic congenital heart disease.

Unlabelled: Transfusion guidelines have been produced for the evidence-based use of fresh frozen plasma (FFP). However, the inappropriate use of FFP is still a worldwide problem, especially in the prophylactic settings. In the present study, 100 cyanotic pediatric patients (age 6 months to 3 years) undergoing cardiac surgery with cardiopulmonary bypass (CPB) were randomized to receive either 10-20 ml/kg FFP (FFP group, n = 50) or 10-20 ml/kg 4 % succinylated gelatin (Gelofusine, GEL group, n = 50) in the priming solution.

Five-year results of 121 consecutive patients treated with extracorporeal membrane oxygenation at Fu Wai Hospital.

Since 2004, our institution has adopted venoarterial (VA) extracorporeal membrane oxygenation (ECMO) for patients who otherwise could not be weaned from cardiopulmonary bypass and patients experiencing cardiogenic shock and/or pulmonary dysfunction unresponsive to conventional treatments. In this study, we reviewed our experience with ECMO support and tried to identify predictors of in-hospital mortality. We retrospectively analyzed the clinical records of 121 consecutive patients receiving ECMO.

Perioperative monitoring of thromboelastograph on blood protection and recovery for severely cyanotic patients undergoing complex cardiac surgery.

In this study, we assessed the clinical effect of a new transfusion therapy guided by thromboelastograph (TEG) on blood protection. Thirty-one children with severe cyanosis (hematocrit ≥54%), who were diagnosed as having transposition of the great arteries or double outlet right ventricle with or without pulmonary valve stenosis, and underwent arterial switch operation or double roots transplantation, were involved and were divided into two groups. In group F (n=17), the transfusion therapy after cardiopulmonary bypass was performed with fibrinogen administration combined with traditional transfusion, guided by TEG.

Effects of peri-operative glucose levels on adverse outcomes in infants receiving open-heart surgery for congenital heart disease with cardiopulmonary bypass.

Objective: Studies designed to evaluate the association of hyperglycemia and adverse events in pediatric patients receiving open cardiac surgery have yielded inconsistent results. The aim of this retrospective, observational study was to evaluate the effects of peri-operative glucose levels on adverse events in infants receiving open-heart surgery with CPB.

Methods: From Nov 2009 through Dec 2009, 100 infants undergoing open-heart surgery were enrolled.

[Retrospective analysis of 100 patients managed by extracorporeal membrane oxygenation].

Objective: To describe the experience with extracorporeal membrane oxygenation (ECMO) for cardiorespiratory support of 100 patients.

Methods: Retrospective analysis of the medical files of 100 patients submitted to the implant of extracorporeal membrane oxygenation system for cardiorespiratory assistance of acute and refractory cardiogenic shock from December 2004 to September 2008. There were 67 males and 33 females, age ranged from 5 d to 76 years with a mean of (28+/-26) years, body mass ranged from 3.

Perioperative monitoring of thromboelastograph on hemostasis and therapy for cyanotic infants undergoing complex cardiac surgery.

This study investigated features and treatments of perioperative coagulopathies in cyanotic infants with complex congenital heart disease (CCHD). Thirty-six infants with cyanotic CCHD were involved and divided into two groups: In group H (n = 20), hematocrit (HCT) > 54%, and in group L (n = 16), HCT < 54%. Blood was sampled at anesthesia induction (T1), rewarming to 36 degrees C (T2), after heparin neutralization (T3), and 4 h after operation (T4).

Retrospective analysis of 99 patients with the application of extracorporeal membrane oxygenation in Fuwai Hospital.

The purpose of this study was to retrospectively summarize and analyze the data of 99 cases with the application of consecutive extracorporeal membrane oxygenation (ECMO) from December 2004 to August 2008 in Fuwai Hospital. The intersurface of the ECMO equipment system was completely heparin coated. All patients received venoarterial ECMO, and the activated clotting time was maintained between 120 and 180 seconds.

Clinical application of pulsatile perfusion during cardiopulmonary bypass in pediatric heart surgery.

