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Blood Lactate Clearance as a Predictor of Mortality in Children Undergoing Cardiac Surgery with Cardiopulmonary Bypass

Abstract Background: Pediatric cardiac surgery is still a high-risk procedure, with mortality being a significant concern. Lactate clearance has been demonstrated to enhance outcomes in critically ill adult populations; however, data..

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Hemofilters versus hemodialyzers: impacts on cytokine removal during cardiopulmonary bypass in pediatric cardiac surgery: a randomized controlled trial

Abstract Background Congenital heart disease (CHD) remains a leading cause of pediatric morbidity and mortality worldwide. Cardiopulmonary bypass (CPB) is crucial for surgical repair but is associated with systemic inflammation..

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Development of new antithrombotic drugs for children (part 1): guidance from the ISTH SSC Subcommittee on Pediatric and Neonatal Thrombosis…

Abstract As adult programs of newer anthrombotic agents, such as those directed against FXIa, are underway, there is both a pressing need and a great opportunity to optimize the design,..

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Cerebral Hemodynamic Changes During Cardiac Surgery: A Feasibility MR Study in Piglets

Abstract Congenital heart disease often requires early surgical intervention. Cardiopulmonary bypass (CPB) is a standard procedure, but infants undergoing CPB show an increased risk of postoperative white matter injury. These..

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Time to extracorporeal cardiopulmonary resuscitation flow and outcomes in paediatric in-hospital cardiac arrest: a 12-year single-centre study

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory paediatric in-hospital cardiac arrest (IHCA). Although rapid initiation of extracorporeal life support (ECLS) is widely considered critical, the relative..

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Pediatric Extracorporeal Cardiopulmonary Resuscitation (ECPR): Understanding Variations in Systems and Clinical Practice

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) for pediatric cardiac arrest relies on enhanced resources and time-critical decision-making. We aimed to evaluate variations in systems and clinical practice among extracorporeal membrane oxygenation..

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Ross(-Konno) Procedure in Neonates and Infants: A Multicentre Experience

Abstract Objectives Neonates and infants who receive a Ross or Ross-Konno operation form a different population from older children and adults who undergo this procedure. We aimed to provide a..

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Quantitative Electroencephalogram Patterns During Neonatal Antegrade Cerebral Perfusion and Deep Hypothermic Circulatory Arrest that Suggest Neurologic Injury

Abstract During cerebral ischemia, the quantitative Electroencephalogram (EEG) Alpha: Delta Ratio (ADR) decreases, and the asymmetry percentage increases. The utility of analyzing these metrics during neonatal Antegrade Cerebral Perfusion (ACP)..

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Avoidance of Hyperoxemia Versus Routine Hyperoxia During Cardiopulmonary Bypass in Children With Cyanotic Congenital Heart Disease—A Systematic Review and Meta-Analysis

Abstract Background Children with cyanotic congenital heart disease undergoing cardiac surgery with cardiopulmonary bypass (CPB) are exposed to varying oxygenation strategies, and the optimal oxygenation strategy and the impact of..

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Early Prediction of Postoperative Peritoneal Dialysis Using Lung Ultrasound Scoring in Neonates After Cardiopulmonary Bypass

Abstract Background: Neonates and young infants undergoing cardiac surgery with cardiopulmonary bypass (CPB) are highly vulnerable to pulmonary dysfunction, systemic inflammation, capillary leak, and fluid overload, which may lead to..

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Unexpected Cardiac Arrest After Cardiopulmonary Bypass Initiation, Likely Due to Cardioplegia Migration: A Case Report

Abstract This case report describes a pediatric cardiac surgery in which electrocardiographic (ECG) changes appeared immediately after the initiation of cardiopulmonary bypass (CPB), followed by severe bradycardia and ultimately flaccid..

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Impact of Priming Volume Reduction on Hematocrit Retention in Pediatric Cardiopulmonary Bypass: A Retrospective Analysis

Abstract Background Retrograde autologous priming and venous antegrade priming replace the cardiopulmonary bypass circuit crystalloid with patient blood to mitigate hemodilution. However, their effectiveness in pediatric patients, particularly when analyzed..

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Intraoperative renal and cerebral tissue oxygen saturation measurements to predict postoperative acute kidney injury in pediatric cardiac surgery: a prospective…

Abstract Purpose Pediatric patients undergoing cardiac surgery are at risk of developing postoperative acute kidney injury (AKI). We hypothesized that a reduction in intraoperative renal (SrO2) or cerebral (ScO2) tissue..

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Results of a Preoperative Screening Brain Magnetic Resonance Imaging Protocol in Neonates Undergoing Cardiopulmonary Bypass

Abstract Background We implemented a preoperative screening brain magnetic resonance imaging (MRI) protocol for neonates undergoing cardiac surgery. The intent was to identify unrecognized central nervous system (CNS) injury that..

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The Potent Complement Stimulus of Sanguineous Versus Crystalloid Cardiopulmonary Bypass Prime during Pediatric Cardiac Surgery

Abstract Background: Sanguineous preparation of the cardiopulmonary bypass (CPB) circuit with allogeneic blood products is known to contain substantial complement mediator burden. This study aims to assess the longitudinal immunologic impacts..

