scholarly journals Implantable loop recorders in patients with a structural or electrical heart disease: comparison of the clinical value in patients with and without a history of syncope

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
A Assaf ◽  
R Sakhi ◽  
M Michels ◽  
JW Roos-Hesselink ◽  
JMA Verhagen ◽  
...  
Keyword(s):  
Heart Disease ◽  
Primary Endpoint ◽  
Clinical Value ◽  
Loop Recorder ◽  
Increased Risk ◽  
Significant Difference ◽  
Electrical Heart Disease ◽  
History Of ◽  
Group A ◽  
Group B

Abstract Funding Acknowledgements Type of funding sources: None. Background Patients with structural and electrical heart disease are at increased risk for sudden cardiac death. Guidelines recommend the use of an implantable loop recorder (ILR) in symptomatic patients when symptoms are sporadic and suspected to be related to arrhythmias. In clinical practice, an ILR is mainly used in patients with unexplained syncope. Purpose To compare the clinical value of an ILR in patients with a heart disease and a history of syncope versus those with non-syncopal suspected arrhythmia-related symptoms. Methods In this observational single-center study we included symptomatic patients with structural or electrical heart disease who received an ILR. The primary endpoint was an actionable event which was defined as an arrhythmic event leading to a change in clinical management. The secondary endpoint was an event leading to implantation of a pacemaker or implantable cardioverter-defibrillator (ICD). Results A total of 120 patients (mean age 47 ± 17 years, 49% men) were included. Underlying disease substrate was inherited cardiomyopathy (31%), congenital heart disease (28%), channelopathy (23%), and other structural heart disease (18%).There were 43 patients with a history of syncope (group A) and 77 patients with non-syncopal symptoms (group B) such as palpitations, dizziness and/or near-syncope at baseline. During a median follow-up of 19 months (IQR 8-36), a primary endpoint was reached in 14 patients (33%) of group A, and in 28 patients (36%) of group B (logrank P = 0.54, Figure A). There was also no significant difference in the cumulative rate of cardiac device implantation between group A and B, 14% versus 10%, respectively (logrank P = 0.97, Figure B). Conclusion Our results show no differences in ILR yield in patients with structural or electrical heart disease who present with any suspected arrhythmia-related symptom, including those with non-syncopal symptoms. Abstract Figure.

scholarly journals Implantable loop recorders in patients with heart disease: comparison between patients with and without syncope

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001748
Author(s):  
Amira Assaf ◽  
Rafi Sakhi ◽  
Michelle Michels ◽  
Jolien W Roos-Hesselink ◽  
Judith M A Verhagen ◽  
...  
Keyword(s):  
Heart Disease ◽  
Primary Endpoint ◽  
Underlying Disease ◽  
Clinical Value ◽  
Loop Recorder ◽  
Device Implantation ◽  
Inherited Cardiomyopathy ◽  
Increased Risk ◽  
Group A ◽  
Group B

ObjectivePatients with heart disease are at increased risk for sudden cardiac death. Guidelines recommend an implantable loop recorder (ILR) for symptomatic patients when symptoms are sporadic and possibly arrhythmia-related. In clinical practice, an ILR is mainly used in patients with unexplained syncope. We aimed to compare the clinical value of an ILR in patients with heart disease and a history of syncope versus those with non-syncopal symptoms.MethodsIn this observational single-centre study, we included symptomatic patients with heart disease who received an ILR. The primary endpoint was an actionable event which was defined as an arrhythmic event leading to a change in clinical management. The secondary endpoint was an event leading to device implantation.ResultsOne hundred and twenty patients (mean age 47±17 years, 49% men) were included. The underlying disease substrate was inherited cardiomyopathy (31%), congenital heart disease (28%), channelopathy (23%) and other (18%). Group A consisted of 43 patients with prior syncope and group B consisted of 77 patients with palpitations and/or near-syncope. The median follow-up duration was 19 months (IQR 8–36). The 3-year cumulative event rate was similar between groups with regard to the primary endpoint (38% vs 39% for group A and B, respectively, logrank p=0.54). There was also no difference in the 3-year cumulative rate of device implantation (21% vs 13% for group A and B, respectively, logrank p=0.65).ConclusionIn symptomatic patients with heart disease, there is no difference in the yield of an ILR in patients presenting with or without syncope.

