Abstract Congenital heart defects (CHDs) are one of the most common congenital malformations and often require heart surgery with cardiopulmonary bypass (CPB). Children undergoing cardiac surgery with CPB are especially at greater risk of post-operative complications due to a systemic inflammatory response caused by innate inflammatory mediators. However, the pathophysiological..
Read MoreAbstract Background: Various mechanisms leading to early hyperlactataemia post-cardiac surgery have been postulated. Specifically, in the paediatric population, benign early hyperlactataemia may be associated with crystalloid priming in the cardiopulmonary bypass circuit. The aim of this study was to review paediatric patients who had crystalloid prime and assess their outcomes...
Read MoreAbstract Objective This study was designed to investigate the distribution of nadir oxygen delivery (DO2), mean DO2, and area under ideal DO2 (AUiDO2) among categorized age groups of pediatric patients and their associations with postoperative cardiac surgery–associated (CSA) acute kidney injury (AKI) and clinical outcomes. Design Retrospective cohort study. Setting A..
Read MoreAbstract Background Acute kidney injury (AKI) is a common complication among patients requiring cardiopulmonary bypass (CPB) during paediatric cardiac surgery. Plasma-free haemoglobin (PFH) produced by haemolysis during CPB contributes to AKI. This study aimed to determine the association between PFH and postoperative AKI during paediatric cardiac surgery requiring CPB. Methods..
Read MoreAbstract Background: Extracorporeal membrane oxygenation (ECMO) is a vital mechanical circulatory support used with increasing frequency in complex congenital cardiac surgeries. This study evaluated the outcomes of a protocol-based venoarterial (VA) ECMO program following congenital heart surgeries. Methods and Results: This was a retrospective review of 198 patients who underwent..
Read MoreAbstract Objectives: To test feasibility of a randomized controlled trial (RCT) with an endpoint of time at goal anticoagulation in children on extracorporeal membrane oxygenation (ECMO) randomized to receive bivalirudin vs. unfractionated heparin. Design: Open-label pilot RCT (NCT03318393) carried out 2018–2021. Setting: Single-center quaternary U.S. pediatric hospital. Patients: Children 0..
Read MoreAbstract Extracorporeal membrane oxygenation (ECMO) provides temporary cardiorespiratory support for neonatal, pediatric, and adult patients when traditional management has failed. This lifesaving therapy has intrinsic risks, including the development of a robust inflammatory response, acute kidney injury (AKI), fluid overload (FO), and blood loss via consumption and coagulopathy. Continuous kidney..
Read MoreAbstract This referral center prospective inception cohort study included 84 consecutive children having extracorporeal membrane oxygenation (ECMO) for noncardiac illness indications at the age of less than 6 years from 2000 to 2017. Long-term outcomes were survival, neurocognitive (Wechsler Preschool and Primary Scales of Intelligence) and functional (General Adaptive Composite)..
Read MoreAbstract Adverse events (AEs) experienced by children and adults with congenital heart disease (CHD) on ventricular assist devices (VADs) are sometimes unique to these populations. The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) and the Academic Research Consortium (ARC) aimed to harmonize definitions of pediatric and CHD AEs for use..
Read MoreAbstract Pediatric extracorporeal membrane oxygenation (ECMO) provides lifesaving cardiopulmonary support for patients with a multitude of clinical diagnoses, resulting from cardiac and/or respiratory failure refractory to conventional supports (). The utilization of pediatric ECMO has doubled over the last decade () with survival outcomes ranging from 58% to 87% across..
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