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Extracorporeal Membrane Oxygenation for Pediatric Respiratory Failure: Risk Factors Associated With Center Volume and Mortality*

Abstract Objectives:  Recent analyses show higher mortality at low-volume centers providing extracorporeal membrane oxygenation. We sought to identify factors associated with center volume and mortality to explain survival differences and..

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Clinical equivalency of cardiopulmonary bypass and extracorporeal membrane oxygenation support for pediatric tracheal reconstruction

Abstract Objective Pediatric surgery for congenital tracheal stenosis continues to be a therapeutic challenge, and it often requires cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) for intra-operative extracorporeal cardiorespiratory..

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Bivalirudin for Alternative Anticoagulation in Extracorporeal Membrane Oxygenation: A Systematic Review

Abstract Background: Extracorporeal membrane oxygenation (ECMO) offers therapeutic options in refractory respiratory and/or cardiac failure. Systemic anticoagulation with heparin is routinely administered. However, in patients with heparin-induced thrombocytopenia or heparin..

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Vitamin D Status After Cardiopulmonary Bypass in Children With Congenital Heart Disease

Abstract Deficiency in 25-hydroxyvitamin D (25OHD) is associated with increased morbidity and mortality in the critically ill. Children who underwent surgery for congenital heart disease under cardiopulmonary bypass (CPB) are..

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Brain in Congenital Heart Disease Across the Lifespan

Abstract The number of patients surviving with congenital heart disease (CHD) has soared over the last 3 decades. Adults constitute the fastest-growing segment of the CHD population, now outnumbering children...

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Intraoperative Red Blood Cell Transfusion in Infant Heart Transplant Patients Is Not Associated with Worsened Outcomes

Abstract BACKGROUND:  Red blood cell (RBC) transfusion is common during infant cardiac surgery. A previous report of pediatric heart transplant recipients showed that increased RBC transfusion volume was independently associated..

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Thromboelastography—does it impact blood component transfusion in pediatric heart surgery?

Abstract Background The administration of blood products during pediatric cardiac surgery is common. We sought to determine if thromboelastography (TEG) is a cost-effective tool to reduce blood product transfusion in..

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Contrast media exposure in the perioperative period confers no additional risk of acute kidney injury in infants and young children…

Abstract Background Recently, there has been an interest in the temporal relationship between contrast exposure (CM) and cardiac surgery suggesting that a “double hit” on the kidney function in close..

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Optimizing Thrombin Generation with 4-Factor Prothrombin Complex Concentrates in Neonatal Plasma After Cardiopulmonary Bypass

Abstract BACKGROUND:  Bleeding is a serious complication after pediatric cardiopulmonary bypass (CPB) that is associated with an increase in perioperative morbidity and mortality. Four-factor prothrombin complex concentrates (4F-PCCs) have been..

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The Kidney in Critical Cardiac Disease: Proceedings From the 10th International Conference of the Pediatric Cardiac Intensive Care Society

Abstract The field of cardiac intensive care continues to advance in tandem with congenital heart surgery. The focus of intensive care unit care has now shifted to that of morbidity..

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“Just-In-Time” Simulation Training Using 3-D Printed Cardiac Models After Congenital Cardiac Surgery

Abstract Background: High-fidelity simulation using patient-specific three-dimensional (3D) models may be effective in facilitating pediatric cardiac intensive care unit (PCICU) provider training for clinical management of congenital cardiac surgery patients...

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Postoperative Abdominal NIRS Values Predict Low Cardiac Output Syndrome in Neonates

Abstract Background: The development of low cardiac output syndrome (LCOS) after cardiopulmonary bypass (CPB) occurs in up to 25% of neonates and is associated with increased morbidity. Invasive cardiac output..

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Advancing Cardiac Critical Care: A Call for Training, Collaboration, and Family Engagement

Abstract The evolution and development of pediatric cardiac critical care as a distinct subspecialty have occurred rapidly over the past 20 years. As the field has grown, models for education,..

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Poly-2-methoxyethylacrylate-coated cardiopulmonary bypass circuit can reduce transfusion of platelet products compared to heparin-coated circuit during aortic arch surgery

Abstract Several coating techniques for extracorporeal circulation have been developed to reduce the systemic inflammatory response during cardiopulmonary bypass (CPB). We compared the clinical effectiveness and biocompatibility of poly-2-methoxyethylacrylate (PMEA)-..

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Prediction of the impact of venoarterial extracorporeal membrane oxygenation on hemodynamics

Abstract Although venoarterial extracorporeal membrane oxygenation (ECMO) was developed to rescue patients with cardiogenic shock, the impact of ECMO on hemodynamics is often unpredictable and can lead to hemodynamic collapse...

