Pediatric

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Preceding Clinical Events in High-risk, Postoperative, Pediatric Cardiac Patients—A Novel…

Abstract Objective: Blood stream infections (BSIs) are well described in pediatric cardiac intensive care units (PCICU). We noted that postoperative high-risk patients may develop BSI after a preceding clinical event (PCE). The study aim was to investigate whether high-risk patients who developed bacteremia experienced more PCEs than a similar group of..

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Hospital ECMO capability is associated with survival in pediatric cardiac…

Abstract Aim Extracorporeal membrane oxygenation (ECMO) provides temporary support in severe cardiac or respiratory failure and can be deployed in children who suffer cardiac arrest. However, it is unknown if a hospital’s ECMO capability is associated with better outcomes in cardiac arrest. We evaluated the association between pediatric cardiac arrest..

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Modifications to therapeutic plasma exchange to achieve rapid exchange on…

Abstract Background Cardiac transplants increasingly occur following placement of ventricular assist devices (VADs). A strong association exists between human leukocyte antigen (HLA) sensitization and VAD placement; however, desensitization protocols that utilize therapeutic plasma exchange (TPE) are fraught with technical challenges and are at increased risk of adverse events. In response..

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Regional Cerebral Oxygen Saturation and Estimated Oxygen Extraction Ratio as…

Abstract Regional cerebral oxygen saturation (ScO2) determined by near-infrared spectroscopy, monitoring both arterial and venous blood oxygenation of the brain, could reflect the balance between oxygen delivery and consumption. The aim of this study was to determine the predictabilities of ScO2 and estimated oxygen extraction ratio (eO2ER) with outcomes in infants..

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Assessing Risk Factors for Prolonged Intensive Care Unit Stay After…

Abstract Background Prolonged post-surgery intensive care unit (ICU) stay for congenital heart disease (CHD) has been explored in the pediatric population. However, there is limited data for adult CHD (ACHD), also called grown-up congenital heart (GUCH) disease, especially in low-resource countries where intensive care beds are scarce. This study identifies..

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Bacteria in Extracorporeal Membrane Oxygenation Circuit Clots of a Patient…

Abstract A neonate with pulmonary hypertension was supported with extracorporeal membrane oxygenation (ECMO). During ECMO support, the patient developed Enterococcus faecalis bacteremia, treated with targeted antibiotics. Despite the maximum dose of antibiotics, routine blood cultures remained positive throughout the ECMO treatment. A circuit change was performed due to buildup of thrombotic material and disseminated intravascular coagulation..

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A report of the first pediatric heart transplant following donation…

Abstract Cardiac donation after circulatory death (DCD) with ex-vivo perfusion (EVP) has the potential to greatly increase the donor pool, a benefit that can extend to selected pediatric patients. We report the first pediatric DCD heart transplantation in the United States (US) using EVP. This report was published with permission..

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Absolute Versus Relative Near-Infrared Spectroscopy in Pediatric Cardiac Patients

Abstract OBJECTIVES:  Near-infrared spectroscopy (NIRS) has been increasingly accepted as a noninvasive marker of regional tissue oxygenation despite concerns of imprecision and wide limits of agreement (LOA) with invasive oximetry. New generation absolute monitors may have improved accuracy compared with trend monitors. We sought to compare the concordance with invasive venous oximetry of a new..

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Refraining from Packed Red Blood Cells in Cardiopulmonary Bypass Priming…

Abstract Congenital heart defect (CHD) surgeries are performed with cardiopulmonary bypass (CPB) and are complicated by several factors that affect the child’s brain. However, to date, the number of studies on brain protection in cardiac surgery remains small. The aim of this study was to assess the impact of refraining..

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Centrifugal or Roller Blood Pumps for Neonatal Venovenous Extracorporeal Membrane…

Abstract Objectives:  To investigate outcomes associated with conventional roller or centrifugal pumps during neonatal venovenous extracorporeal membrane oxygenation (ECMO). Our primary hypothesis is that in comparison with conventional roller-pump support, centrifugal pump use is associated with greater odds of survival. Our secondary hypothesis is that centrifugal pump use is associated with lesser odds of..

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