Risk of Damaging Anatomical Structures During Minimally Invasive Hallux Valgus Correction (Bösch Technique): An Anatomical Study

2018 ◽  
Vol 39 (11) ◽  
pp. 1355-1359 ◽  
Author(s):  
Martin Kaipel ◽  
Lukas Reissig ◽  
Lukas Albrecht ◽  
Stefan Quadlbauer ◽  
Joachim Klikovics ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Complication Rate ◽  
Metatarsal Osteotomy ◽  
Anatomical Structures ◽  
Intensive Training ◽  
Increased Risk ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Percutaneous, transverse distal metatarsal osteotomy with K-wire fixation (the Bösch technique) is an established technique for hallux valgus correction. Nevertheless, the risk of damaging the anatomical structures during the operation is unknown. Methods: Forty fresh-frozen anatomical foot specimens with hallux valgus deformity underwent a percutaneous corrective procedure. Specimens of group A (n = 20) were operated by an experienced surgeon while specimens of group B (n = 20) were done by untrained residents. Results: The dorsal cutaneous nerve was injured in 1 of 20 cases in group A and 6 of 20 cases in group B ( P = .037). There was a significant difference in overall complication rate between specimens of group A and group B ( P = .043). Conclusions: The results show an increased risk of perioperative injury of the dorsal cutaneous branch of the deep peroneal nerve as well as a significant effect of the surgeon’s experience on the overall complication rate. Clinical Relevance: Results of this study are highly relevant for all surgeons who perform percutaneous, minimally invasive hallux valgus surgery to avoid damage to the peripheral nerves. In addition, the data suggest an intensive training for surgeons before minimally invasive hallux valgus surgery is performed without supervision.

Comparison of Efficacy of I/V Tramadol and Bupivacaine Irrigation through Drains after Modified Radical Mastectomy

2021 ◽  
Vol 15 (11) ◽  
pp. 3007-3011
Author(s):  
Zarqa Rani ◽  
Iqra Mushtaq ◽  
Mehreen Akram ◽  
Zahra Ishrat
Keyword(s):  
Breast Cancer ◽  
Urinary Retention ◽  
Controlled Trial ◽  
Radical Mastectomy ◽  
Breast Cancer Surgery ◽  
Modified Radical Mastectomy ◽  
Increased Risk ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Severe postsurgical pain continues to be hard to manage in patients who experience breast cancer surgery. Badly managed pain can lead to meager patient satisfaction, prolonged hospital stay, and increased risk of complication by analgesics, and may be a reason in the development of long-lasting pain. Aim: To compare the efficacy of Intravenous Tramadol and Bupivacaine irrigation through surgical drains after Modified Radical Mastectomy in patients with carcinoma breast. Methods: This was a randomized controlled trial conducted in the Department of Anesthesia, Mayo Hospital Lahore. Total 70 female patients aged 18-70 years undergoing radical mastectomy for CA breast diagnosed on histopathology were selected. Patients were divided into two groups A and B through simple random sampling technique. Group A received intravenous Tramadol. Group B received Bupivacaine through surgical drains. Results: At 0, 2, 4 and 6 hour postoperatively no significant difference was seen in severity of pain in both treatment groups. In Group-A at 0, 2, 4 and 6 hour postoperatively, 68.8%, 71.4%, 57.1% and 60% respectively had reported no pain while in Group-B at 0, 2, 4 and 6 hour postoperatively, 48.6%, 65.7%, 45.7% and 54.3% patients had reported no pain. Complaints of Nausea, vomiting, sedation, urinary retention was higher in patients in Tramadol Group as compared to Bupivacaine Group. Conclusion: Results of this study demonstrated that bupivacaine administrated through surgical drain was equally effective as intravenous tramadol for controlling postoperative mastectomy pain with less side effects. Keyword: Breast Cancer, Acute Pain, Analgesia, Tramadol, Bupivacaine, Radical Mastectomy, Nausea, Vomiting, Sedation, Urinary retention, Hypotension

Pentraxin 3 and other inflammatory biomarkers related to atrial fibrillation in cardiac surgery

