Pediatric cardiology
-
Pediatric cardiology · Sep 2005
Case ReportsUse of dexmedetomidine in a pediatric heart transplant patient.
Dexmedetomidine is a new sedative and analgesic agent that has a unique property of lack of respiratory depression. We describe a pediatric case in which the use of dexmedetomidine enabled us to successfully extubate a 12-year-old heart transplant patient with acute pneumonia after several failed attempts with the use of more conventional sedation.
-
Pediatric cardiology · Sep 2005
Randomized Controlled TrialPropofol and propofol-ketamine in pediatric patients undergoing cardiac catheterization.
We investigated the effects of propofol and propofol-ketamine on hemodynamics, sedation level, and recovery period in pediatric patients undergoing cardiac catheterization. We performed a prospective, randomized, double-blind study. The study included 60 American Society of Anesthesiologists physical status II or III (age range, 1 month-13 years) undergoing cardiac catheterization for evaluation of congenital heart disease. ⋯ Ten patients in group 1 and 3 patients in group 2 required additional fentanyl doses (p = 0.057). The number of additional propofol doses was lower in group 2 (p < 0.05). Propofol combined with low-dose ketamine preserves mean arterial pressure better without affecting the recovery and thus is a good option in pediatric patients undergoing cardiac catheterization.
-
Pediatric cardiology · Sep 2005
Case ReportsStent implantation for recurrent interatrial obstruction in an infant with hypoplastic left heart syndrome.
We report the case of a 19-month-old girl with hypoplastic left heart syndrome who, after Norwood stage 1 and 2 procedures, developed recurrent interatrial obstruction and was treated effectively with stent implantation. The stent was explanted electively 14 months after implantation and showed almost no endothelium formation. Therefore, there was no need for redo atrioseptectomy and the surgical intervention could be staged electively.
-
Pediatric cardiology · Sep 2005
Nitric oxide in the evaluation of congenital heart disease with pulmonary hypertension: factors related to nitric oxide response.
Inhaled nitric oxide (NO) has been used in the preoperative evaluation of patients with congenital heart disease and pulmonary hypertension. The purpose of this study was to characterize responses in pulmonary vascular resistance (PVR) to oxygen and increasing doses of NO during cardiac catheterization and to determine if any related factors affect the response of the pulmonary vascular bed to NO. A prospective analysis of 42 patients (median age, 3.0 years) with congenital heart disease and pulmonary hypertension who underwent NO testing was performed. ⋯ There is no difference in determining PVR response with doses of NO beyond 20 ppm during cardiac catheterization. Age, gender, and baseline PVR/SVR ratio are not associated with responsiveness to NO. Patients with trisomy 21 may be less responsive to NO.
-
Pediatric cardiology · Sep 2005
Multicenter Study Controlled Clinical TrialAdministration of steroids in pediatric cardiac surgery: impact on clinical outcome and systemic inflammatory response.
Cardiopulmonary bypass (CPB) is associated with a systemic inflammatory response. Pre-bypass steroid administration may modulate the inflammatory response, resulting in improved postoperative recovery. We performed a prospective study in the departments of cardiovascular surgery and pediatric intensive care medicine of two university hospitals that included 50 infants who underwent heart surgery. ⋯ Postoperative plasma levels of interleukin-8 were correlated with the duration of CPB time (r = 0.62, p < 0.001). Administration of steroids had no significant impact on the laboratory parameters of inflammation. Administration of prednisolone into the priming solution of the CPB circuit had no measurable influence on postoperative recovery and did not suppress the inflammatory response.