Congenital heart disease
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Congenital heart disease · Jan 2015
Preoperative trophic feeds in neonates with hypoplastic left heart syndrome.
The aim of this is study is to determine if preoperative trophic feeds (TFs) can improve outcomes after Norwood palliation. ⋯ Preoperative TFs before Norwood palliation appear safe and are associated with shorter duration of mechanical ventilation, a trend toward more stable postoperative hemodynamics, less fluid overload, and earlier postoperative feeding tolerance.
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Congenital heart disease · Jan 2015
High resource use among adult congenital heart surgery admissions in adult hospitals: risk factors and association with death and comorbidities.
Adult hospitals are a common location of adult congenital heart disease (ACHD) admissions, including cardiac surgical admissions. Understanding the patterns and predictors of resource use could aid these institutions by identifying and targeting potentially modifiable determinants of high resource use (HRU). Our objectives were to examine resource use during adult congenital heart surgical admissions in adult hospitals, determine the association of HRU with mortality, and identify risk factors for HRU. ⋯ HRU admissions for adult congenital heart surgery consumed a disproportionate amount of resources and were associated with higher mortality. HRU risk factors included nonelective admissions, government insurance, heart failure, surgical complexity, renal failure, and complications. Complications, if preventable, may be a target for improvement strategies to decrease resource use. Other risk factors may require a broader patient care approach.