Perfusion ◽  
2016 ◽  
Vol 32 (4) ◽  
pp. 269-278 ◽  
Author(s):  
Zdenka Holubcova ◽  
Pavel Kunes ◽  
Jiri Mandak ◽  
Dana Vlaskova ◽  
Martina Kolackova ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Serum Levels ◽  
Inflammatory Biomarkers ◽  
Surgical Patients ◽  
Significant Difference ◽  
History Of ◽  
Group A ◽  
Group B ◽  
New Onset

Objectives: The aim was to evaluate the association between perioperative inflammatory biomarkers and atrial fibrillation (AF) in cardiac surgical patients. Methods: Forty-two patients undergoing cardiac surgery were divided into three groups according to the occurrence of AF: Group A (n = 22) – patients with no AF, Group B (n = 11) – patients with new onset AF postoperatively and Group C (n = 9) – patients with preoperative history of atrial fibrillation. The serum levels of PTX3, CRP, TLR2, IL-8, IL-18, sFas, MMP-7 and MMP-8 were measured at the following time points: before surgery, immediately and 6 h after surgery and on the 1st, 3rd and 7th postoperative days (POD). Results: Serum levels of PTX3 showed a significant difference between Groups A and C on the 3rd POD (p<0.05) and on the 7th POD (p<0.0001). IL-8 levels were different between Groups A and C immediately after surgery (p<0.05), 6 hours after surgery (p<0.05) and on the 3rd POD (p<0.05). There was a difference between Groups B and C on the 1st POD in IL-8 levels (p<0.05). The sFas levels differed between Groups A and C on the 3rd POD (p<0.01) and the 7th POD (p<0.05). There was also a difference on the 7th POD (p<0.05) between the Groups B and C. No significant differences between the groups was seen for other biomarkers. Conclusion: This study demonstrates significantly different dynamics of PTX3, IL-8 and sFas levels after cardiac surgery in relation to AF.

scholarly journals Adequate timing of thromboembolic prophylaxis in colorectal cancer surgery

2018 ◽  
Vol 5 (2) ◽  
pp. 576
Author(s):  
Ghada Morshed ◽  
Nader Zaki
Keyword(s):  
Colorectal Cancer ◽  
Venous Thromboembolism ◽  
Prospective Study ◽  
Bleeding Complications ◽  
Thromboembolic Prophylaxis ◽  
Colorectal Cancer Surgery ◽  
Increased Risk ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: It has been found that patients with colorectal cancer are at increased risk for postoperative venous thromboembolism. The aim of this prospective study is to evaluate the incidence of venous thromboembolism and major bleeding complications in patients undergoing colorectal cancer who are treated with preoperative or postoperative venous thromboprophylaxis.Methods: This prospective study included 30 patients from September 2013 to November 2017. There were 22 males and 8 females; mean age was 66.7±5.5 years (range 44-78). Author divided the patients randomly into two groups (group A=15 cases with preoperative and group B = 15 cases with postoperative venous thromboprophylaxis).Results: There was no significant difference in preoperative versus postoperative thromboembolic prophylaxis regarding postoperative DVT 0/15(0%) vs 1/15 (6.6%), P=0.69, no bleeding complications and no pulmonary embolism.Conclusions: Preoperative and postoperative thromboembolic prophylaxis are equally safe in venous thromboembolism protection. 

P3130Relation between serum levels of long acting penicillin and the inflammatory markers: High sensitivity C-reactive protein and interleukin-6 in patients with chronic rheumatic heart disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
O A Rifaie ◽  
M A Hamza ◽  
S M Amin ◽  
M A Yousef
Keyword(s):  
Heart Disease ◽  
High Sensitivity ◽  
Serum Levels ◽  
Control Group ◽  
P Value ◽  
Significant Difference ◽  
Inflammatory State ◽  
Group A ◽  
Long Acting ◽  
Group B

