Pediatric cardiology
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Pediatric cardiology · Aug 2019
Thenar Muscle Oxygen Saturation Using Vascular Occlusion Test: A Novel Technique to Study Microcirculatory Abnormalities in Pediatric Heart Failure Patients.
Heart failure (HF) is associated with microcirculatory changes secondary to neuro-humoral imbalance, vascular stiffness and increased sympathetic tone. Near Infra-Red Spectroscopy (NIRS) derived Thenar muscle tissue oxygenation levels (StO2) can provide an estimate of the functional status of microcirculation. There is a paucity of literature regarding evaluation of microcirculation in pediatric subjects with HF. ⋯ This study is the first to report an objective assessment of microcirculation and Thenar tissue oxygen dynamics in pediatric subjects with HF in comparison with HC. Our study suggests altered microcirculation and oxygenation patterns in these subjects as well as correlation with a validated pediatric heart failure clinical score. Large-scale prospective studies are needed to further study the utility of this novel technology in HF subjects.
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Pediatric cardiology · Aug 2019
Case ReportsImproved Left Ventricular Strain and Dyssynchrony After Pulmonary Artery Banding in an Infant with End-Stage Dilated Cardiomyopathy: Insights from Three-Dimensional Speckle Tracking.
Pulmonary artery banding may benefit infants with dilated cardiomyopathy. We present the case of an infant with end-stage dilated cardiomyopathy and intractable heart failure who received pulmonary artery banding. Serial follow-up through two-dimensional and three-dimensional echocardiography revealed gradual improvement in the left ventricular ejection fraction and favorable remodeling. The result of three-dimensional speckle tracking suggested that this benefit is associated with improvements in global strain and intraventricular dyssynchrony.
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Pediatric cardiology · Aug 2019
Randomized Controlled TrialDevelopment and Evaluation of a New Chest Compression Technique for Cardiopulmonary Resuscitation in Infants.
We designed the newly developed flexed two-finger chest compression technique for cardiopulmonary resuscitation (CPR) in infants to increase the quality of chest compression by considering the advantages and disadvantages of the two-thumb encircling hand technique and conventional two-finger technique. The aim of the study is to compare the performance of the flexed two-finger technique and the currently used two-thumb technique or two-finger technique for infant CPR. A total of 42 doctors conducted 2-min single-rescuer CPR on a cardiac arrest infant model using the two-thumb technique followed, in a random order, by the two-finger technique and the flexed two-finger technique. ⋯ The number of total chest compressions of the two-thumb technique was significantly lower than in the two-finger technique and flexed two-finger technique (150 [148-159] vs. 159 [149-173] vs. 162 [150-172], respectively, P < 0.001). The newly developed chest compression technique could provide adequate compression depth without increasing the hand-off time during single-rescuer infant CPR. Trial registration: Clinical Research Information Service, KCT0002730.
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Pediatric cardiology · Aug 2019
Comparative Study Observational StudyArterial Pressure Monitoring in Pediatric Patients Undergoing Cardiac Surgery: An Observational Study Comparing Invasive and Non-invasive Measurements.
In pediatric cardiac surgery patients, when an artifact due to overdamping or to underdamping is suspected to affect the invasive arterial blood pressure (IABP) measure and waveform, a check against non-invasive blood pressure (NIBP) could be useful. In this study, we aimed to retrospectively analyze the differences between IABP (single site) and NIBP, measured at four limbs in children admitted to pediatric cardiac intensive care unit. Overall, 51 patients were enrolled for a total of 546 measurements. ⋯ Average systolic, diastolic, and mean IABP-NIBP differences of 45 patients without underdamping artifacts were not significantly different compared to those of 6 patients with underdamping (p = 0.17, 0.84, and 0.08, respectively). In conclusion, a wide bias can be detected in post-cardiac surgery children between IABP and NIBP pressures in more than half of measurements, with underdamping/resonance incidence being relatively low. Measurement of both methods without a limb preference should be considered in cardiac surgery children.
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Pediatric cardiology · Jun 2019
Ambulatory Arrhythmia Detection with ZIO® XT Patch in Pediatric Patients: A Comparison of Devices.
Ambulatory electrocardiogram monitoring devices can be used for 24-72 h to detect arrhythmias. A new device, the ZIO® XT Patch has cardiac monitoring capabilities that can be utilized for up to 14 days. The purpose of this study is to describe duration of ZIO use by age, and to compare its time to arrhythmia detection with the Holter monitor in a pediatric population. ⋯ The ZIO® XT Patch may be considered as an ambulatory ECG monitor to diagnose arrhythmia in pediatric patients of all ages. Increasing patient age resulted in increasing duration of ZIO monitoring. Majority of arrhythmias detected with ZIO were identified after 24 h, which would have been missed by other short-term monitors.