Pediatric cardiology
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A 2-year-old boy with a history of presumed viral pharyngitis presented with rheumatic fever. The episode of pharyngitis was not treated with antibiotic at five years of age, physicians should be aware of the sequelae of untreated group A beta-hemolytic streptococcal pharyngitis.
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Pediatric cardiology · Jan 2008
Prognostic value of B-type natriuretic peptide in surgical palliation of children with single-ventricle congenital heart disease.
The objective of this prospective study was to assess the prognostic role of perioperative B-type natriuretic peptide (BNP) levels in infants and children with single-ventricle congenital heart disease undergoing Norwood, bidirectional cavopulmonary anastomosis (BCPA), or Fontan operation. BNP levels were measured at baseline, after cardiopulmonary bypass, 6 to 12 hours after surgery, and then daily until indwelling vascular catheters were removed. Outcome measures included length of mechanical ventilation, inotropic support, and hospital stay. ⋯ Early postoperative BNP levels correlate significantly with the ensuing duration of inotropic support and length of hospitalization. An increase in BNP after extubation may be reflective of the degree of underlying cardiopulmonary instability. Further investigation is necessary to define this important relation.