Abstract Background There is evidence of a chronic inflammatory state in patients with chronic rheumatic valvular heart disease (RhD) as shown by high serum levels of high sensitivity C-reactive protein (CRP) and interleukin-6 (IL6). Despite the efficacy of long acting penicillin (LAP) in secondary prevention of rheumatic fever, its effect on this inflammatory state is still unknown Objective We sought to study the effect of (LAP) on the inflammatory markers, (CRP) and (IL-6), in patients with chronic rheumatic heart disease. Methods Eighty patients having (RhD) patients coming to our university hospitals outpatient clinic for rheumatic fever secondary prophylaxis by regular administration of (LAP) were enrolled in. the study. Patients were divided into to 3 groups: Group A; 70 patients with (RhD) already on prophylactic (LAP), Group B; 10 patients with (RhD) who have not yet started prophylactic (LAP), Group C; control group of 10 healthy individuals not known to have (RhD). Serum levels of (LAP), (IL6) and (CRP) were measured for the three groups. Results . Group A had significantly lower (IL6) levels than group B (25.22±33.50 vs. 126.1±33.76ng/ml, respectively, p<0.0001). (IL6) levels were significantly lower in control subjects compared to patients in group B (3.600±2.319, 25.22±33.50 ng/ml respectively, p<0.0001). However, IL6 levels in the control group were lower but non-significantly different compared to Group A . (CRP) level was lower in group A than group B (8419±4935 vs. 14400±3375mg/dl respectively, p=0.0002). (CRP) levels were significantly lower in control subjects compared to patients in group A and group B. (IL6) values were positively correlated with (CRP) values (r=0.6387, p<0.0001). (CRP) level negatively correlated with Long acting penicillin level (r=−0.5277, p<0.0001). (IL-6) level negatively correlated with (LAP) level (r=−0.4401, p<0.0001). There was a highly significant difference between (LAP) level in compliant and non-compliant patients (1.045±1.270 vs. 0.0785±0.1057ng/ml, respectively, p value <0.0001). There was also a highly significant difference between (CRP) level in compliant and non-compliant patients (7640±4558 vs. 13090±4717 mg/dl, respectively, p value 0.005).Moreover, there was a significant difference between (IL-6) levels in compliant and non-compliant patients (21.53±32.70 vs. 47.40±30.91 ng/ml, respectively, p value 0.03). Conclusion Serum (LAP) has a strong negative correlation with (IL-6) and (CRP) levels. Regular administration of (LAP) strongly ameliorates the inflammatory state seen in patients with (RhD).

Seroepidemiology ofStrongyloides stercoralisin Dhaka, Bangladesh

Parasitology ◽  
2012 ◽  
Vol 139 (11) ◽  
pp. 1513-1520 ◽  
Author(s):  
YASMIN SULTANA ◽  
GWENDOLYN L. GILBERT ◽  
BE-NAZIR AHMED ◽  
ROGAN LEE
Keyword(s):  
Strongyloides Stercoralis ◽  
Epidemiological Studies ◽  
Igg Subclasses ◽  
Personal Hygiene ◽  
Individual Risk ◽  
Slum Dwellers ◽  
Significant Difference ◽  
History Of ◽  
Group A ◽  
Group B

SUMMARYHuman strongyloidiasis is a neglected tropical disease with global distribution and this infection is caused by the parasitic nematodeStrongyloides stercoralis. The aim of this study was to determine the prevalence of strongyloidiasis in Dhaka, Bangladesh. Sera from 1004 residents from a slum (group A) and 299 from city dwellers (group B) were tested for total IgG and IgG subclasses toStrongyloidesantigen. There was a significant difference (P < 0·001) in IgG seroprevalence between group A (22%) and group B (5%). Reactive IgG subclasses (IgG1 and IgG4) were also higher in group A (P < 0·05). The seroprevalence of strongyloidiasis in group A increased with age but was unrelated to sex. The presence of reactive IgG toStrongyloidesantigen had no correlation with either socio-economic or personal hygiene factors. However, a history of diarrhoea in a family member, in the past 6 months, but not in the respondents was associated with detection of antibodies toS. stercoralis(P < 0·01). None of the sera from either group had an HTLV-I reaction. This study demonstrates that strongyloidiasis is prevalent in Dhaka, especially among slum dwellers, but concurrent infection with HTLV-I was not found. Future epidemiological studies should identify individual risk factors and other communities at risk so that appropriate interventions can be planned.

scholarly journals Study of the relation between serum levels of long-acting penicillin and the inflammatory markers: C-reactive protein and interleukin-6 in patients with chronic rheumatic heart disease

