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  • 1
    Online Resource
    Online Resource
    Biomarkers in low cardiac output syndrome after open cardiac surgery in children
    Paediatrica Indonesiana - Indonesian Pediatric Society ; 2021
    In:  Paediatrica Indonesiana Vol. 61, No. 4 ( 2021-08-23), p. 223-8
    Details
    In: Paediatrica Indonesiana, Paediatrica Indonesiana - Indonesian Pediatric Society, Vol. 61, No. 4 ( 2021-08-23), p. 223-8
    Abstract: Background Corrective cardiac surgery is the standard management for complex congenital heart disease. Cardiopulmonary bypass surgery and post-surgical intensive care may lead to low cardiac output syndrome (LCOS), as a major complication after open heart surgery.  To diagnose early LCOS, lactate level, pCO2 gap, and mixed venous oxygen saturation (SvO2) are parameters reported to have correlations with decreased cardiac output, morbidity, and post-cardiac surgery mortality. Objective To determine the usefulness of lactate level, pCO2 gap (arterial-vein), and SvO2 for early detection of LCOS in children post-open heart surgery. Methods This prospective cohort study was done from August to October 2017 in the ICU of the Integrated Cardiac Center, Dr. Cipto Mangunkusumo Hospital, Jakarta. Subjects were pediatric patients who underwent cardiac surgery. After surgery, patients underwent monitoring in the ICU for clinical signs of LCOS and examinations for lactate levels, pCO2 gap, and SvO2 at 15 minutes, 4 hours and 8 hours. Results Thirty-three open heart surgery patients were the subjects. Lactate level at 4 hours and 8 hours post-operative were significantly higher in the LCOS group compared to non-LCOS group. For the pCO2 gap, only the 4-hour post-operative results were significantly higher in LCOS group compared to non-LCOS groups. In addition, only SvO2 at 4 hours after surgery was significantly lower in LCOS group compared to non-LCOS group. Conclusion Elevated lactate, high pCO2 gap, as well as decreased SvO2 at 4 hours post-operatively are the most reliable markers of LCOS after pediatric open heart surgery.
    Type of Medium: Online Resource
    ISSN: 2338-476X , 0030-9311
    URL: Issue
    URL: Article
    DOI: 10.14238/pi61.4.2021
    DOI: 10.14238/pi61.4.2021.223-8
    Language: Unknown
    Publisher: Paediatrica Indonesiana - Indonesian Pediatric Society
    Publication Date: 2021
    detail.hit.zdb_id: 2716888-8
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  • 2
    Online Resource
    Online Resource
    Short-term outcomes following congenital heart surgery in children with Down syndrome
    Paediatrica Indonesiana - Indonesian Pediatric Society ; 2023
    In:  Paediatrica Indonesiana Vol. 63, No. 3 ( 2023-06-29), p. 181-8
    Details
    In: Paediatrica Indonesiana, Paediatrica Indonesiana - Indonesian Pediatric Society, Vol. 63, No. 3 ( 2023-06-29), p. 181-8
    Abstract: Background Children with Down syndrome (DS) differ from typical children because of many genetic-related aspects that may affect outcomes after congenital heart surgery. To date, there have been no studies on outcomes after congenital heart surgery on pediatric DS patients in Indonesia. Objective To determine outcomes and mortality in DS patients who underwent heart surgery at Dr. Cipto Mangunkusumo Hospital, Jakarta. Methods A prospective and retrospective cohort study was conducted in DS patients aged 〈 15 years who underwent heart surgery from July 2007 to April 2015. The control group were patients in the same age range without DS who underwent heart surgery for various types of heart defects. Results  There were 57 DS and 43 non-DS patients during study period. The types of heart defects found in DS patients were atrioventricular septal defect (AVSD) and ventricular septal defect (VSD) in 18/57 (31.6%) patients each, tetralogy of Fallot (12/57; 21%), atrial septal defect (ASD) (4/57; 7%), patent ductus arteriosus (PDA) (4/57; 7%) and transposition of the great arteries with VSD (TGA-VSD) (1/57; 1.8%). DS patients showed an increased incidence of preoperative PH (63.1%)  compared to non-DS patients (25.6%). Median duration of surgery was longer in DS [2.9 (range 0.5-5.8) hours] than in non-DS [2.2 (range 0.7-4.7) hours] . DS patients have a longer mean cardiopulmonary bypass duration [79.5 (SD 33.9) minutes] compared to non-DS [59.9 (SD 23.6) minutes] , longer mean aortic cross-clamp duration [45.3 (SD 23.7) minutes] compared to non-DS [34.8 (SD 15.7)] . There were significant differences in the incidence of preoperative pulmonary hypertension, surgical time, duration of cardiopulmonary bypass (CPB), and length of the aortic cross-clamp in DS patients compared to non-DS (P 〈 0.05). Median length of ICU stay was 1.9 (range 0.6 to 34) days in DS and 1 (range 0.3 to 43) day in non-DS patients (P=0.373). Median duration of mechanical ventilation [19.9 (range 3-540) vs. 8 (range 3-600) hours (P=0.308)], rate of pulmonary complications [14/57 (24.6%) vs. 6/43 (14%) patients (P=0.216)] , and incidence of sepsis [16/57 (28.1%) vs. 6/43 (14%) patients (P=0.143)] were not significantly different between DS and non-DS patients. However, complete atrioventricular (AV) block only occurred in DS patients [6/57 (10.5%)] . In the DS group, 5/57 (8.8%) patients died. There was no mortality in the non-DS group. Conclusion  Morbidity and mortality after cardiac surgery in were higher in DS than in non-DS patients. DS patients may have problems related to preoperative PH, AV block, longer surgical time, duration of CPB, and aortic cross-clamp compared to non-DS.
