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 Health Information System database was queried from January, 2008 to December, 2010 for patients with trisomy 21 who underwent CHD surgery. Patients who received dexmedetomidine were matched to patients who did not by propensity score. The primary outcome was ventilator days charged, and secondary outcomes included ICU and hospital length of stay. RESULTS:A total of 1088 patients (544 matched pairs) met inclusion criteria. Patient characteristics were similar, with the exception of more patients in the dexmedetomidine group undergoing repair of complete atrioventricular canal and fewer undergoing mechanical valve replacement (p<0.01). More patients in the dexmedetomidine group were administered milrinone, epinephrine, vasopressin, benzodiazepines, opiates, and adjunct pain and sedative medications (p<0.01). The dexmedetomidine group had greater time on the ventilator [7 (4.5-11) versus 6 (4-10) days (median, interquartile range) p<0.01] and similar ICU length of stay, hospital length of stay, and mortality compared with controls. Mixed-effects modelling clustered on institution did not show beneficial effect of dexmedetomidine on ventilator time, ICU stay, or hospital length of stay. CONCLUSIONS:The use of dexmedetomidine was not associated with the decreased ventilatory time. Routine use of dexmedetomidine is not warranted in this patient population.
journal_name
Cardiol Youngjournal_title
Cardiology in the youngauthors
Moffett BS,Mossad EB,Tobias JD,Cabrera AGdoi
10.1017/S1047951114001462subject
Has Abstractpub_date
2015-06-01 00:00:00pages
958-62issue
5eissn
1047-9511issn
1467-1107pii
S1047951114001462journal_volume
25pub_type
杂志文章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::Large volumes of data and multiple computing platforms are now universal components of paediatric cardiovascular medicine, but are in a constant state of evolution. Often, multiple sets of related data reside in disconnected "silos", resulting in clinical, administrative, and research activities that may be duplicativ...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/S1047951116001268
更新日期:2017-05-01 00:00:00
abstract::The supramitral ring is a rare congenital malformation formed by presence of a ridge of connective tissue, usually attached at or above the mitral annulus. The incidence and clinical presentation is highly variable due to difficulty in diagnosis. A review of autopsied congenital heart diseases at our institute over a ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951108003399
更新日期:2009-02-01 00:00:00
abstract::We report a case in which a meandering right pulmonary vein connecting to the left atrium is associated with hypoplasia of the right lung, horseshoe lung, abnormal pulmonary lobation, and abnormal branching of the pulmonary arteries. We discuss its relationship to the so-called scimitar variant, and to the scimitar sy...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951106000461
更新日期:2006-06-01 00:00:00
abstract::With the increase in long-term survival of post-transplant children, there is a paradigm shift in the emphasis of post-transplant care. We describe de novo cardiovascular abnormalities, which occurred in otherwise asymptomatic paediatric liver transplant recipients, who received liver allografts between 1991 and 2014 ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795111800063X
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:CHDs form a complex and heterogeneous group of clinical entities, with high morbidity and mortality. With the advancement of surgical and invasive techniques and clinical treatment, the survival of these patients has increased significantly, and there are reports of a high prevalence of ocular abnormalities ...
journal_title:Cardiology in the young
pub_type: 杂志文章,meta分析,评审
doi:10.1017/S104795111500044X
更新日期:2016-03-01 00:00:00
abstract::In this study, we summarise a case of a myofibroma causing mid-aortic syndrome due to obstruction of the distal thoracic and abdominal aorta leading to severe left ventricular dysfunction. The patient was managed with percutaneous intervention via balloon dilation and stent placement. On follow-up, the patient has nor...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115001936
更新日期:2016-04-01 00:00:00
abstract::An unusual combination of three types of interatrial communications - coronary sinus defect, primum defect, and secundum defect - occurring together in a 3-year-old child is presented. ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795112000400X
更新日期:2020-12-01 00:00:00
abstract::Improvements in diagnosis and surgical technique for correction have led to an increasing number of women with congenital heart disease reaching the child-bearing age. Pregnancy places considerable strain on the heart and circulation and necessitates marked cardiorespiratory adaptation. Today, with the exception of th...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/s1047951100007496
更新日期:1999-01-01 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:BACKGROUND:Children with congenital cardiac disease experience challenges in developing healthy patterns of physical activity due to decreased exercise capacity and parental fear and confusion about what is permissible. The purpose of this study was to describe physical activity habits in children 10-14 years of age wi...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951111000540
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:We aimed to apply systems engineering principles to address hospital-acquired infections in the paediatric intensive care setting. DESIGN:Mixed method approach involving four steps: perform time-motion study of cardiac intensive care unit (CICU) care processes, establish a meaningful schema to classify obser...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951120003777
更新日期:2020-11-10 00:00:00
abstract:BACKGROUND:Perceived correlation between the coronary arterial anatomy in patients with complete transposition, and the outcome of the arterial switch procedure, has made preoperative identification of their patterns standard practice. PURPOSE:Our purpose was to assess the accuracy of preoperative echocardiographic id...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951102000537
更新日期:2002-05-01 00:00:00
abstract::Persistent patency of the arterial duct represents one of the most common lesions in the field of congenital cardiac disease. The strategies for management continue to evolve. In this review, we focus on management beyond the neonatal period. We review the temporal evolution of strategies for management, illustrate th...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/S1047951107001175
更新日期:2007-09-01 00:00:00
abstract:INTRODUCTION:Anomalous origin of one pulmonary artery from the ascending aorta is a rare cardiac anomaly in which the pulmonary artery abnormally arises from the ascending aorta. Physiologically, most patients develop signs of cardiac failure due to high flow to both lungs, with systemic or supra-systemic pressures in ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951110000892
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated structural changes in the heart and cardiac dysfunction in foetuses with intrauterine growth restriction. There are no available data that evaluated left ventricular dimensions and mass in neonates with symmetric and asymmetric intrauterine growth restriction. Therefore, we...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951113002199
更新日期:2015-02-01 00:00:00
abstract::IntroductionChildren with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.Materials and methodsWe sought to evaluate the occurrence of adverse tracheal-intubation-associate...
