Objective: In this Consensus Statement, we review the etiology and pathophysiology of inflammatory processes seen in critically ill children with cardiac disease. Immunomodulatory therapies aimed at improving outcomes in patients with myocarditis, heart failure, and transplantation are extensively reviewed.
Data Sources: The author team experience and along with an extensive review of the medical literature were used as data sources.
Data Synthesis: The authors synthesized the data in the literature to present current immumodulatory therapies. For each drug, the physiologic rationale, mechanism of action, and pharmacokinetics are synthesized, and the evidence in the literature to support the therapy is discussed.
Conclusions: Immunomodulation has a crucial role in the treatment of certain pediatric cardiac diseases. Immunomodulatory treatments that have been used to treat myocarditis include corticosteroids, IV immunoglobulin, cyclosporine, and azathioprine. Contemporary outcomes of pediatric transplant recipients have improved over the past few decades, partly related to improvements in immunomodulatory therapy to prevent rejection of the donor heart. Immunosuppression therapy is commonly divided into induction, maintenance, and acute rejection therapy. Common induction medications include antithymocyte globulin, muromonab-CD3, and basiliximab. Maintenance therapy includes chronic medications that are used daily to prevent rejection episodes. Examples of maintenance medications are corticosteroids, cyclosporine, tacrolimus, sirolimus, everolimus, azathioprine, and mycophenolate mofetil. Rejection of the donor heart is diagnosed either by clinically or by biopsy and is treated with intensification of immunosuppression.
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http://dx.doi.org/10.1097/PCC.0000000000000626 | DOI Listing |
PLoS One
January 2025
Department of Pediatrics, University of Washington, Seattle, Washington, United States of America.
Aim: To evaluate the impact of heart rate-guided basic resuscitation compared to Helping Babies Breathe on neonatal outcomes and resuscitation practices in the Democratic Republic of the Congo.
Methods: We conducted a pre-post clinical trial comparing heart rate-guided basic resuscitation to Helping Babies Breathe in three facilities, enrolling in-born neonates ≥28 weeks gestation. We collected observational data during a convenience sample of resuscitations and extracted clinical data from the medical record for all participants.
Pediatr Cardiol
January 2025
Cardiothoracic Department, Children's Health Ireland at Crumlin, Dublin, Ireland.
Lead strangulation is a dangerous complication of epicardial pacemaker insertion. This complication has been increasingly highlighted lately. Our institution has recently identified four cases over the past five years.
View Article and Find Full Text PDFPediatric patients undergoing cardiothoracic surgery are at increased risk for health care-associated infections, especially surgical site infections (SSIs). Delayed sternal closures are associated with prolonged lengths of stay and contribute to infection risks and morbidities. At a single-site academic pediatric center, we created an SSI-prevention bundle targeting the preoperative, intraoperative, and postoperative care periods.
View Article and Find Full Text PDFInt J Gynecol Cancer
January 2025
Hacettepe University, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Faculty of Medicine, Ankara, Turkey.
Background: Vulvar squamous cell carcinoma incidence is increasing, especially among women under 60, largely attributed to human papillomavirus infections. Precursor pre-invasive vulvar lesions are frequently underdiagnosed. Routine vulvar inspection during cervical cancer screening could offer an opportunity for the detection of these lesions.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!