    Type of Medium: Online Resource
    ISSN: 2338-476X , 0030-9311
    URL: Issue
    URL: Article
    DOI: 10.14238/pi63.3.2023
    DOI: 10.14238/pi63.3.2023.181-8
    Language: Unknown
    Publisher: Paediatrica Indonesiana - Indonesian Pediatric Society
    Publication Date: 2023
    detail.hit.zdb_id: 2716888-8
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  • 3
    Online Resource
    Online Resource
    Correlation expression Toll-like receptor 4 with multidrugs resistant tuberculosis in diabetes mellitus condition
    Elsevier BV ; 2023
    In:  Indian Journal of Tuberculosis Vol. 70, No. 1 ( 2023-01), p. 59-64
    Details
    In: Indian Journal of Tuberculosis, Elsevier BV, Vol. 70, No. 1 ( 2023-01), p. 59-64
    Type of Medium: Online Resource
    ISSN: 0019-5707
    URL: Article
    DOI: 10.1016/j.ijtb.2022.03.012
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2164411-1
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  • 4
    Online Resource
    Online Resource
    Calciferol Status and Clinical Outcomes in Children with Congenital Heart Disease after Heart Surgery
    Universitas Airlangga ; 2023
    In:  Folia Medica Indonesiana Vol. 59, No. 2 ( 2023-06-10), p. 197-204
    Details
    In: Folia Medica Indonesiana, Universitas Airlangga, Vol. 59, No. 2 ( 2023-06-10), p. 197-204
    Abstract: Highlights: Calciferol has cardioprotective properties, and a severe deficiency of calciferol is associated with septic shock, a longer duration of mechanical ventilation and treatment in the intensive care unit, and mortality.  The role of calciferol in critical conditions has been described in several research reports, but relatively little is known about its function in pediatric cardiac surgery.  Abstract Calciferol is a micronutrient and a secosteroid hormone that plays a role in maintaining the health of bones and soft tissues in the body, such as the myocardium, as well as the immune system. Hypovitaminosis D has been reported to be associated with poor clinical outcomes and child mortality in pediatric intensive care units. Children with congenital heart disease (CHD) are vulnerable to critical conditions and require early intervention due to heart failure. This study aimed to investigate the influence of calciferol status on the clinical outcomes of pediatric CHD patients who underwent heart surgery. A systematic literature review was conducted using the electronic databases from PubMed, Elsevier, and Cochrane. This study included observational and randomized control studies that assessed the calciferol status of pediatric CHD patients undergoing cardiac surgery. From a total of 168 studies, 8 studies were selected for review. The preoperative and postoperative calciferol status as well as clinical outcomes following pediatric cardiac surgery were reviewed. According to the findings, most pediatric CHD patients suffered from calciferol deficiency prior to corrective heart surgery, which further decreased postoperatively and was associated with clinical outcomes in the intensive care unit (ICU). Preoperative calciferol supplementation has been reported to enhance serum calciferol levels and is associated with good clinical outcomes in pediatric patients undergoing cardiac surgery.
    Type of Medium: Online Resource
    ISSN: 2599-056X , 2355-8393
    URL: Article
    DOI: 10.20473/fmi.v59i2.44534
    Language: Unknown
    Publisher: Universitas Airlangga
    Publication Date: 2023
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