World journal for pediatric & congenital heart surgery
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World J Pediatr Congenit Heart Surg · Jul 2015
ReviewNutrition Support for Children Undergoing Congenital Heart Surgeries: A Narrative Review.
Energy imbalance in infants and children with congenital heart disease (CHD) is common and influenced by age, underlying cardiac diagnoses, and presence or absence of congestive heart failure. During the surgical hospitalization period, these children are prone to nutritional deterioration due to stress of surgery, anesthetic/perfusion techniques, and postoperative care. ⋯ This review aims to examine various aspects of nutrition in critically ill children with CHD, including (1) energy expenditure, (2) perioperative factors that contribute to energy metabolism, (3) bedside practices that are potentially able to optimize nutrient delivery, and (4) medium- to long-term impact of energy balance on clinical outcomes. We propose a nutrition algorithm to optimize nutrition of these children in the perioperative period where improvements in nutrition status will likely impact surgical outcomes.
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World J Pediatr Congenit Heart Surg · Jul 2015
Comparative StudyComparative Review of Outcomes in Patients With Congenital Heart Disease Requiring Cardiopulmonary Support for Failure to Wean From Cardiopulmonary Bypass or for Refractory Sudden Cardiac Arrest.
We reviewed the outcomes of patients who underwent cardiopulmonary support (CPS) for either refractory sudden cardiac arrest or failure to wean from cardiopulmonary bypass (CPB). ⋯ Comparable rates of survival to discharge can be obtained when CPS is initiated for E-CPR or for failure to wean from CPB in resuscitating patients with CHD. Hepatic and renal factors indicative of inadequate early tissue perfusion, single-ventricle physiology, and lower bicarbonate level are factors associated with poor outcome.
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World J Pediatr Congenit Heart Surg · Jul 2015
Arterial Switch for Transposition of the Great Arteries With Large Ventricular Septal Defect and for Taussig Bing Anomaly: Experience From a Tertiary Care Center in the Developing World.
Results of the arterial switch operation (ASO) for transposition of the great arteries (TGA) with large ventricular septal defect (VSD) and for Taussig Bing anomaly (TBA) in a tertiary care center of a developing country were retrospectively analyzed. ⋯ Our experience at a tertiary center in a developing country suggests that preoperative need for IPPV for pneumonia is a major determining factor for mortality and morbidity in patients undergoing ASO for TBA and TGA/VSD. This appears to be of greater consequence than details of the underlying disease per se.
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World J Pediatr Congenit Heart Surg · Jul 2015
Acute Kidney Injury and Fluid Overload in Neonates Following Surgery for Congenital Heart Disease.
Acute kidney injury (AKI) and fluid overload have been shown to increase morbidity and mortality. The reported incidence of AKI in pediatric patients following surgery for congenital heart disease is between 15% and 59%. Limited data exist looking at risk factors and outcomes of AKI or fluid overload in neonates undergoing surgery for congenital heart disease. ⋯ To avoid increased risk of morbidity and possibly mortality, every attempt should be made to identify and intervene on those risk factors, which may be modifiable or identifiable preoperatively, such as small kidneys by renal ultrasound.
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World J Pediatr Congenit Heart Surg · Apr 2015
Case ReportsPostpartum pulmonary embolism in a patient with Fontan circulation.
Pregnancy is typically not recommended in patients with Fontan circulation. Although patients are well aware of the risks for the mother and fetus, an increasing number opt to become pregnant. ⋯ Postpartum thromboembolism is a known complication, but its prevalence and management are not clearly defined. We present a case of massive pulmonary embolism two weeks postpartum in a patient with double inlet left ventricle palliated with lateral tunnel Fontan.