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Ahmad M. Yousef ◽  
Osama A. Rifaie ◽  
Mohamed A. Hamza ◽  
Sameh A. Amin
Keyword(s):  
Heart Disease ◽  
Serum Levels ◽  
Control Group ◽  
Reactive Protein ◽  
Significant Difference ◽  
Inflammatory State ◽  
Group A ◽  
Long Acting ◽  
Group B ◽  
Rheumatic Heart

Abstract Background There is an evidence of a chronic inflammatory state in patients with chronic rheumatic valvular heart disease (RHD) as shown by high serum levels of high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL6). Despite the efficacy of long-acting penicillin (LAP) in secondary prevention of rheumatic fever, its effect on this inflammatory state is still unknown. So, we sought to study the effect of LAP on the inflammatory markers, CRP and IL-6, in patients with chronic rheumatic heart disease. Results Eighty RHD patients coming to our hospital’s outpatient clinic for rheumatic fever secondary prophylaxis by regular administration of LAP were enrolled in the study. Patients were divided into 3 groups: group A, 70 patients with RHD already on prophylactic LAP, group B, 10 patients with RHD who have not yet started prophylactic LAP, and group C, control group of 10 healthy individuals not known to have RHD. Serum levels of LAP, IL-6, and CRP were measured for the three groups. Group A had significantly lower IL-6 levels than group B (25.22 ± 33.50 vs. 126.1 ± 33.76nng/ml, respectively, p < 0.0001). IL-6 levels were significantly lower in control subjects compared to patients in group B (3.600 ± 2.319, 25.22 ± 33.50 ng/ml, respectively, p < 0.0001). However, IL-6 levels in the control group were lower but non-significantly different compared to group A. CRP level was lower in group A than group B (8419 ± 4935 vs. 14400 ± 3375 mg/dl, respectively, p = 0.0002). CRP levels were significantly lower in control subjects compared to patients in group A and group B. IL-6 values were positively correlated with CRP values (r = 0.6387, p < 0.0001). CRP values were negatively correlated with LAP values (r = -0.5277, p < 0.0001). IL-6 values were negatively correlated with LAP values (r = − 0.4401, p < 0.0001). There was a highly significant difference between LAP level in compliant and non-compliant patients (1.045 ± 1.270 vs. 0.0785 ± 0.1057 ng/ml, respectively, p value < 0.0001). There was also a highly significant difference between CRP level in compliant and non-compliant patients (7640 ± 4558 vs. 13090 ± 4717 mg/dl, respectively, p = 0.005). Moreover, there was a significant difference between IL-6 levels in compliant and non-compliant patients (21.53 ± 32.70 vs. 47.40 ± 30.91 ng/ml, respectively, p value 0.03). Conclusion Serum LAP has a strong negative correlation with IL-6 and CRP levels. Regular administration of LAP strongly ameliorates the inflammatory state seen in patients with RHD.

P1895Predictors of left atrial thrombosis in patients undergoing planned electrical cardioversion of atrial fibrillation treated with direct anticoagulant

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
V Lio ◽  
E Causin ◽  
P Devecchi ◽  
G Dell'era ◽  
E Occhetta
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation ◽  
Electrical Cardioversion ◽  
Consecutive Series ◽  
Increased Risk ◽  
Significant Difference ◽  
Group A ◽  
Male Sex ◽  
Group B

