Congenital heart disease
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Congenital heart disease · Sep 2015
Multicenter Study Observational StudyGrowth Restriction in Infants and Young Children with Congenital Heart Disease.
The purpose of this study was to determine the prevalence of growth restriction in infants and young children with congenital heart disease (CHD) and investigate the relationship between poor growth, feeding difficulties, cardiac classification, and nutrition intervention on outcomes. ⋯ Growth restriction remains an ongoing problem in children with CHD. Faltering growth preadmission and lower growth parameters were associated with an increased hospital length of stay. Nutritional screening from diagnosis may detect growth faltering, improve access to early nutrition intervention, and improve patient outcomes.
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Congenital heart disease · Jul 2015
Comparative Study Observational StudySerum Cystatin C as an Early Marker of Neutrophil Gelatinase-associated Lipocalin-positive Acute Kidney Injury Resulting from Cardiopulmonary Bypass in Infants with Congenital Heart Disease.
Acute kidney injury (AKI) is a common complication resulting from cardiopulmonary bypass in infants. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a sensitive and specific marker of such injury. In this study, we compared the performance of serum cystatin C (Cys C) and serum creatinine (Cr) as early markers of renal dysfunction in infants undergoing cardiac surgery under bypass. ⋯ Postoperative serum Cys C appears to be a more specific and sensitive biomarker for NGAL-positive AKI resulting from cardiopulmonary bypass surgery in infants undergoing cardiac surgery.
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Congenital heart disease · Jul 2015
Fluoroscopy-guided Umbilical Venous Catheter Placement in Infants with Congenital Heart Disease.
The objective of this study was to (1) describe the technical aspects of fluoroscopy-guided umbilical venous catheter placement (FGUVCP); and (2) determine the procedural success rate, factors contributing to procedural failure, and risks of the procedure. ⋯ FGUVCP is a safe and highly successful way to obtain central venous access in neonates with congenital heart disease. Older age at the time of procedure is associated with procedural failure, but utilization of an age cutoff may not be clinically useful.
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Congenital heart disease · May 2015
Clinical Hemodynamic Parameters Do Not Accurately Reflect Systemic Oxygen Transport in Neonates after the Norwood Procedure.
Clinical hemodynamic parameters (heart rate, systolic arterial pressure [SAP], and arterial and venous oxygen saturation saturations [SaO2 and SvO2 ]) are commonly used to guide management to optimize oxygen transport after the Norwood procedure. The adequacy of this practice has not been demonstrated. We examined the correlations between these clinical parameters and direct measurements of oxygen transport in these patients. ⋯ Routine clinical hemodynamic parameters do not accurately reflect oxygen transport after the Norwood procedure, except for SvO2, which does not differentiate between VO2 and DO2. Higher heart rate and SAP are correlated with a worse balance of oxygen transport. The results of clinical hemodynamic monitoring should be interpreted with caution. Direct measurements of oxygen transport parameters are important in the care of neonates after the Norwood procedure.