Pediatric cardiology
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Pediatric cardiology · Mar 2013
Comparative StudyTissue Doppler imaging detects impaired biventricular performance shortly after congenital heart defect surgery.
Cardiac surgery with cardiopulmonary bypass is associated with the development of a systemic inflammatory response, which can lead to myocardial damage. However, knowledge concerning the time course of ventricular performance deterioration and restoration after correction of a congenital heart defect (CHD) in pediatric patients is sparse. Therefore, the authors perioperatively quantified left ventricular (LV) and right ventricular (RV) performance using echocardiography. ⋯ In conclusion, both systolic and diastolic biventricular performances were impaired shortly after CHD correction. This impairment was detected only by TDI parameters and TAPSE. Furthermore, a longer-lasting negative influence of cardiopulmonary bypass on myocardial performance was suggested.
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Pediatric cardiology · Mar 2013
Comparative StudyMidterm survival of infants requiring postoperative extracorporeal membrane oxygenation after Norwood palliation.
This study reports the mid-term survival for neonates undergoing extracorporeal membrane oxygenation (ECMO) after Norwood palliation at a single center. Limited data exist on the mid-term survival of patients undergoing ECMO after Norwood palliation. We reviewed our ECMO experience from July 1994 to October 2008 and compared two groups: patients who required ECMO after Norwood palliation and patients who underwent Norwood palliation without ECMO. ⋯ Of the original Norwood/ECMO hospital survivors, only half of these patients survived a mean of nearly 4 years. ECMO after Norwood palliation is associated with significant mortality. Our data suggest that neonates who require ECMO after Norwood palliation are prone to continued attrition once discharged from the hospital.
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Pediatric cardiology · Mar 2013
Comparative StudyProspective assessment of novice learners in a simulation-based extracorporeal membrane oxygenation (ECMO) education program.
This study aimed to assess the impact of integrating a simulation-based education module into an extracorporeal membrane oxygenation (ECMO) curriculum on novice learners and to test the duration of time that skills obtained during this training exercise were retained. The authors hypothesized that multidisciplinary, simulation-based ECMO training would improve comfort and confidence levels among participants. An ECMO training curriculum was developed that incorporated in situ simulation modules to train multidisciplinary health care professionals involved in the management of patients receiving ECMO in the pediatric cardiac intensive care unit (PCICU). ⋯ All four questionnaires were completed by 18 participants. Simulation-based training is an effective method of improving knowledge, ability, and confidence levels among novice ECMO specialists and physician trainees. Further research is needed to assess real-time demonstration of skills retention during ECMO emergencies.
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Pediatric cardiology · Mar 2013
Case ReportsLate manifestation of coarctation of the aorta after arterial switch operation for D-transposition of the great arteries with intact ventricular septum.
We describe an infant with D-transposition of the great arteries with an intact ventricular septum who developed coarctation of the aorta 13 days after arterial switch operation. A mildly hypoplastic aortic isthmus was present on echocardiogram at the time of the arterial switch operation, but there was no echocardiographic or clinical evidence of coarctation of the aorta.
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Pediatric cardiology · Mar 2013
Improving teamwork, confidence, and collaboration among members of a pediatric cardiovascular intensive care unit multidisciplinary team using simulation-based team training.
Findings show that simulation-based team training (SBTT) is effective at increasing teamwork skills. Postpediatric cardiac surgery cardiac arrest (PPCS-CA) is a high-risk clinical situation with high morbidity and mortality. Whereas adult guidelines managing cardiac arrest after cardiac surgery are available, little exists for pediatric cardiac surgery. ⋯ A significant increase (p < 0.05) also was observed in the use of Team STEPPS concepts immediately after training and 3 months later. This study showed SBTT to be effective in improving communication and increasing confidence among members of a multidisciplinary team during crisis scenarios. Thus, SBTT provides an excellent tool for teaching and implementing new processes.