The benefits of pulsatile over nonpulsatile perfusion has been widely debated in pediatric cardiac operations with cardiopulmonary bypass (CPB). To evaluate the role of pulsatile perfusion in pediatric complicated patients with congenital heart disease undergoing open heart surgery, we performed pulsatile CPB and compared several effects with nonpulsatile perfusion. Pediatric patients (n = 24) diagnosed as typical tetralogy of Fallot (TOF) were randomly divided into two groups: pulsatile perfusion (PP) group and nonpulsatile perfusion (NP) group.

The myocardial protection of HTK cardioplegic solution on the long-term ischemic period in pediatric heart surgery.

Cardioplegic reperfusion during a long term ischemic period interrupts cardiac surgery and also increase cellular edema due to repeated administration. We reviewed the clinical experiences on myocardial protection of one single perfusion with histidine-ketoglutarate-tryptophan (HTK) for infants. This retrospective study included 118 infants who underwent open-heart surgery between January 2004 and December 2007.

Clinical outcomes and experience of 20 pediatric patients treated with extracorporeal membrane oxygenation in Fuwai Hospital.

The purpose of this study was to report retrospectively the summarized clinical findings from 20 consecutive pediatric extracorporeal membrane oxygenation (ECMO) patients and to investigate the factors associated with mortality. The ECMO circuit system was completely covered using heparin-coating technique, and venoarterial ECMO was used in all patients. Heparin dosage was 4-20 U/kg/h and active clotting time was maintained between 146 and 360 seconds.

The effect of preprocessing stored red blood cells on neonates undergoing corrective cardiac surgery.

This study compared the effect of unprocessed and processed packed red blood cells (PRBCs) with the continuous autotransfusion system (CATS) during neonate heart surgery. Sixteen neonatal patients undergoing cardiac surgery were randomly divided into two groups: unprocessed PRBC (C group, n = 8); processed PRBC (P group, n = 8). The CATS was employed perioperatively.

Application of modified perfusion technique on one stage repair of interrupted aortic arch in infants: a case series and literature review.

One stage repair of interrupted aortic arch (IAA) associated with cardiac anomalies in neonates and infants is challenging for the entire surgical team. Deep hypothermic circulatory arrest (DHCA) prolongs myocardial and cerebral ischemia and may induce heart, brain, and major organ dysfunction. From May 2004 to May 2006, 13 infants with IAA underwent one stage repair by median sternotomy under DHCA with continuous regional cerebral perfusion (RCP) in Fuwai Children's Heart Center.

Overactivation of poly(adenosine phosphate-ribose) polymerase 1 and molecular events in neuronal injury after deep hypothermic circulatory arrest: study in a rabbit model.

Objective: Although deep hypothermic circulatory arrest has been known to induce neuronal injury, the molecular mechanism of this damage has not been identified. We studied the key molecular mediators through cellular energy failure, excitotoxicity, and overactivation of poly(adenosine diphosphate-ribose) polymerase 1 in brain tissues of a rabbit model of deep hypothermic circulatory arrest similar to clinical settings.

Methods: We established 2 models of cardiopulmonary bypass (n = 15) and deep hypothermic circulatory arrest (n = 15) associated with cerebral microdialysis in rabbits.

Warm induction cardioplegia and reperfusion dose influence the occurrence of the post CABG TnI level.

As a new biochemical marker cardiac troponin-I (CTnI) is a more sensitive and specific marker for detection of differences in myocardium injuries than other chemical enzymes. This study investigates the effect of warm induced and reperfusion blood cardioplegia on the release of troponin-I during the CABG. In our research, 24 three-vessel coronary artery disease (CAD) patients underwent CABG and were divided into two groups randomly: Group of warm induction and reperfusion blood cardioplegia (Group W N=12); Group of simple warm induction and no reperfusion (Group C N=12).

Comparative effectiveness of methylprednisolone and zero-balance ultrafiltration on inflammatory response after pediatric cardiopulmonary bypass.

Studies have demonstrated that systemic inflammatory response syndrome (SIRS) remains one of the major causes of cardiopulmonary bypass (CPB)-associated organ injury during pediatric cardiac surgery. The purpose of this investigation was to compare the effectiveness of methylprednisolone (MP) and zero-balance ultrafiltration (ZBUF) on SIRS during pediatric CPB. Thirty infants undergoing open-heart surgeries were randomized to receive either MP in the priming solution (group M, n = 15) or ZBUF during CPB (group Z, n = 15).