C-Reactive Protein and Procalcitonin after Congenital Heart Surgery Utilizing Cardiopulmonary Bypass: When Should We Be Worried?
Both CRP and PCT increase after CHS with CPB and peak on postoperative day 2. PCT has a greater statistically significant difference in those with documented infection when compared to CRP and a PCT of greater than 5.6 ng/ml should raise suspicion for infection.
Preoperative Anemia and Outcomes After Corrective Surgery in Neonates With Dextro-Transposition of the Great Arteries
Untreated preoperative anemia was not associated with adverse outcomes in neonates undergoing reparative surgery for d-TGA.
Extracorporeal Life Support Organization (ELSO) Guidelines for Follow-up After Neonatal and Pediatric Extracorporeal Membrane Oxygenation
Thus, ECMO centers should adapt follow-up program to their specific populations and resources with the predischarge and postdischarge c
Blood Pressure Variability during Pediatric Cardiac Surgery is Associated with Acute Kidney Injury
Greater BPV during cardiac surgery with CPB was associated with development of postoperative AKI in infants, suggesting that BPV is a potentially modifiable risk factor for AKI in this high-risk population.
Early Motor Outcomes in Infants with Critical Congenital Heart Disease are Related to Neonatal Brain Development and Brain Injury
Neonatal brain development and injury are associated with fewer favourable early motor outcomes in infants with CCHD.
The Albumin-to-Fibrinogen Ratio Independently Predicts Acute Kidney Injury in Infants With Ventricular Septal Defect Undergoing Cardiac Surgery With Cardiopulmonary Bypass
This study demonstrated that a low AFR (<9.35) during CPB was an independent risk factor for AKI in VSD infants following cardiac surgery with CPB.
Centrifugal and Roller Pumps in Neonatal & Pediatric Extracorporeal Membrane Oxygenation
A total of four studies with 9111 patients were included. There was a statistically significant difference in in-hospital mortality, favoring the groups where roller pumps were used. Roller pumps were associated with fewer episodes of hemolysis, mechanical complications, cardiac complications, renal complications, and less inotropic support. ECMO with roller pumps may be associated with lower mortality in children. Roller pumps were associated with fewer complications, as well as reduced hemolysis and use of inotropes.
Evaluation of Seizure Risk in Infants After Cardiopulmonary Bypass in the Absence of Deep Hypothermic Cardiac Arrest
Seizure incidence was similar to recent estimates even in the absence of deep hypothermic cardiac arrest. By employing random forest analysis, we were able to identify novel risk factors for postoperative seizure in this population and generate a robust model of seizure risk. Further work to validate our model in an external population is needed.
Use Of Bivalirudin for Anticoagulation in Pediatric Extracorporeal Membrane Oxygenation (ECMO)
This study describes the use of bivalirudin in children on extracorporeal membrane oxygenation (ECMO). Pediatric patients receiving bivalirudin were compared to patients receiving heparin as the anticoagulant on ECMO. Bivalirudin may provide stable and successful anticoagulation in children. Further large, multicenter studies are needed to confirm these finding
Sequestration of Dexmedetomidine in Ex Vivo Cardiopulmonary Bypass Circuits
The percent sequestration of DEX was lower in CPB circuits at lower DEX doses compared to higher doses. A combination of DEX initial loading dose and continuous infusion resulted in steady concentrations of DEX over 4 hours. At therapeutically relevant concentrations of DEX (485–1,013 pg/ml), lower sequestration was observed in ex vivo CPB circuits compared to higher doses. The sequestration of DEX to circuits should be considered to achieve the optimal concentration of DEX during CPB surgery.
Nomenclature for Pediatric and Congenital Cardiac Care: Unification of Clinical and Administrative Nomenclature – The 2021 International Paediatric and Congenital Cardiac Code (IPCCC) and the Eleventh Revision of the International Classification of Diseases (ICD-11)
In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature.
The Lower Threshold of Hypothermic Oxygen Delivery to Prevent Neonatal Acute Kidney Injury
The importance of hypothermic DO2i should be highlighted, even when SvO2 was satisfactory. A lower threshold of DO2i > 269 mL min−1 m−2 may help protect neonates from the risk of postoperative AKI.