Abstract:
OBJECTIVES:It is accepted treatment to give vasopressin to adults in postcardiotomy shock, but such use in children is controversial. Cardiopulmonary bypass is presumed to attenuate the normal endogenous vasopressin response to shock. We hypothesized that levels of vasopressin in children are altered by bypass, and that children having low endogenous levels perioperatively are more likely to develop hypotension, or require vasopressors. METHODS:Serial levels of vasopressin were assessed prospectively in children undergoing bypass at a single center. RESULTS:Of 61 eligible patients, we enrolled 39 (63%). Their median age was 5 months. The mean level of vasopressin prior to bypass was 18.6 picograms per millilitre, with an interquartile range from 2.6 to 11.4. Levels of vasopressin peaked during bypass at 87.1, this being highly significant compared to baseline (p < 0.00005), remained high for 12 hours at a mean of 73.5, again significantly different from baseline (p = 0.002), were falling at 24 hours, with a mean of 28.1 (p = 0.04), and had returned to baseline by 48 hours, when the mean was 7.4 (p = 0.3). Age, gender, and the category for surgical risk had no influence on the levels of vasopressin. There was no statistically significant relationship between the measured levels and hypotension or the requirement for vasopressors, although a few persistently hypotensive patients had high levels subsequent to bypass. Higher levels correlated with higher levels of sodium in the serum (r(s) = 0.37, p < 0.00005), higher osmolality (r(s) = 0.37, p < 0.00005), and positive fluid balance (r(s) = 0.23, p < 0.008). Preoperative use of inhibitors of angiotensin converting enzyme, preoperative congestive cardiac failure, and longer periods of bypass predicted higher levels during the first eight postoperative hours. CONCLUSIONS:Children do not have deficient endogenous levels of vasopressin following bypass, and lower levels are not associated with hypotension. Any therapeutic efficacy of infusion of vasopressin for post-cardiotomy shock in children is likely due to reasons other than physiologic replacement.
journal_name
Cardiol Youngjournal_title
Cardiology in the youngauthors
Morrison WE,Simone S,Conway D,Tumulty J,Johnson C,Cardarelli Mdoi
10.1017/S1047951108001881subject
Has Abstractpub_date
2008-04-01 00:00:00pages
135-40issue
2eissn
1047-9511issn
1467-1107pii
S1047951108001881journal_volume
18pub_type
杂志文章abstract::Infants with hypoplastic left heart syndrome often experience difficulty with oral feeding, which contributes to growth failure, morbidity, and mortality. In response to feeding difficulty, clinicians often change the bottle nipple, and thus milk flow rate. Slow-flow nipples have been found to reduce the stress of fee...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951116000251
更新日期:2017-01-01 00:00:00
abstract::Patients with pulmonary regurgitation after tetralogy of Fallot repair have impaired aerobic capacity; one of the reasons is the decreasing global ventricular performance at exercise, reflected by decreasing peak oxygen pulse. The aims of our study were to evaluate the impact of pulmonary valve replacement on peak oxy...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115002504
更新日期:2016-10-01 00:00:00
abstract::Partially anomalous pulmonary venous connection of a solitary pulmonary vein in the setting of an intact atrial septum is often subclinical, and the indications for surgical repair are controversial. Here we describe a patient who developed a significant shunt over a period of 10-years. Flow through the anomalously co...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795110700159X
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:Children with congenital cardiac defects may have associated chromosomal anomalies, airway compromise, and/or pulmonary hypertension, which can pose challenges to adequate sedation, weaning from mechanical ventilation, and successful extubation. Propofol, with its unique properties, may be used as a bridge t...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951110001344
更新日期:2011-02-01 00:00:00
abstract::The arterial switch operation has become the preferred procedure for surgical management of transposition, defined on the basis of concordant atrioventricular and discordant ventriculo-arterial connections. We conducted a retrospective evaluation of our experience in 61 infants with this segmental combination, seen fr...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951107001746
更新日期:2008-02-01 00:00:00
abstract::We report a novel technique using an Amplatzer atrial septal occluder to close a defect located in the inferior-posterior portion of the interatrial septum that extended into the mouth of the inferior caval vein. Because of the close relation of the defect to the inferior caval vein, the right atrial disc was opened i...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951103000386
更新日期:2003-04-01 00:00:00
abstract::A female neonate, born at term, presented with complex cardiac anatomy dominated by right isomerism and infra-diaphragmatic totally anomalous pulmonary venous connection. Surgical repair was performed using circulatory arrest under deep hypothermia. In the postoperative period, the patient could not be weaned off mech...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951105001836
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Young patients suffering from rhythm disorders have a negative impact in their quality of life. In recent years, ablation has become the first-line therapy for supraventricular arrhythmias in children. In the light of the current expertise and advancement in the field, we decided to evaluate t...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951120000256
更新日期:2020-03-01 00:00:00
abstract::Valvar heart disease can be complicated by hemodynamic derangements, depending on the degree of the abnormality. Stenosis causes pressure overload of the chamber draining through the valve and regurgitation results in volume overload. Many lesions have a component of both, resulting in both pressure and volume overloa...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951114001978
更新日期:2014-12-01 00:00:00
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journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115001213
更新日期:2016-02-01 00:00:00
abstract::Introduction Carbon monoxide poisoning may cause myocardial toxicity and cardiac autonomic dysfunction, which may contribute to the development of life-threatening arrhythmias. We investigated the potential association between acute carbon monoxide exposure and cardiac autonomic function measured by heart rate variabi...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951117000944
更新日期:2017-11-01 00:00:00
abstract::The update course in foetal cardiology held by the Fetal Working Group of the Association for European Paediatric and Congenital Cardiology in Istanbul in May 2012 included a session on foetal cardiac therapy. In the introductory overview to this symposium, we critically examine the level of evidence supporting or ref...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/S1047951114001231
更新日期:2014-10-01 00:00:00
abstract::Adult survivors of aortic interruption is extremely rare. Diagnosis mostly depends on additional imaging with CT and MRI. We present a rare case of acquired complete interruption of the aorta that was found incidentally at the time of coronary angiography. This finding was confirmed by CT scan. ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951114001693
更新日期:2015-03-01 00:00:00
abstract::Tetralogy of Fallot, when associated with atrioventricular septal defect permitting shunting at ventricular level, represents a complex cyanotic congenital malformation. Experience with surgical repair is limited, and results vary considerably. Between 1984 and 1996, we repaired 14 consecutive patients with this combi...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951100004728
更新日期:1998-01-01 00:00:00
abstract::Communications between the pulmonary artery and left atrium cause cyanosis. The images document serial haemodynamic changes in such a fistula from fetal life to the postnatal period with a successful transcatheter intervention. ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951118000616
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To describe the gross motor development of infants who had undergone cardiac surgery in the neonatal or early infant period. METHODS:Gross motor performance was assessed when infants were 4, 8, 12, and 16 months of age with the Alberta Infant Motor Scale. This scale is a discriminative gross motor outcome me...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951112000121
更新日期:2012-10-01 00:00:00
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journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951119000088
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Risk for neurodevelopmental delay in infants and children with CHD is well established, but longer-term outcomes are equivocal. A meta-analysis was conducted to establish whether cognitive deficits remain beyond childhood - into teenage and young adult years. Methods and results A total of 18 unique samples,...