journal_title:Cardiology in the young
pub_type: 杂志文章,多中心研究
doi:10.1017/S1047951118000495
更新日期:2018-07-01 00:00:00
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 positi...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951112002181
更新日期:2014-02-01 00:00:00
abstract::Congenital complete tracheal rings are usually associated with pulmonary slings. We report a rare association of congenital complete tracheal rings with hypoplastic left heart variant. A term infant with diagnosis of a mildly hypoplastic mitral valve, unicuspid aortic valve, and moderately hypoplastic aortic arch with...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951118002391
更新日期:2019-03-01 00:00:00
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::Herein, we present the first case of dilated cardiomyopathy due to premature constriction of the ductus arteriosus. A fetal echocardiography showed narrowing in the ductus arteriosus, and colour Doppler flow mapping could not identify blood flow through the ductus. Neonatal echocardiography revealed a left ventricular...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951118001002
更新日期:2018-09-01 00:00:00
abstract::Although extrarenal manifestations of haemolytic-uraemic syndrome are not frequent, myocardial dysfunction should be given special consideration because of the importance of proper early haemodynamic management and potential complications. We report the case of a 21-month-old child with haemolytic-uraemic syndrome who...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115002759
更新日期:2016-06-01 00:00:00
abstract::Atrioventricular valve regurgitation is widely known as a risk factor for Fontan completion in patients with univentricular physiology. To date, indications and timing for atrioventricular valve repair remain unclear and different surgical techniques have been advocated. Since 2013, 50 consecutive patients underwent e...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951114002352
更新日期:2015-10-01 00:00:00
abstract::We report the case of a child with cor triatriatum dexter masquerading as Ebstein's anomaly on transthoracic echocardiography. This was attributed to a floppy membrane arising from the right atrium, protruding into the tricuspid valve and pushing the leaflets downwards, giving an impression of Ebstein's anomaly. The i...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951111000023
更新日期:2011-06-01 00:00:00
abstract::Noonan's syndrome involves the association of multiple congenital abnormalities, with a variety of cardiac defects. We describe here the association of Noonan's syndrome with multiple pulmonary arteriovenous fistulas and bilateral duplicated renal collecting systems. To the best of our knowledge, this is the first rep...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951107000352
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Tetralogy of Fallot is a common congenital cardiac malformation. A rare subgroup includes unilateral absence of the pulmonary artery, either the left or the right main branch. The literature lacks an established treatment for these cases, and surgical options carry certain mortality and morbidity. PATIENTS ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951112000911
更新日期:2013-06-01 00:00:00
abstract::To date, no reference values have been provided for right and left atrial filling in normal children. The aim of our study, therefore, was to characterize measurements of superior caval, hepatic, and pulmonary venous flow using Doppler echocardiography in a large group of normal children to reflect the effects of age,...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951103000283
更新日期:2003-04-01 00:00:00
abstract::ABSTRACTPatent ductus arteriosus is among the most common congenital heart diseases. With the increasing use of transcatheter closure procedures, the incidence of complications related to the procedure has increased. Embolization of the ductus closure device to the pulmonary artery is a very rare complication. Since t...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951119000921
更新日期:2019-05-01 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:INTRODUCTION:Dilatation of the ascending aorta is described in Turner's syndrome with variable prevalence (6.8-32%). Reported series typically include patients with associated cardiac anomalies. OBJECTIVE:To characterise the prevalence, age of onset, and the progress of dilatation of the ascending aorta in Turner's sy...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115000682
更新日期:2016-03-01 00:00:00