Pediatric

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Use of plasmapheresis during cardiopulmonary bypass in a pediatric heart…

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 human leucocyte antigen (HLA) I of 18% and for HLA II of 37%, so the decision was made to administer..

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Intraoperative sodium range affects white matter microstructure in neonatal congenital…

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 is associated with white matter injury in adults. This study examined the potential effects of a rapid intraoperative sodium increase..

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Regional Variation in Congenital Heart Surgery in Brazil: A National…

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, and regional disparities in congenital heart surgery.  Methods: Retrospective analysis of the National Database (SIH/SUS) via DATASUS from January 2019 to..

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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 carried out in the immediate pre bypass setting to ensure a successful outcome.

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Evaluation of thromboelastometry (Rotem) - guided and conventional hemostasis management…

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 of intraoperative ROTEM as a decision parameter would reduce perioperative transfusions, modulate transfusion patterns and improve the outcomes in newborns..

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Clinical Application of Inhaled Nitric Oxide in Conditions of Excessive…

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 syndrome, and death. Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator that improves ventilation–perfusion matching and unloads the RV..

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Hereditary Antithrombin Deficiency in Pediatric Patients: Pathophysiology, Clinical Features, Diagnosis,…

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 activity up to 1000-fold. Deficiency in AT contributes to a hypercoagulable state associated with adverse clinical outcomes, including morbidity and..

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Pediatric ECPR as Bridge to Surgery: Successful Management of Refractory…

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 membrane oxygenation (ECMO) during ongoing CPR, provides circulatory and respiratory support and can serve as a bridge to definitive interventions...

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High-Exchange Ultrafiltration to Enhance Recovery After Pediatric Cardiac Surgery: The…

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. Methods This single-center, double-blind trial enrolled pediatric patients weighing <15 kg undergoing cardiac surgery who were randomly allocated to continuous..

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Prevention of blood dilution during cardiopulmonary bypass surgery in a…

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 right fifth intercostal thoracotomy using a right atrial approach. To avoid excessive blood dilution, blood cardioplegia, retrograde autologous priming, conventional..

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