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Antithrombin III for critically ill patients

Abstract Background Critical illness is associated with uncontrolled inflammation and vascular damage which can result in multiple organ failure and death. Antithrombin III (AT III) is an anticoagulant with anti‐inflammatory..

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Transparency and Public Reporting of Pediatric and Congenital Heart Surgery Outcomes in North America

Abstract Health care is embarking on a new era of increased transparency. In January 2015, the Society of Thoracic Surgeons (STS) began to publicly report outcomes of pediatric and congenital..

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Changes in thrombin generation in children after cardiac surgery and ex-vivo response to blood products and haemostatic agents

Abstract Impaired haemostasis has been reported in children with congenital heart disease undergoing cardiopulmonary bypass. As thrombin generation encompasses all phases of the coagulation process, this analysis might provide the best assessment..

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Nadir oxygen delivery during pediatric bypass as a predictor of acute kidney injury

Abstract Background Cardiac surgery associated acute kidney injury (CS-AKI) is common in infants and associates with negative outcomes. Nadir indexed oxygen delivery (DO 2i) during cardiopulmonary bypass (CPB) is associated with..

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Takotsubo Cardiomyopathy Following Cardiac Surgery

Abstract Background Coronavirus disease 2019 (COVID-19) remains a worldwide pandemic with a high mortality rate among patients requiring mechanical ventilation. The limited data that exist regarding the utility of extracorporeal..

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Bridging the Gap Between Intensivists and Primary Care Clinicians in Extracorporeal Membrane Oxygenation for Respiratory Failure in Children

Abstract Importance  Extracorporeal membrane oxygenation (ECMO) is a form of advanced life support that may be used in children with refractory respiratory or cardiac failure. While it is required infrequently, in..

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Bridging the Gap Between Intensivists and Primary Care Clinicians in Extracorporeal Membrane Oxygenation for Respiratory Failure in Children

Abstract Importance  Extracorporeal membrane oxygenation (ECMO) is a form of advanced life support that may be used in children with refractory respiratory or cardiac failure. While it is required infrequently, in..

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Bedside Allogeneic Erythrocyte Washing with a Cell Saver to Remove Cytokines, Chemokines, and Cell-derived Microvesicles: A Clinical Feasibility Study

Abstract Background Removal of cytokines, chemokines, and microvesicles from the supernatant of allogeneic erythrocytes may help mitigate adverse transfusion reactions. Blood bank–based washing procedures present logistical difficulties; therefore, we tested..

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Factors associated with acute kidney injury and mortality during cardiac surgery

Abstract Background Cardiac surgery with cardiopulmonary bypass (CPB) is known to contribute towards the incidence of acute kidney injury (AKI) and peri-operative morbidity and mortality. There are several patient, anaesthetic..

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Cardiovascular Consequences and Considerations of Coronavirus Infection – Perspectives for the Cardiothoracic Anesthesiologist and Intensivist During the Coronavirus Crisis

THE CURRENT pandemic owing to coronavirus disease 2019 (COVID-19) has been associated in about 10% to 15% of cases with severe clinical presentations that require admission to hospital.  In the..

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Extracorporeal Membrane Oxygenation Support in Severe COVID-19

Abstract Background Coronavirus disease 2019 (COVID-19) remains a worldwide pandemic with a high mortality rate among patients requiring mechanical ventilation. The limited data that exist regarding the utility of extracorporeal..

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Bridging the Gap Between Intensivists and Primary Care Clinicians in Extracorporeal Membrane Oxygenation for Respiratory Failure in Children

Abstract Importance  Extracorporeal membrane oxygenation (ECMO) is a form of advanced life support that may be used in children with refractory respiratory or cardiac failure. While it is required infrequently, in..

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DUKE HEALTH PERFORMS WORLD’S FIRST PARTIAL HEART TRANSPLANT

 A team at Duke Health has performed what is believed to be the world’s first partial heart transplant, with the living arteries and valves from a freshly donated heart fused..

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Continuous Metabolic Monitoring in Infant Cardiac Surgery: Toward an Individualized Cardiopulmonary Bypass Strategy

Abstract Cardiopulmonary bypass (CPB) in infants is associated with morbidity due to systemic inflammatory response syndrome (SIRS). Strategies to mitigate SIRS include management of perfusion temperature, hemodilution, circuit miniaturization, and..

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Current status of brain protection during surgery for congenital cardiac defect

Abstract The long-term neurodevelopmental outcome has been a great concern for cardiac surgeons although it is still unclear. There are some risks regarding the neurological and neuropsychological deficits before, during..

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