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  • 1
    Online Resource
    Online Resource
    Modified Blalock-Thomas-Taussig Shunt Using Femoral Artery Homograft
    Elsevier BV ; 2023
    In:  Annals of Thoracic Surgery Short Reports Vol. 1, No. 1 ( 2023-03), p. 94-95
    Details
    In: Annals of Thoracic Surgery Short Reports, Elsevier BV, Vol. 1, No. 1 ( 2023-03), p. 94-95
    Type of Medium: Online Resource
    ISSN: 2772-9931
    URL: Article
    DOI: 10.1016/j.atssr.2022.11.004
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
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  • 2
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    Online Resource
    Abstract 16941: Diagnostic Performance of NephroCheck™ in the Prediction of Acute Kidney Injury in Neonates Undergoing Surgery for Congenital Heart Disease
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: Acute kidney injury (AKI) is a common and serious complication in patients undergoing cardiac surgery and is associated with adverse outcomes. TIMP-2 and IGFBP-7 are cell cycle arrest proteins that are detected in urine during periods of kidney stress or injury. The NephroCheck™ system measures urine concentrations of these two biomarkers and calculates a score which has been validated in adults as a predictor of AKI. The utility of these markers in identifying AKI in neonates after congenital heart surgery (CHS) has not been determined. Hypothesis: Concentrations of TIMP-2 and IGFBP-7 as measured by the NephroCheck™ system will be elevated in neonates with AKI following CHS requiring cardiopulmonary bypass (CPB). Methods: We conducted a single center, prospective, observational study in neonates less than 31 days old undergoing CHS requiring CPB between 9/2017 and 5/2019. Urine samples were collected and analyzed using the NephroCheck™ system prior to surgery and at 6, 12, 24 and 96 hours (h) post CPB. All patients were evaluated for staging of AKI using the Acute Kidney Injury Network criteria (AKIN). Wilcoxon Rank Sum tests were used to compare the medians of the NephroCheck™ values in the AKIN negative and positive groups for each of the time points. ROC curves and AUCs with 95% CIs were used to measure how well the NephroCheck™ values predict the AKIN negative and positive status of the patients. Results: Thirty-six patients were included, 56% were male. Median age and weight were 7 days and 3.14 kg. Pre-surgically, no patients met AKI definition by AKIN criteria or by NephroCheck™ values. Post surgically, 52% of patients had AKI by AKIN criteria. All patients with AKI had elevated biomarkers. The presence of elevated biomarkers as determined by NephroCheck™ had a statistically significant association for the presence of AKI at the 6 h (p = 0.036) and 24 h (p = 0.00037) time points. Of all time points analyzed, samples obtained at 24h were best at predicting the development of AKI in the post-surgical period (AUC: 0.848). Conclusions: Elevation in urine concentration of TIMP-2 and IGFBP-7 is associated with AKI in neonates after CHS requiring CPB. Urinary biomarkers levels 24 h after CPB are good predictors of AKI in this population.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.16941
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
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  • 3
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    Online Resource
    Developing a new pediatric extracorporeal membrane oxygenation (ECMO) program
    Walter de Gruyter GmbH ; 2023
    In:  Journal of Perinatal Medicine Vol. 51, No. 5 ( 2023-06-27), p. 697-703
    Details
    In: Journal of Perinatal Medicine, Walter de Gruyter GmbH, Vol. 51, No. 5 ( 2023-06-27), p. 697-703
    Abstract: We aimed to critically evaluate the effectiveness of a designated ECMO team in our ECMO selection process and patient outcomes in the first 3 years of our low-volume pediatric ECMO program. Methods We conducted a retrospective chart review of patients who received an ECMO consultation between the start of our program in March 2015 and May 2018. We gathered clinical and demographic information on patients who did and did not receive ECMO, and described our selection process. We reflected on the processes used to initiate our program and our outcomes in the first 3 years. Results Sixty-nine patients received consultations, and of those, 50 patients were potential candidates. 19 (38%) of the candidates were ultimately placed on ECMO. There were statistically significant differences in oxygen saturation, paO 2 , oxygenation index, A-aDO 2 , lactate, and pH between the patients who went on ECMO and who did not. We improved our outcomes from 0% survival to discharge in 2015, to 60% in 2018, with an average of 63% survival to discharge over the first 3 years of our program. Conclusions In a low-volume pediatric ECMO center, having a designated team to assist in the patient selection process and management can help provide safe and efficient care to these patients, and improve patient outcomes. Having a strict management protocol and simulation sessions involving all members of the medical team yields comfort for the providers and optimal care for patients. This study describes our novel structure, processes, and outcomes, which we hope will be helpful to others seeking to develop a new pediatric ECMO program.
    Type of Medium: Online Resource
    ISSN: 0300-5577 , 1619-3997
    URL: Article
    DOI: 10.1515/jpm-2022-0298
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2023
    detail.hit.zdb_id: 1467968-1
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  • 4
    Online Resource
    Online Resource
    CANGRELOR FOR COMPLEX PCI IN A CHILD
    Elsevier BV ; 2023
    In:  Journal of the American College of Cardiology Vol. 81, No. 8 ( 2023-03), p. 3301-
    Details
    In: Journal of the American College of Cardiology, Elsevier BV, Vol. 81, No. 8 ( 2023-03), p. 3301-
    Type of Medium: Online Resource
    ISSN: 0735-1097
    URL: Article
    DOI: 10.1016/S0735-1097(23)03745-2
    RVK:
    XA 17760
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 1468327-1
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  • 5
    Online Resource
    Online Resource
    Pharmacologic therapies for the low cardiac output syndrome in children after cardiac surgery: evidence of their efficacy and trends in their use
    OAE Publishing Inc. ; 2022
    In:  Vessel Plus ( 2022)
    Details
    In: Vessel Plus, OAE Publishing Inc., ( 2022)
    Abstract: The low cardiac output syndrome describes the phenomenon of the reduction of cardiac output that can occur following cardiac surgery requiring cardiopulmonary bypass. If unrecognized or untreated, this condition can result in significant morbidity and mortality. Along with non-pharmacologic therapies, pharmacologic agents used to help manage the low cardiac output syndrome include catecholamine inotropes, inodilators, systemic vasodilators, pulmonary vasodilators, and other classes of medications. We summarize the rationale and key evidence supporting the use of these therapies in children. In addition, utilizing provider surveys and registry reviews, we describe the current trends in the use of these medications and the variation demonstrated between providers and centers. Given the heterogeneous etiology of low cardiac output syndrome, successful management requires that pharmacologic therapies be tailored to the physiologic derangements of each patient.
