Bloodless Pediatric Cardiac Surgery? Deliverance with Erythropoietin

1998 ◽  
Vol 6 (3) ◽  
pp. 237-238
Author(s):  
W David Creery ◽  
Michael D Black ◽  
Ian Adatia ◽  
Brian McIntyre
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Human Albumin ◽  
Recombinant Erythropoietin ◽  
Blood Products ◽  
Homologous Blood ◽  
Elective Cardiac Surgery ◽  
Human Recombinant Erythropoietin

A 2-year-old 11.6 kg boy with congenital heart disease whose parents refused homologous blood products was treated preoperatively with iron and human recombinant erythropoietin for 6 weeks. Surgical repair was performed without exposure to blood products other than human albumin. Treatment with iron and erythropoietin in combination with post-bypass modified ultrafiltration, minimization of hemodilution, reinfusion of residual pump prime, and diuresis may reduce or avoid the need for blood transfusion in acyanotic children undergoing elective cardiac surgery.

Psychological functioning in parents of children undergoing elective cardiac surgery

2004 ◽  
Vol 14 (2) ◽  
pp. 131-139 ◽  
Author(s):  
Jo Wray ◽  
Tom Sensky
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Surgical Procedures ◽  
Congenital Heart ◽  
Individual Characteristics ◽  
Hospital Treatment ◽  
Healthy Children ◽  
Elective Cardiac Surgery ◽  
Over Time

Purpose: To assess levels of distress, the marital relationship, and styles of coping of parents of children with congenital heart disease, to evaluate any change in these parameters following elective cardiac surgery for their child, and to compare these parents with parents of children undergoing another form of hospital treatment, and with parents of healthy children.Design:A prospective study in which parents were assessed the day before the surgical procedure being undergone by their child, and 12 months afterwards.Participants:We assessed three groups of parents of 75 children, aged from birth to 16.9 years. The first was a group whose children were undergoing surgery because of congenital heart disease, the second was a group whose children were undergoing transplantation of bone marrow, and the third was a group whose children were healthy. Measures used for assessment included the General Health Questionnaire, the Dyadic adjustment scale, and the Utrecht coping list.Results:Parents in both groups of children undergoing surgery had significantly higher rates of distress prior to the surgical procedures than did the parents of the healthy children, but within those whose children were undergoing cardiac surgery, there were no differences between parents of children with cyanotic and acyanotic lesions. Following treatment, there was a significant reduction in the levels of distress in both groups whose children had undergone surgery. There were few differences between any of the groups on the other parameters, and the evaluated indexes showed stability over time.Conclusion:Despite elevated levels of psychological distress prior to surgical procedures, which had fallen after one year, the stability of other parameters of parental functioning over time suggests that the surgical interventions are of less significance than either factors attributable to the presence of chronic illness, or the individual characteristics of the parents.

scholarly journals Effects of Cardiac Surgery and Surgical Procedures on Neurocognitive Function in Patients with Congenital Heart Disease: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Xiaoqi Su ◽  
Cheng Xu ◽  
Siyu Ma ◽  
Yiwei Pu ◽  
Zhiqi Wang ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Intelligence Quotient ◽  
Congenital Heart ◽  
Surgical Repair ◽  
Meta Analysis ◽  
Mean Difference ◽  
Verbal Iq ◽  
Surgical Methods

Abstract Objective: To determine the neurodevelopmental function in patients with congenital heart disease (CHD) after cardiac surgery and the influence of surgical repair versus transcatheter repair on neurodevelopment.Methods: We searched PUBMED, EMBASE and Cochrane Controlled Trials (Central) in September 2019 by using Medical Subject Headings. We extracted data using a customized data extraction sheet and employed standard methodological procedures as expected by Cochrane. We used a fixed-effect or random-effect model for meta-analysis. Results: We included a total of seven articles. The assessed neurodevelopment outcomes were the full intelligence quotient (full IQ), verbal intelligence quotient (verbal IQ) and performance intelligence quotient (performance IQ). The intelligence quotient was statistically significant after cardiac surgery compared with that of the normal control (full IQ: mean difference = -5.79 [95% CIs -10.14, -1.44], P = 0.009, I2=71%; verbal IQ: mean difference = -4.46 [95% CIs -7.99, -0.93], P = 0.01, I2=56%; performance IQ: mean difference = -7.13 [95% CIs -10.90, -3.35], P =0.0002, I2=64%). The neurodevelopment functions were no different after surgical repair versus transcatheter repair (full IQ: mean difference = 0.19 [95% CIs -4.10, 4.49], P = 0.93, I2=0%; verbal IQ: mean difference = 2.29 [95% CIs -1.60, 6.18], P = 0.25, I2=0%; performance IQ: mean difference = -2.49 [95% CIs -6.49, 1.52], P = 0.22, I2=0%).Conclusion: We found that patients with CHD undergoing cardiac surgery may exhibit a negative effect on neurodevelopment, and there may be no difference in the effects of the two different surgical methods on neurodevelopment.

