Abstract:
OBJECTIVE:The objective of the study was to identify incidence, aetiology, and outcomes of extubation failure in infants with shunt-dependent pulmonary blood flow at a single tertiary care, academic children's hospital. The second objective of this study was to determine the haemodynamic effects of transition of positive pressure ventilation to spontaneous breathing in infants with extubation failure. PATIENTS AND METHODS:Extubation failure for our study was defined as the need for positive pressure ventilation within 96 hours after extubation. We collected demographics, pre-operative, intra-operative, post-operative, and peri-extubation data in a retrospective, observational format in patients who underwent a modified Blalock-Taussig shunt between January, 2005 and March, 2011. Infants undergoing Norwood operation or Damus-Kaye-Stansel with modified Blalock-Taussig shunt were excluded from the study. The cardiorespiratory variables collected before extubation and immediately after extubation included heart rate, respiratory rate, mean arterial blood pressure, central venous pressures, near infrared spectroscopy, oxygen saturations, and lactate levels. Clinical outcomes evaluated included the success or failure of extubation, cardiovascular intensive care unit length of stay, hospital length of stay, and mortality. Descriptive and univariate statistics were utilised to compare groups with extubation failure and extubation success. RESULTS:Of the 55 eligible patients during the study period, extubation failure occurred in 27% (15/55) of the patients. Of the 15 patients with extubation failure, 10 patients needed reintubation and five patients received continuous positive pressure ventilation without getting reintubated. There were three patients who had extubation failure in the first 2 hours after extubation, nine patients in the 2-24-hour period, and three patients in the 24-96-hour period. In all, eight patients were extubated in the second attempt after the first extubation failure, with a median duration of mechanical ventilation of 2 days (1 day, 6 days). The median age of patients at extubation was 19 days (12 days, 22 days) and median weight of patients was 3.6 kg (3.02 kg, 4.26 kg). In all, 38% (21/55) of the patients were intubated before surgery. The most common risk factors for failed extubation were lung disease in 46% (7/15), cardiac dysfunction in 26% (4/15), diaphragmatic paralysis in 13% (2/15), airway oedema in 6% (1/15), and vocal cord paralysis in 6% (1/15). The median duration of mechanical ventilation was 4 days (1 day, 10.5 days), median cardiovascular intensive care unit length of stay was 11 days (6.5 days, 23.5 days), and the median hospital length of stay was 30 days (14 days, 48 days). The overall mortality at the time of hospital discharge was 7%. CONCLUSIONS:Extubation failure in infants with shunt-dependent pulmonary blood flow and univentricular physiology is high and aetiology is diverse. Cardiopulmonary effects of removal of positive pressure ventilation are more pronounced in children with extubation failure and include escalation in the need for oxygen requirement and increase in mean arterial blood pressure. The majority of extubation failures in this select patient population occurs in the first 24 hours. Extubation failure in these patients is not associated with increased hospital length of stay or mortality.
journal_name
Cardiol Youngjournal_title
Cardiology in the youngauthors
Gupta P,McDonald R,Goyal S,Gossett JM,Imamura M,Agarwal A,Butt W,Bhutta ATdoi
10.1017/S1047951112002181subject
Has Abstractpub_date
2014-02-01 00:00:00pages
64-72issue
1eissn
1047-9511issn
1467-1107pii
S1047951112002181journal_volume
24pub_type
杂志文章abstract:AIM:We aimed to investigate the role of adiponectin in acute rheumatic fever by evaluating correlations with cytokines and acute-phase reactants. METHODS:Patients were divided into three groups by clinical findings. Group 1 included 8 patients with only chorea, Group 2 included 13 patients with arthritis and carditis,...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951114001012
更新日期:2015-06-01 00:00:00
abstract::Cardiac involvement is a rare complication of infection by the influenza B virus. It usually presents with ventricular dysfunction, arrhythmias, or both. We report a 13-year-old boy with clinical, electrocardiographic, and laboratory findings of myocardial ischaemia during an otherwise silent acute infection with infl...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951105000454
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:Efficient diagnosis of an underlying genetic aetiology in a patient with congenital heart disease is essential to optimising clinical care. Copy number variants are one aetiology of congenital heart disease; the majority are identifiable by targeted fluorescence in situ hybridisation or array comparative geno...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951113001868
更新日期:2015-01-01 00:00:00
abstract::An infant developed severe desaturation within a few hours of construction of a modified Blalock-Taussig shunt. Echocardiography revealed that the shunt had become occluded, and this was confirmed angiographically. At catheterisation, therefore, we passed a 0.014" percutaneous transluminal coronary angioplasty wire th...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951100008957
更新日期:2000-11-01 00:00:00
