Characteristics of Pediatric Extracorporeal Membrane Oxygenation Programs in the United States and Canada
The majority of pediatric ECMO centers have adopted the infrastructure recommendations from the Extracorporeal Life Support Organization. However, there remains broad variability of practice characteristics and organizational infrastructure for pediatric ECMO centers across the United States and Canada.
COVID-19 Testing, Surgical Prioritization, and Reactivation in a Congenital Cardiac Surgery Program
In summary, our institutional experience demonstrates that the implementation of universal COVID-19 screening, surgical prioritization, and eventual reactivation is feasible for congenital cardiac surgery programs.
Combined Use of Rotational Thromboelastometry (Rotem) and Platelet Impedance Aggregometry (Multiplate Analyzer) in Cyanotic and Acyanotic Infants and Children Undergoing Cardiac Surgery With Cardiopulmonary Bypass: Subgroup Analysis of a Randomized Clinical Trial
This study showed that Rotem, but not Multiplate results, were associated with platelet transfusion in pediatric cardiac surgery with no intake of platelet inhibitors. The usefulness of combining these tests in platelet transfusion decision-making needs to be evaluated in larger populations.
Impact of Miniaturized Cardiopulmonary Bypass Circuits on Ultrafiltration During Congenital Heart Surgery
The miniaturized CPB system could decrease the usage of UF. Good results were achieved in children who did not use UF based on the miniaturized CPB circuit system during congenital heart surgery.
Biomarkers as Predictors of Renal Damage in Neonates Undergoing Cardiac Surgery
In our study, biomarkers did not show any correlation with the appearance of AKI.
A Randomized Controlled Trial Comparing Controlled Reoxygenation and Standard Cardiopulmonary Bypass in Paediatric Cardiac Surgery
Controlled reoxygenation (normoxic) CPB is safe but with no evidence of a clinical advantage over hyperoxic CPB.
Early Impact of the COVID-19 Pandemic on Congenital Heart Surgery Programs Across the World: Assessment by a Global Multi-Societal Consortium
We present the results of an international survey sent to pediatric and congenital heart surgeons characterizing the early impact of COVID-19 on the care of patients with CHD.
Effect of Albumin Addition to Cardiopulmonary Bypass Prime on Outcomes in Children Undergoing Open-Heart Surgery (EACPO Study)—A Randomized Controlled Trial
High oncotic pressure CPB prime using albumin addition might be beneficial over conventional blood prime, and our study does provide a rationale for further studies.
Viscoelastic Testing in Pediatric Patients
This manuscript is intended to give a structured overview of what has been published on the use of viscoelastic testing to guide bleeding management in neonates and children.
Prophylactic Corticosteroids for Paediatric Heart Surgery with Cardiopulmonary Bypass
Corticosteroids probably do not change the risk of mortality for children having heart surgery using CPB at any time point. They probably reduce the duration of postoperative ventilation in this context, but have little or no effect on the total length of postoperative ICU stay or total postoperative hospital stay.
Continuous Monitoring of Cerebral Autoregulation in Children Supported by Extracorporeal Membrane Oxygenation: A Pilot Study
CA assessment is feasible in pediatric ECMO. The first 24 h following ECMO represents the most critical period regarding CA. Impaired autoregulation is significantly more severe among patients who experience ANE.
Extracorporeal Membrane Oxygenation Support for Failure to Wean From Cardiopulmonary Bypass After Pediatric Cardiac Surgery: Analysis of Extracorporeal Life Support Organization Registry Data
Children supported with extracorporeal membrane oxygenation for failure to wean from cardiopulmonary bypass after cardiac surgery are at high risk of mortality (55%).
Extracorporeal Membrane Oxygenation in Children With COVID-19: Preliminary Report from The Collaborative Euroelso Prospective Survey
We report the preliminary data from 52 neonatal and pediatric ECMO centers across Europe during the first wave of the Covid-19 pandemic.
Low Antithrombin Levels in Neonates and Infants Undergoing Congenital Heart Surgery Result in More Red Blood Cell and Plasma Transfusion on Cardiopulmonary Bypass
Low preoperative AT level is associated with increased transfusion of RBC and FFP on CPB in neonates and infants undergoing congenital heart surgery. Low preoperative AT level did not result in coagulation activation after CPB and after surgery.
Sustained Total All-Region (STAR) Perfusion for Norwood Reconstruction With Complex Intracardiac Repair
Here, we introduce a novel technique for sustained total all-region perfusion of the heart, upper body, and lower body throughout the Norwood operation.
COVID-19: FAQs in Pediatric Cardiac Surgery—A Sequel
Our knowledge of the COVID-19 pandemic continues to grow rapidly, leading to further clarity and revealing new questions in turn, thus it is critically important that clinician knowledge is updated frequently.
External Validation of The Pediatric Extracorporeal Membrane Oxygenation Prediction Model for Risk Adjusting Mortality
While the model overestimates mortality for the highest risk patients, it remains the only prediction model applicable to both neonates and pediatric patients who require ECLS for any indication and thus maintains potential for application in research and quality benchmarking.
Perioperative Complications in A Paediatric Cardiac Surgery Program with Limited Systemic Resources
Despite the comparable crude mortality, the operative mortality among patients with perioperative complications in our series was significantly higher than in the developed world. A number of initiatives are needed in order to improve failure-to-rescue rates in low- and middle-income countries.
Mobile Extracorporeal Membrane Oxygenation: 5-Year Experience of a French Pediatric and Neonatal Center
We describe one of the largest cohorts of infants and children transported by a mobile unit while on extracorporeal membrane oxygenation. Our findings confirm that it is safe to start extracorporeal membrane oxygenation in a referring center and to transport patients using an extracorporeal membrane oxygenation mobile team.
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.