Abstract:
BACKGROUND:Cardiopulmonary bypass is associated with systemic inflammatory response. Steroids suppress this response, although the therapeutic evidence remains controversial. We hypothesised that intravenous steroids in children undergoing open-heart surgery would decrease inflammation leading to better early post-operative outcomes. We conducted a randomised controlled trial to evaluate the trends in the levels of immunomodulators and their effects on clinical parameters. OBJECTIVE:To assess the effects of intravenous steroids on early post-operative inflammatory markers and clinical parameters in children undergoing open-heart surgery. MATERIALS AND METHODS:A randomised controlled trial involving 152 patients, from one month up to 18 years of age, who underwent open-heart surgery for congenital heart disease from April 2010-2012 was carried out. Patients were randomised and administered either three scheduled intravenous pulse doses of dexamethasone (1 mg/kg) or placebo. Blood samples were drawn at four time intervals and serum levels of inflammatory cytokines - Interleukin-6, 8, 10, 18, and tumour necrosis factor-alpha - were measured. Clinical parameters were also assessed. RESULTS:Blood cytokine levels were compared between the dexamethasone (n=65) and placebo (n=64) groups. Interleukin-6 levels were lower at 6 and 24 hours post-operatively (p<0.001), and Interleukin-10 levels were higher 6 hours post-operatively (p<0.001) in the steroid group. Interleukin-8, 18, and tumour necrosis factor-alpha levels did not differ between the groups at any time intervals. The clinical parameters were similar in both the groups. CONCLUSION:Dexamethasone caused quantitative suppression of Interleukin-6 and increased Interleukin-10 activation, contributing to reduced immunopathology, but it did not translate into clinical benefit in the short term.
journal_name
Cardiol Youngjournal_title
Cardiology in the youngauthors
Amanullah MM,Hamid M,Hanif HM,Muzaffar M,Siddiqui MT,Adhi F,Ahmad K,Khan S,Hasan Zdoi
10.1017/S1047951115000566subject
Has Abstractpub_date
2016-03-01 00:00:00pages
506-15issue
3eissn
1047-9511issn
1467-1107pii
S1047951115000566journal_volume
26pub_type
杂志文章,随机对照试验abstract::Oxidative stress may contribute to the pathogenesis of congenital heart defects, but the role of dynamic thiol/disulphide homeostasis has not been evaluated. The objective of this study was to assess whether there are changes in thiol/disulphide homeostasis and nitric oxide levels in children with tetralogy of Fallot ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795111900012X
更新日期:2019-04-01 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:PURPOSE:Developmental care of neonates with CHD is essential for proper neurodevelopment. Measurement of developmental care specific to these neonates is needed to ensure consistent implementation within and across cardiac ICUs. The purpose of this study was to psychometrically test the Developmental Care Scale for Neo...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951119000337
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The initial classic Fontan utilising a direct right atrial appendage to pulmonary artery anastomosis led to numerous complications. Adults with such complications may benefit from conversion to a total cavo-pulmonary connection, the current standard palliation for children with univentricular hearts. METHOD...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S104795111900146X
更新日期:2019-08-01 00:00:00
abstract::A ventricular septal defect in transposition of the great arteries is frequently closely related to the cardiac valves. The valvar function after arterial switch operation of patients with transposition of the great arteries and ventricular septal defect or intact ventricular septum was compared. We analysed the funct...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951111000084
更新日期:2011-08-01 00:00:00
abstract::Supravalvular aortic stenosis is associated with the Williams-Beuren syndrome, but it also occurs in a non-syndromatic congenital form. An elastin gene mutation of chromosome 7q11.23 is responsible in both cases. The vascular features are identical. These patients have a higher risk of sudden death, particularly when ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951110001563
更新日期:2011-02-01 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:OBJECTIVE:To categorise records according to primary cardiac diagnosis in the United Kingdom Central Cardiac Audit Database in order to add this information to a risk adjustment model for paediatric cardiac surgery. DESIGN:Codes from the International Paediatric Congenital Cardiac Code were mapped to recognisable prim...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951112001369
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To examine the clinical utility of the Pediatric Symptom Checklist 17 for identifying psychosocial concerns and improving access to psychology services within a paediatric cardiology clinic. METHOD:Parents of 561 children (aged 4-17 years) presenting for follow-up of CHD, acquired heart disease, or arrhythmi...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115001900
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:There is a great need for echocardiographic criterions for accurate diagnosis of carditis in acute rheumatic fever. AIM:To test the efficacy of proposed echocardiographic criterions for the diagnosis of carditis. MATERIALS AND METHODS:We studied 333 patients suspected of having acute rheumatic fever, under...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951108003107
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:CHD is the leading cause of mortality due to birth defects. Array comparative genomic hybridisation (aCGH) detects submicroscopic copy number changes and may improve identification of the genetic basis of CHD. METHODS:This is a retrospective analysis of 1252 patients from a regional referral centre who had ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951114001838
更新日期:2015-08-01 00:00:00