abstract::Improvements in the care of children with cardiomyopathy, CHDs, and acquired heart disease have led to an increased number of children surviving with advanced heart failure. In addition, the advent of more durable mechanical circulatory support options in children has changed the outcome for many patients who otherwis...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/S1047951116000184
更新日期:2016-06-01 00:00:00
abstract::Berry syndrome is a rare CHD. Approximately 29 cases have been described in the literature. Surgical correction has been successfully performed as well. We report the case of a newborn diagnosed with Berry syndrome who was subsequently diagnosed with trisomy 13. Cytogenetic analysis should be performed before surgical...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115000256
更新日期:2016-01-01 00:00:00
abstract::Dysfunction of the autonomic nervous system, or dysautonomia, is an uncommon disease. Postural orthostatic tachycardia syndrome is one of the several types of dysautonomia. Postural orthostatic tachycardia syndrome, also known as chronic orthostatic intolerance, is the most common but least severe of the dysautonomic ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951110001198
更新日期:2010-12-01 00:00:00
abstract::Our long-term follow-up has revealed that symmetrical development of the breasts is significantly impaired in pre-pubescent female patients subsequent to an anterolateral thoracotomy. Although standard posterolateral and anterolateral right-sided thoracotomies are used for correction of "simple" cardiac lesions such a...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:
更新日期:2003-12-01 00:00:00
abstract::Critical heart disease in the pediatric population is associated with high morbidity and mortality. Research around the most effective communication and decision-making strategies is lacking. This systematic review aims to summarise what is known about parent preference for communication and decision-making in childre...
journal_title:Cardiology in the young
pub_type: 杂志文章,meta分析,评审
doi:10.1017/S1047951118001233
更新日期:2018-10-01 00:00:00
abstract::Pneumopericardium, defined as air in the pericardial cavity, is a rare condition with potentially severe complications and mortality. In the neonatal period, pneumopericardium is associated with prematurity, very low birth weight, and assisted ventilation. We report the occurrence of spontaneous pneumopericardium in a...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951117002657
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Anomalous left coronary artery from the pulmonary artery is a rare congenital heart disease (CHD) with diverse clinical presentations despite the same anatomy. Factors determining this heterogeneous presentation are not well understood. METHOD AND RESULTS:We retrospectively investigated 14 patients (12 fema...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951119003299
更新日期:2020-03-01 00:00:00
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 tha...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951108001881
更新日期:2008-04-01 00:00:00
abstract::A bicuspid aortic valve is not only a common congenital heart defect but also an enigmatic condition that can cause a large spectrum of diseases, such as aortic valve stenosis and severe heart failure in newborns whereas aortic dissection in adults. On the contrary, a bicuspid aortic valve can also occur with normal f...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/S1047951118001658
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to see whether the open anastomosis technique using vacuum-assisted venous drainage at the time of the Fontan procedure was associated with decreased post-operative pleural effusion. METHODS:We analysed a subgroup of patients with a functional single ventricle who underwent non-fen...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951110001010
更新日期:2010-12-01 00:00:00
abstract::This study was carried out to analyse seasonal variations in live births with congenital heart disease in the overall population of Malta. Included were all patients diagnosed as having congenital heart disease by echocardiography, cardiac catheterization, surgery or post mortem, by 1 year of age, and who were born be...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/s1047951100005205
更新日期:1999-07-01 00:00:00
abstract::We report a left atrial appendage diverticulum in close proximity to the left coronary artery, thereby mimicking a fistulous connection between the two structures. ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795111400211X
更新日期:2015-03-01 00:00:00
abstract::With the advent of improved medical and surgical care in congenital heart disease, there has been an increase in the number of patients who survive into adulthood, giving rise to a new patient population 'Adults with congenital heart disease'. In the past, morbidity and mortality were the primary concerns for this gro...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/S1047951113000747
更新日期:2014-02-01 00:00:00
abstract::Cardiac anesthesia and critical care provide an important continuum of care for patients with congenital heart disease. Clinicians in both areas work in complex environments in which the interactions between humans and technology is critical. Understanding our contributions to outcomes (modifiable risk) and our abilit...
