Abstract An 11-month-old infant was admitted to the intensive care unit after cardiorespiratory arrest associated with the parainfluenza virus. Despite interventions, deterioration persisted. Echocardiography revealed severe pulmonary hypertension, tricuspid gradient >100 mm Hg, and right ventricular dilation. Maximal vasodilator therapy failed. At 72 hours, cardiogenic shock led to carotid-jugular venoarterial..
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Abstract Purpose Methylprednisolone is used during paediatric cardiac surgery with cardiopulmonary bypass to attenuate the systemic inflammatory response. However, developmental differences in drug disposition and cardiopulmonary bypass–related factors contribute to pharmacokinetic variability in this population. We aimed to develop a population pharmacokinetic model of methylprednisolone in neonates and paediatric patients..
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Abstract Neonatal cardiac surgery requires cardiopulmonary bypass (CPB) strategies that minimize hemodilution while maintaining adequate oxygen delivery and hemostatic balance. Despite increasing emphasis on patient blood management (PBM), contemporary CPB priming and perioperative hemostasis practices across European neonatal cardiac surgery programs remain poorly characterized. This prospective, 26-item, web-based cross-sectional survey..
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Abstract Background Cardiopulmonary bypass is associated with systemic inflammation during pediatric cardiac surgery and features elevated systemic concentrations of complement, cytokines and chemokines. The objective of this study is to quantify the immunologic efficacy of ultrafiltration (UF) used continuously throughout CPB. Methods Pediatric patients were enrolled in a single-arm prospective..
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Abstract Background Brain development is altered in neonates with congenital heart disease (CHD), with well-characterised reductions in regional brain volumes and enlargement of CSF spaces. However, perioperative morphological changes remain incompletely understood. Purpose To identify brain regions showing spatial patterns of coordinated expansion and contraction that differ between neonates with..
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Abstract Objectives The hemostatic system in neonates and infants with congenital heart disease is distinct as a result of developmental and disease-specific factors, necessitating population-specific periprocedural evaluation and antithrombotic management. Ongoing practice variation reflects limited evidence and highlights the need for structured guidance and further study. Methods To develop a..
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Abstract Purpose To evaluate changes in post-operative transfusion requirements of infants undergoing congenital diaphragmatic hernia (CDH) repair on ECMO following implementation of a perioperative guideline. Methods In 2021, a multidisciplinary team created a guideline for perioperative management of CDH repair on ECMO, including guidance on pre-operative lab values, antifibrinolytic dosing,..
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Abstract Objectives Cardiopulmonary bypass is necessary for surgical repair of complex congenital heart disease. We studied whether whole blood use in circuit prime and for initial intraoperative transfusion needs improved postoperative outcomes in infants less than 2 months of age. Methods This was a single-center retrospective chart review of infants..
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Abstract Background: Among infants undergoing cardiac surgery, AKI may affect as many as 40% of this population and carries an unfavorable prognosis. A range of contributors has been implicated, including early age, cyanotic physiology, and extended time on cardiopulmonary bypass (CPB). Nadir-indexed oxygen delivery (DO2) is an important determinant for early..
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Abstract BACKGROUND We sought to determine if modified ultrafiltration (MUF) in the current era was associated with improved outcomes after neonatal cardiopulmonary bypass (CPB). METHODS Retrospective analysis of the PC4/NEPHRON dataset from 22 centers (2015-18). Neonates were stratified by MUF use and outcomes were compared. Multivariable regression models were adjusted..
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