Abstract Background Scheduled electrical cardioversion (CV) of persistent atrial fibrillation (AF) can be performed after an adequate period of oral anticoagulation (OAC) therapy to reduce thromboembolic complications. Exclusion of left atrial appendage (LAA) thrombi can be achieved by transoesophagel echocardiography (TOE), that is indicated if early CV is desired in patients (pts) with ≥48 hours-lasting arrhythmia, while is not recommended after at least 3 weeks of OAC. Purpose We investigated with TOE the presence of LAA thrombi in a consecutive series of ambulatory pts scheduled for electrical CV of AF and treated with DOAC for at least 3 weeks. Methods We evaluated 93 pts referred to our Clinic for CV of persistent AF (October 2017–December 2018), all treated with DOAC. We collected clinical history, physical examination, 12-lead ECG, lab tests and transthoracic echocardiography measures. Right before cardioversion we systematically performed TOE to exclude LAA thrombi. If absent, we proceeded to CV, while in case of grade III echo-contrast and/or thrombotic stratification we didn't perform the procedure. All values are reported, as appropriate, as mean±SD or number and percentage. All results were considered statistically significant when p<0.05. The entire analysis was performed using the Statistical Package for Social Sciences package, version 19.0 (SPSS, Chicago, Illinois). Results 76 out of 93 pts (82% – group A) were free from intracavitary thrombi and underwent successful electrical CV; the other 17 pts (18% – group B) had thrombi in LAA that contraindicated electrical CV. Group B pts (74±10 years old, 65% male sex) had higher CHA2DS2-VASc score (4,1±2 vs 3,1±1,4, p=0,014), they were significantly more affected by chronic kidney disease (CKD, 59% vs 32%, p=0.035), peripheral artery disease (PAD, 35% vs 12%, p=0.017), they had larger LA dimension (48±5 vs 45±5 mm, p=0,09 - non significant) and as expected they had reduced LAA emptying velocity (76% vs 30%, p<0.001) compared to group A pts (73±8 years old, 70% male sex). There was no significant difference neither in duration (median 7 weeks) nor in type of DOAC therapy between the two groups. Conclusions Current Guidelines recommend at least three weeks of OAC before electrical CV of persistent AF. TOE is recommended only if early cardioversion is needed. We observed that in a significant part of pts treated with DOAC for more than 3 weeks TOE still identified LAA thrombi, especially in pts with multiple comorbidities. Even if we currently don't have data on clinical endpoints in this population, CV of patients with LAA thrombi despite adequate DOAC therapy may lead to an increased risk of thromboembolic events. We think it's necessary to identify more accurate predictors (i.e. CKD) to stratify the thromboembolic risk. Further randomized studies are needed to identify whether there are patients in which CV shouldn't be performed without TOE, irrespective of anticoagulation duration.

scholarly journals ED50 of Intranasal Dexmedetomidine Sedation for Transthoracic Echocardiography in Children with or without a History of Cardiac Surgery for Cyanotic Congenital Heart Disease

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
HongBin Gu ◽  
YunAn Song ◽  
Jie Bai
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Congenital Heart ◽  
Onset Time ◽  
Cyanotic Congenital Heart Disease ◽  
Significant Difference ◽  
History Of ◽  
Group A ◽  
Correction Surgery ◽  
Group B

Background and Objective. Dexmedetomidine (DEX) can provide adequate sedation during short procedures. However, the median effective dose (ED50) of intranasal DEX sedation has not been well established in children with a history of correction surgery for cyanotic congenital heart disease (cCHD). This study was to determine ED50 of intranasal DEX sedation for transthoracic echocardiography (TTE) in young children with a history of correction surgery for cCHD. Methods. This prospective single-blinded clinical trial included 72 ASA I-II stage children aged 1-36 months with cCHD who were scheduled to undergo TTE under sedation. Children were assigned to group A ( n = 37 ) with a previous history of cardiac surgery and group B ( n = 35 ) with no history of cardiac surgery. Doses of intranasal DEX were analyzed by up-down sequential allocation at an initial dose of 2.3 μg/kg and an increase in steps of 0.2 μg/kg. Intranasal DEXED50 values were analyzed by the up-and-down method of Dixon-Massey and probit regression to determine ED50 and 95% confidence interval (CI) for sedation. The time to effective sedation, time to regaining consciousness, vital signs, oxygen saturation, time of performing TTE, clinical adverse effects, and characteristics of regaining consciousness were compared between the two groups. Results. ED50 of intranasal DEX sedation was 2.530 μg/kg (95% CI, 1.657-4.156) in group A and 2.500 μg/kg (95% CI, 1.987-3.013) in group B. There was no significant difference in sedation onset time and time to regaining consciousness between the two groups. Additionally, no significant adverse hemodynamic or hypoxemic effect was observed. There was no significant difference in sedation-onset time and wake-up time between the two groups ( 15 ± 4  min vs. 16 ± 5  min; 50 ± 11  min vs. 48 ± 10  min). This trial is registered with the China Clinical Trials Registry (ChiCTR-IOR-1800015038). Conclusions. ED50 of intranasal DEX sedation for TTE is similar in children with and without a history of cardiac surgery for cCHD.

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