journal_title:Cardiology in the young
pub_type:
doi:10.1017/S104795111700213X
更新日期:2017-12-01 00:00:00
abstract::Improvement in operative survival of patients with hypoplastic left heart syndrome has led to increasing emphasis on prevention of interstage mortality. Many centres have improved interstage results through programmes of home monitoring following discharge after the Norwood (Stage 1) operation. Experience with heighte...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/S1047951111001600
更新日期:2011-12-01 00:00:00
abstract::Senning operation is a surgical treatment for transposition of great arteries that can be complicated by post-procedural atrial or caval baffle leaks. We present a 6-year-old boy with a history of Senning repair for transposition of great arteries, who developed a pulmonary venous baffle leak. Percutaneous baffle leak...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951120002255
更新日期:2020-10-01 00:00:00
abstract::This article is to commemorate and celebrate achievements of Professor Milan Šamánek who passed away on 29 April, 2020. Milan was an excellent and visionary paediatric cardiologist who helped to establish paediatric cardiology as a speciality in Czechoslovakia and several other east European countries in the late 1970...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951120001547
更新日期:2020-09-01 00:00:00
abstract:UNLABELLED:Real-time three-dimensional echocardiography can surpass simple cross-sectional echocardiography in providing precise details of cardiac lesions. For the purpose of optimising treatment, we describe our findings with real-time three-dimensional echocardiography when interrogating different types of communica...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951111001107
更新日期:2012-04-01 00:00:00
abstract::Hypereosinophilic syndrome is defined as persistent eosinophilia in the blood for more than 6 months, without any identifiable cause and with end-organ involvement evidence. Cardiac manifestations of HES include heart failure due to restrictive cardiomyopathy, arrhythmia, intraventricular thrombosis, and coronary arte...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951120004862
更新日期:2021-01-25 00:00:00
abstract::We present two cases of percutaneous Sapien XT valve-in-valve implantation in the tricuspid position: a 20-year-old man with severe congenital pulmonary stenosis and percutaneous valvuloplasty, who required surgical implantation of two protheses, pulmonary and tricuspid, and a 12-year-old boy with CHD and a degenerate...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951117000786
更新日期:2017-10-01 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::Traditional ambulatory rhythm monitoring in children can have limitations, including cumbersome leads and limited monitoring duration. The ZioTM patch ambulatory monitor is a small, adhesive, single-channel rhythm monitor that can be worn up to 2 weeks. In this study, we present a retrospective cross-sectional analysi...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951118001142
更新日期:2018-10-01 00:00:00
abstract::Acute myocardial infarction is rarely reported in children. Most of the cases are secondary to congenital anomalies or Kawasaki disease. Coronary artery total occlusion caused by fibromuscular dysplasia has never been reported in young children. Here we report a case of a 12-year-old boy with fibromuscular dysplasia, ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951113002394
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the safety and efficacy of the ASDOS-technique (Sulzer-Osypka GmbH, Germany) for transcatheter closure of atrial septal defects within the oval fossa. BACKGROUND:Although several attempts have been made to occlude defects within the oval fossa by transcatheter techn...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951100007125
更新日期:1998-10-01 00:00:00
abstract::We found spontaneous echoes in two teenagers with nephrotic syndrome and profound hypoalbuminemia, both having normal cardiac structure, function and output. The phenomenon disappeared after the level of albumin normalized. In one patient, all spontaneous echoes disappeared following convalescence, the level of albumi...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951104005153
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:Patients with CHD exhibit reduced isometric muscle strength and muscle mass; however, little is known how these parameters relate. Therefore, the aim was to investigate the relation between isometric limb muscle strength and muscle mass for patients in comparison to age- and sex-matched control subjects. ME...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951120004709
更新日期:2021-01-18 00:00:00