abstract::Aneurysm of the sinus of Valsalva is a rare congenital cardiac anomaly. It occurs as an outpouching that progresses like a windsock, and it may rupture producing aortic regurgitation, cardiac tamponade, congestive heart failure, conduction abnormalities, and stroke. We describe a case of rupture of the sinus of Valsal...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951116001621
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Kawasaki disease, which is characterised by systemic vasculitides accompanied by acute fever, is regularly treated by intravenous immunoglobulin to avoid lesion formation in the coronary artery; however, the mechanism of intravenous immunoglobulin therapy is unclear. Hence, we aimed to analyse the global exp...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951117001433
更新日期:2017-11-01 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:BACKGROUND:We have used the Amplatzer ductal occluder for transcatheter closure of large persistently patent arterial ducts, and used our experience to assess the safety and efficacy of the device in young children and infants. METHODS AND PATIENTS:We used the Amplatzer ductal occluder prospectively in 43 patients wit...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951105000570
更新日期:2005-06-01 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:Although some prior studies have provided evidence to question the historical belief that pulmonary vascular resistance index ⩾6 Wood Units×m2 should be a contraindication to heart transplantation in children, no national analyses specific to the modern area have addressed this question. METHODS:Data were a...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951114001796
更新日期:2015-08-01 00:00:00
abstract::Primary tumors of the cardiac valves are rare. One of the most common reasons that left-sided cardiac tumors come to clinical attention is embolization to the systemic circulation. We present two children who suffered left coronary arterial occlusion due to embolization of a sarcoma of the mitral valve. A 6-year-old f...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/s1047951101000786
更新日期:2001-09-01 00:00:00
abstract:AIMS:To assess results of closure of atrial septal defects within the oval fossa by devices delivered by catheterisation in symptomatic infants and children under 2 years of age. METHODS AND RESULTS:The Amplatzer septal occluder was used. Results, and complications of transcatheter device treatment in patients aged be...
journal_title:Cardiology in the young
pub_type: 临床试验,杂志文章
doi:10.1017/s1047951100008234
更新日期:2000-09-01 00:00:00
abstract::Congenital heart disease is a significant cause of morbidity and mortality in the newborn. Its diagnosis may lead to a crisis in the affected families; there are the perceived implications of having an abnormality of so vital an organ. To that may be added the assumed guilt or blame, grief and at times anger, frequent...
journal_title:Cardiology in the young
pub_type: 杂志文章,评审
doi:10.1017/s104795110000696x
更新日期:1998-07-01 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::A 34-week premature neonate presented with drug-refractory permanent junctional incessant tachycardia and haemodynamic compromise. The patient underwent successful radiofrequency catheter ablation using a single-catheter approach. The child remains in sinus rhythm, without pharmacological treatment, 2 years after the ...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951112000182
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:This study aimed to examine the differences between arterial and inferior caval vein oxygen saturation, fractional oxygen extraction, and the shunt index, which were calculated in the diagnosis of patent ductus arteriosus. METHODS:Twenty-seven preterm infants were included in this study and were divided int...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951113000772
更新日期:2014-08-01 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 neonate with transposition of the great arteries and intact ventricular septum presented without pulmonary over-circulation, and subsequently developed pulmonary haemorrhage after corrective surgery. Postoperative CT revealed an aortopulmonary collateral artery arising from the descending aorta, and we performed suc...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951115001328
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to describe the approach to stenting arterial shunts in adult congenital patients with single-ventricle physiology and to assess the medium-term clinical and haemodynamic outcomes following stent insertion. BACKGROUND:Adult patients with single-ventricle physiology and pulm...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951118001464
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Providing appropriate care for adults with congenital heart disease requires the evaluation of their current situation. There is limited research in Iran about these patients, particularly in relation to gender differences in the demographic/socio-economic and lifestyle factors, as well as disease parameters...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951112000625
更新日期:2013-04-01 00:00:00
abstract::Sudden death and ventricular tachycardia are known to occur late after correction of tetralogy of Fallot. Abnormal dispersion of the QT interval, ventricular late potentials, and prolongation of the QRS complex, alone or in combination, are useful markers of the risk for such complications. Our present prospective stu...
journal_title:Cardiology in the young
pub_type: 杂志文章
doi:10.1017/S1047951104004020
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:We sought to use techniques of decision analysis to compare values or preferences for balloon angioplasty versus surgery for treatment of aortic coarctation in children. BACKGROUND:Balloon angioplasty and surgery for aortic coarctation have a differing spectrum and prevalence of outcomes and complications, m...
journal_title:Cardiology in the young
pub_type: 杂志文章,meta分析,评审
doi:10.1017/S1047951107001795
更新日期:2008-02-01 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