    Type of Medium: Online Resource
    ISSN: 2574-1209
    URL: Journal
    URL: Article
    DOI: 10.20517/2574-1209
    DOI: 10.20517/2574-1209.2021.94
    Language: Unknown
    Publisher: OAE Publishing Inc.
    Publication Date: 2022
    detail.hit.zdb_id: 2999725-2
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  • 6
    Online Resource
    Online Resource
    Elevated Levels of Urinary Biomarkers TIMP-2 and IGFBP-7 Predict Acute Kidney Injury in Neonates after Congenital Heart Surgery
    Georg Thieme Verlag KG ; 2022
    In:  Journal of Pediatric Intensive Care Vol. 11, No. 02 ( 2022-06), p. 153-158
    Details
    In: Journal of Pediatric Intensive Care, Georg Thieme Verlag KG, Vol. 11, No. 02 ( 2022-06), p. 153-158
    Abstract: Objectives This article investigated the utility of urine biomarkers tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein-7 (IGFBP-7) in identifying acute kidney injury (AKI) in neonates after congenital heart surgery (CHS). TIMP-2 and IGFBP-7 are cell cycle arrest proteins detected in urine during periods of kidney stress/injury. Methods We conducted a single-center, prospective study between September 2017 and May 2019 with neonates undergoing CHS requiring cardiopulmonary bypass (CPB). Urine samples were analyzed using NephroCheck prior to surgery and 6, 12, 24, and 96 hours post-CPB. All patients were evaluated using the Acute Kidney Injury Network (AKIN) criteria. Wilcoxon rank sum tests were used to compare the medians of the [TIMP-2*IGFBP-7] values in the AKIN negative and positive groups at each time point. Receiver operating characteristic curves were used to measure how well the [TIMP-2*IGFBP-7] values predict AKIN status. Results Thirty-six patients were included. No patients met the AKIN criteria for AKI preoperatively. Postoperatively, 19 patients (53%) met the AKIN criteria for AKI diagnosis: 13 (36%) stage 1, 5 (14%) stage 2, and 1 (3%) stage 3. None required renal replacement therapy. At the 24-hour time points, patients who met the AKIN criteria for AKI had a statistically significantly higher [TIMP-2*IGFBP7] values than the patients without AKI (1.1 vs. 0.27 [ng/mL] 2/1,000) at 24 hours (adj-p = 0.0019). Conclusion AKI is a serious complication associated with adverse outcomes in patients undergoing cardiac surgery. [TIMP-2*IGFBP-7] urinary level 24 hours after CPB is a good predictor of AKI in this population.
    Type of Medium: Online Resource
    ISSN: 2146-4618 , 2146-4626
    URL: Article
    DOI: 10.1055/s-0041-1740359
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2661407-8
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  • 7
    Online Resource
    Online Resource
    Safety Checklist Implementation Did Not Reduce Central Venous Catheter Duration in Pediatric Cardiac ICU Patients
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Pediatric Quality & Safety Vol. 5, No. 1 ( 2020-01-22), p. e253-
    Details
    In: Pediatric Quality & Safety, Ovid Technologies (Wolters Kluwer Health), Vol. 5, No. 1 ( 2020-01-22), p. e253-
    Abstract: The Center for Disease Control recommends prompt removal of nonessential central venous catheters (CVCs) to reduce the risk for central line–associated bloodstream infections. Safety checklists have been trialed to reduce nonessential CVC days, but pediatric studies are lacking. Our specific aim was to detect 〉 10% reduction in mean CVC duration after implementation of a safety checklist addressing CVCs in our unit. Methods: All patients admitted to the Congenital Cardiovascular Care Unit at New York University Langone Medical Center who had a CVC placed between January 1, 2012, and December 31, 2017, were included. We implemented a checklist addressing CVC use in our unit on June 7, 2013, and modified it on March 10, 2016. We analyzed quarterly mean CVC duration and postsurgical CVC duration over the study period using statistical process control charts. Results: We placed 778 CVCs for 7,947 CVC days during the study period. We noted special cause variation from Q4 2013 to Q2 2014 and a centerline shift in mean CVC duration from 8.91 to 11.10 days in Q1 2015. In a subgroup analysis of the 657 lines placed in surgical patients, there was a centerline shift in mean CVC duration from 6.48 to 8.86 days in Q4 2013. Conclusions: Our study demonstrated an unexpected increase in mean CVC duration after the implementation of a safety checklist designed to decrease nonessential CVC days. Additional studies are needed to identify the ideal method to detect and remove nonessential CVCs and reduce the risk of preventable harm.
    Type of Medium: Online Resource
    ISSN: 2472-0054
    URL: Article
    DOI: 10.1097/pq9.0000000000000253
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 2898348-8
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