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The Impact of Body Temperature on Neurologic Outcomes in Neonatal Aortic Arch Surgery Using Antegrade Cerebral Perfusion: A Scoping Review

Abstract Antegrade cerebral perfusion (ACP) and hypothermia are widely used neuroprotective strategies during neonatal aortic arch repairs. Still, over 50% of neonates exhibit new or worsened white matter injury in..

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Use of plasmapheresis during cardiopulmonary bypass in a pediatric heart transplant of a patient with Failing Fontan Physiology: first case…

Abstract Background: A 17-year-old male patient diagnosed with a single ventricle, in a failed Fontan stage, was evaluated prior to heart transplantation. The patient had a panel-reactive antibody (PRA) for..

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Intraoperative sodium range affects white matter microstructure in neonatal congenital heart disease

Abstract Background Intraoperative sodium changes and new postoperative white matter injury are prevalent in neonates with congenital heart disease (CHD) who undergo cardiopulmonary bypass surgery. Rapid sodium correction in hyponatremia..

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Regional Variation in Congenital Heart Surgery in Brazil: A National Database Analysis

Abstract Introduction: The absence of a congenital heart surgery national registry limits understanding of access, surgical volume, and mortality. This study analyzes the Brazilian administrative data to assess procedural distribution, outcomes,..

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Hereditary spherocytosis in a neonate during cardiac surgery

Abstract Hereditary spherocytosis (HS) is a rare inherited haemolytic anaemia. This case report outlines a neonatal patient with presumed HS requiring cardiopulmonary bypass (CPB) and the whole blood exchange transfusion..

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Evaluation of thromboelastometry (Rotem) - guided and conventional hemostasis management effectiveness in neonatal congenital cardiac surgery

Abstract Introduction Post-CPB bleeding remains a critical challenge in neonatal cardiac surgery, and early detection of coagulopathy to guide transfusion decisions may offer significant benefits. We hypothesized that routine use..

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Clinical Application of Inhaled Nitric Oxide in Conditions of Excessive Right Heart Load: A Review from Neonatal Pulmonary Hypertension to…

Abstract Excessive right heart load imposes an acute or chronic injury on the right ventricle (RV), predisposing critically ill neonates and cardiac surgical patients to RV failure, low cardiac output..

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Hereditary Antithrombin Deficiency in Pediatric Patients: Pathophysiology, Clinical Features, Diagnosis, and Antithrombin Replacement Therapy

Abstract Antithrombin (AT), a glycoprotein, plays a key role in anticoagulation by inhibiting coagulation proteases. It is also the primary mediator of heparin's anticoagulant effect, with heparin binding amplifying AT..

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Pediatric ECPR as Bridge to Surgery: Successful Management of Refractory Cardiac Arrest in High-Risk ICD Lead Extraction

Abstract Background Refractory cardiac arrest remains a major challenge in children, with poor survival despite advances in cardiopulmonary resuscitation (CPR). Extracorporeal cardiopulmonary resuscitation (ECPR), defined as rapid deployment of extracorporeal..

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High-Exchange Ultrafiltration to Enhance Recovery After Pediatric Cardiac Surgery: The ULTRA Randomized Controlled Trial

Abstract Background Pediatric cardiac surgery with cardiopulmonary bypass (CPB) is associated with systemic inflammation. This trial aimed to determine whether continuous high-exchange ultrafiltration during CPB has a clinical immunomodulatory effect...

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Prevention of blood dilution during cardiopulmonary bypass surgery in a cat with ventricular septal defect

Abstract A six-month-old, 3.3-kg, intact male American shorthair cat with a ventricular septal defect (VSD) underwent open-heart surgery using total cardiopulmonary bypass. Repair of the VSD was performed via a..

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Impact of Endogenous Melatonin Status on Perioperative Oxidative Stress in Pediatric Cardiac Surgery With Cardiopulmonary Bypass

Abstract Objectives This study aimed to investigate whether prebypass endogenous melatonin concentrations are associated with perioperative oxidative DNA injury, indexed by urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), and to explore their relationship with..

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Three Decades of Evidence on Pulsatile Cardiopulmonary Bypass in Pediatrics: No Significant Clinical Benefit

Abstract Background Drawing on more than 30 years of valuable expertise in in-vitro, in-vivo, and clinical trials, we report the key findings of our institutional research on pulsatile cardiopulmonary bypass..

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Renal regional oxygenation during pediatric cardiac surgery predicts acute kidney injury: a prospective cohort study with model comparisons

Abstract Background Acute kidney injury (AKI) is a common complication after pediatric cardiac surgery using cardiopulmonary bypass (CPB). This study evaluated renal regional oxygen saturation (R-rSO₂), measured via near-infrared spectroscopy..

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A Plan-Do-Study-Act Cycle to Enhance Operational Efficiency in a Newly Established Paediatric Cardiac Operating Room

Abstract Objectives This quality improvement project aimed to enhance operating room efficiency in a newly established paediatric cardiac operating room by focusing on key performance indicators (KPI), including (1) first..

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