Use of Factor VIIa and Anti-inhibitor Coagulant Complex in Pediatric Cardiac Surgery Patients
Both rFVIIa and FEIBA reduced blood product usage in pediatric patients following cardiac procedures.
The Use of Hemostatic Blood Products in Children Following Cardiopulmonary Bypass and Associated Outcomes
Larger studies should be performed to determine the hemostatic efficacy of these products, as well as to clarify associated morbidities, in order to inform proper blood management.
Continuous Cerebral and Myocardial Selective Perfusion in Neonatal Aortic Arch Surgery
CCMSP is a safe and reproducible strategy for cerebral, myocardial and visceral protection in neonatal aortic arch repair, with or without VSD closure, resulting in low complication and mortality.
Right Watershed Cerebral Infarction Following Neck Cannulation for Veno-Arterial Extracorporeal Membrane Oxygenation in Pediatric Septic Shock: A Case Series
The risk of ipsilateral watershed injury should be considered before cervical cannulation, notably in the context of sepsis.
Determinants of Neurological Outcome in Neonates with Congenital Heart Disease Following Heart Surgery
For HLHS and d-TGA patients, duration of mechanical ventilation and DHCA are associated with adverse neurologic outcome. Neonatal brain MRI commonly demonstrates acquired brain injuries, but the clinical impact of these abnormalities are not often seen before 2 years of age.
Association Between Lactates, Blood Glucose, and Systemic Oxygen Delivery in Children After Cardiopulmonary Bypass
In children after cardiopulmonary bypass, lactates are not correlated with higher oxygen extraction, but are correlated with hyperglycemia, at both 4 and 12 h after PICU admission. Future research is warranted to better define this relationship.
Predictors of Increased Lactate in Neonatal Cardiac Surgery: The Impact of Cardiopulmonary Bypass
These results emphasized the importance of blood pressure management during CPB and the importance of the duration of circulatory arrest.
Efficacy of Nitric Oxide Administration in Attenuating Ischemia/Reperfusion Injury During Neonatal Cardiopulmonary Bypass
Systemic administration of NO during the Norwood procedure has myocardial protective effects (lower Troponin levels) but we observed no effect on postoperative recovery. Larger sample size may be needed to show clinical differences.
Impact of Different Cardiopulmonary Bypass Strategies on Renal Injury after Pediatric Heart Surgery
In this contemporary comparative study, higher flow rates and higher hematocrit during cardiopulmonary bypass were associated with better preservation of renal function.
Effect of Intraoperative Dexamethasone on Major Complications and Mortality Among Infants Undergoing Cardiac Surgery The DECISION Randomized Clinical Trial
Among infants younger than 12 months undergoing cardiac surgery with cardiopulmonary bypass, intraoperative administration of dexamethasone, compared with placebo, did not significantly reduce major complications and mortality at 30 days.
The Developing Balance of Thrombosis and Hemorrhage in Pediatric Surgery: Clinical Implications of Age-Related Changes in Hemostasis
We review the current understanding of the development and function of the hemostatic system, including the complex and overlapping interactions of coagulation proteins, platelets, fibrinolysis, and immune mediators from the neonatal period through early childhood and to young adulthood.
Use of Coagulation Point-of-Care Tests in the Management of Anticoagulation and Bleeding in Pediatric Cardiac Surgery: A Systematic Review
At present, literature data are too weak to define POCTs as a “gold standard” for the treatment of perioperative bleeding in pediatric cardiac surgery.
Antifactor Xa Monitoring and Hematologic Complications of Pediatric Extracorporeal Membrane Oxygenation
Management of anticoagulation based on anti-Xa levels appears to be as effective as management based on ACT results.
Comparison of Three Autotransfusion Devices for Utilization in the Pediatric Population
Each device proved effective within our pediatric population.
Hemodynamics of Neonatal Double Lumen Cannula Malposition
Results obtained through computational fluid dynamics methodology can provide valuable foresight in assessing the performance of the dual lumen cannula in patient-specific configurations.
Effects of Cardiopulmonary Bypass with Low-priming Volume on Clinical Outcomes in Children Undergoing Congenital Heart Disease Surgery
The usage of PRBCs in CPB with low-priming volume decreased significantly, but the postoperative Hb concentration and platelet count could still be maintained at a high level, improving the use efficiency of PRBCs. CPB with low-priming volume did not affect the postoperative recovery of patients, so it is worthy of continuous promotion and optimization.
Neuromonitoring Modalities in Pediatric Cardiac Anesthesia: A Review of the Literature
This review provides a brief overview of the current knowledge regarding neurodevelopmental outcomes in children with CHD and summarizes the evidence for the use of the following 4 neuromonitoring modalities: transcranial Doppler, cerebral near-infrared spectroscopy, standard electroencephalography, and processed electroencephalography.
Comparison of Outcomes of the Use of Del Nido and St. Thomas Cardioplegia in Adult and Paediatric Cardiac Surgery: a Systematic Review and Meta-analysis
Del Nido cardioplegia may be a viable alternative to the use of St. Thomas cardioplegia in both adult and paediatric patients, providing similar postoperative outcomes while also affording the additional advantage of shorter aortic cross-clamp time and cardiopulmonary bypass time (in adult cardiac surgery) and decreased rates of defibrillation (in both adult and paediatric cardiac surgery).
Childhood Extracorporeal Membrane Oxygenation Survivors: Parents Highlight Need for Structured Follow-Up and Support After Hospital Discharge
A proportion of children who have undergone extracorporeal membrane oxygenation treatment have needs that are not being met, with variable access to service provision.
Towards Integrative Neuromonitoring of the Surgical Newborn – A Systematic Review
Neuromonitoring with the techniques currently used will neither help our understanding of the altered neonatal pathophysiology, nor enable early detection of deviation from the norm. The modalities lack specificity and are not related to clinical (long-term) outcome or prognosis. Accordingly, we were unable to draw up a monitoring guideline.
Validation of the ‘Paediatric Extracorporeal Membrane Oxygenation Prediction’ Model in a UK Extracorporeal Membrane Oxygenation Centre
This small single-centre study with a small number of events was unable to validate the paediatric extracorporeal membrane oxygenation prediction-model of risk-adjustment. Although this remains the most promising of all the available models, further validation in larger data sets and/or refinement may be required before widespread use.
Extracorporeal Membrane Oxygenation Support for Pediatric Burn Patients: Is It Worth the Risk?
Extracorporeal membrane oxygenation could be considered as an additional level of support for the pediatric burn population, especially in the setting of respiratory failure.
Minimally Invasive Cardiac Surgical Procedures in Children
In this summary we will review the approaches that have been described and comment on the evidence that they achieve the desired goal of minimizing the trauma of the surgical procedure and enhancing recovery.
Clinical Application of a New Ternary Polymer, SEC-1 coat™, for Pediatric Cardiopulmonary Bypass Circuits: a Prospective Randomized Pilot Study
SEC-1 coat™ for cardiopulmonary bypass circuits have good biocompatibility with regard to platelet preservation and in terms of attenuating inflammatory reaction or coagulation activation during pediatric cardiac surgery.