journal_title:Cardiology in the young
pub_type: 杂志文章,meta分析
doi:10.1017/S104795111700230X
更新日期:2018-03-01 00:00:00
abstract::We describe 3 siblings with muscular ventricular septal defects, two requiring surgical closure. One of their offspring had a rare congenital aneurysm of the muscular ventricular septum, also requiring surgery. Another had a small muscular ventricular septal defect which closed spontaneously. Their father had echocard...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951107000996
更新日期:2007-10-01 00:00:00
abstract:BACKGROUND:There is no standard dose or protocol for beta-blocker administration as preconditioning in children undergoing coronary CT angiography. METHODS:A total of 63 consecutive patients, with a mean age of 10.0±3.1 years, who underwent coronary CT angiography to assess possible coronary complications were enrolle...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795111800118X
更新日期:2018-10-01 00:00:00
abstract::A 9-month-old infant presented with fever, dyspnoea, and a murmur. Echocardiography showed a mitral vegetation with significant regurgitation. Mitral valve plasty was performed on day 6, and was polymerase chain reaction positive for Kingella kingae. The cardiac outcome was favourable. This case illustrates a subtle p...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951110000351
更新日期:2010-08-01 00:00:00
abstract::IntroductionDiagnostic and interventional catheter angiography of the heart is frequently used in paediatric cardiology. It is also possible to detect urinary system anomalies with cineurography images that may be obtained during angiocardiography. In this study, the aim was to determine the frequency, distribution, a...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951118001828
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the family psycho-social outcomes of children with Down syndrome and atrioventricular septal defect, and examine the impact of these variables on the child's neurodevelopmental outcome. METHODS:This was a cross-sectional study that consisted of 57 children with Down syndrome - 20 cases and 37 con...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115000062
更新日期:2016-02-01 00:00:00
abstract::We describe a patient with the rare association of the heart in the left chest, congenitally corrected transposition, pulmonary atresia and an intact ventricular septum. There were associated fistulous communications between the morphologically left ventricle and the coronary arteries. Diagnosis was made by echocardio...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951100009227
更新日期:2000-05-01 00:00:00
abstract:INTRODUCTION:The diagnosis of trisomy 21 in children has been associated with failed extubation after CHD surgery. Dexmedetomidine may be a useful agent to improve postoperative outcomes in these patients, such as ventilator time, ICU length of stay, or hospital length of stay. MATERIALS AND METHODS:The Pediatric Heal...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951114001462
更新日期:2015-06-01 00:00:00
abstract::We carried out a retrospective case control analysis to evaluate the outcome, and the need for treatment, of problems with atrioventricular conduction occurring during an acute attack of rheumatic fever, assessing the occurrence of second and third atrioventricular block versus first degree block. We reviewed and anal...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:
更新日期:2003-12-01 00:00:00
abstract::There exists a population of adults with undiagnosed coronary arterial lesions due to Kawasaki disease occurring before 1967. We report the clinical features in 6 adult males with coronary arterial lesions caused by presumed Kawasaki disease, whose dates of birth ranged from 1945 to 1963. The age of the diagnosed coro...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951107000169
更新日期:2007-02-01 00:00:00
abstract::In a neonate born prior to term with a weight of 1825 grams, and diagnosed prenatally as having atrioventricular septal defect and Down's syndrome, we found the aortic arch to be interrupted between the left carotid artery and the left subclavian artery, with the arterial duct being the only route of distal perfusion....
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951101000622
更新日期:2001-07-01 00:00:00
abstract::Fibrates are peroxisome proliferator-activated receptor-α agonists and are clinically used for treatment of dyslipidemia and hypertriglyceridemia. Fenofibrate is reported as a cardioprotective agent in various models of cardiac dysfunction; however, limited literature is available regarding the role of gemfibrozil as ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795111400081X
更新日期:2015-04-01 00:00:00
abstract::We report an extremely rare case of a 14-month-old girl who was diagnosed with a single right coronary artery with coronary artery fistula communicating with the right ventricle and congenital absence of left coronary artery. Angiography showed a dilated and tortuous single right coronary artery draining into the righ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951119002105
更新日期:2019-11-01 00:00:00