scholarly journals Predictive role of perioperative neutrophil to lymphocyte ratio in pediatric congenital heart disease associated with pulmonary arterial hypertension

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoqiang Yin ◽  
Mei Xin ◽  
Sheng Ding ◽  
Feng Gao ◽  
Fan Wu ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Congenital Heart ◽  
Prolonged Mechanical Ventilation ◽  
Pulmonary Arterial ◽  
Mechanical Ventilation Time

Abstract Background We aimed to explore the relationship between the neutrophil to lymphocyte ratio (NLR) and the early clinical outcomes in children with congenital heart disease (CHD) associated with pulmonary arterial hypertension (PAH) after cardiac surgery. Methods A retrospective observational study involving 190 children from January 2013 to August 2019 was conducted. Perioperative clinical and biochemical data were collected. Results We found that pre-operative NLR was significantly correlated with AST, STB, CR and UA (P < 0.05), while post-operative NLR was significantly correlated with ALT, AST, BUN (P < 0.05). Increased post-operative neutrophil count and NLR as well as decreased lymphocyte count could be observed after cardiac surgery (P < 0.05). Level of pre-operative NLR was significantly correlated with mechanical ventilation time, ICU stay time and total length of stay (P < 0.05), while level of post-operative NLR was only significantly correlated to the first two (P < 0.05). By using ROC curve analysis, relevant areas under the curve for predicting prolonged mechanical ventilation time beyond 24 h, 48 h and 72 h by NLR were statistically significant (P < 0.05). Conclusion For patients with CHD-PAH, NLR was closely related to early post-operative complications and clinical outcomes, and could act as a novel marker to predict the occurrence of prolonged mechanical ventilation.

scholarly journals Is alternative cardiac surgery an option in adults with congenital heart disease referred for thoracic organ transplantation?†

2012 ◽  
Vol 43 (2) ◽  
pp. 344-351 ◽  
Author(s):  
Andrew Robert Harper ◽  
David Steven Crossland ◽  
Gianluigi Perri ◽  
John Jude O'Sullivan ◽  
Milind Pralhad Chaudhari ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Organ Transplantation ◽  
Congenital Heart ◽  
Thoracic Organ

scholarly journals Down syndrome and congenital heart disease: perioperative planning and management

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Dennis R. Delany ◽  
Stephanie S. Gaydos ◽  
Deborah A. Romeo ◽  
Heather T. Henderson ◽  
Kristi L. Fogg ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Down Syndrome ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Single Ventricle ◽  
Heart Defects ◽  
Careful Consideration ◽  
Children With Down Syndrome ◽  
Perioperative Planning

AbstractApproximately 50% of newborns with Down syndrome have congenital heart disease. Non-cardiac comorbidities may also be present. Many of the principles and strategies of perioperative evaluation and management for patients with congenital heart disease apply to those with Down syndrome. Nevertheless, careful planning for cardiac surgery is required, evaluating for both cardiac and noncardiac disease, with careful consideration of the risk for pulmonary hypertension. In this manuscript, for children with Down syndrome and hemodynamically significant congenital heart disease, we will summarize the epidemiology of heart defects that warrant intervention. We will review perioperative planning for this unique population, including anesthetic considerations, common postoperative issues, nutritional strategies, and discharge planning. Special considerations for single ventricle palliation and heart transplantation evaluation will also be discussed. Overall, the risk of mortality with cardiac surgery in pediatric patients with Down syndrome is no more than the general population, except for those with functional single ventricle heart defects. Underlying comorbidities may contribute to postoperative complications and increased length of stay. A strong understanding of cardiac and non-cardiac considerations in children with Down syndrome will help clinicians optimize perioperative care and long-term outcomes.

The role of EEG recordings in children undergoing cardiac surgery for congenital heart disease

2017 ◽  
Vol 167 (11-12) ◽  
pp. 251-255
Author(s):  
Sascha Meyer ◽  
Martin Poryo ◽  
Mohammed Shatat ◽  
Ludwig Gortner ◽  
Hashim Abdul-Khaliq
Keyword(s):  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Eeg Recordings
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