Pediatric cardiology
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Pediatric cardiology · Sep 2008
Multicenter StudyThe reliability of a single pulse oximetry reading as a screening test for congenital heart disease in otherwise asymptomatic newborn infants.
Routine pulse oximetry has been studied to detect children with otherwise undiagnosed congenital heart disease prior to nursery discharge. The reported sensitivities in asymptomatic patients have been less than expected and vary widely, bringing into question the reliability of the test. The purpose of this study was to assess whether routine pulse oximetry contributes to identifying patients with critical congenital heart disease and to determine the reliability of a single pulse oximeter reading in screening asymptomatic newborn infants. ⋯ With routine surveillance and quality improvement, the reliability of this test can be increased. Future studies to determine the effectiveness of pulse oximetry screening for the diagnosis of congenital heart disease in the asymptomatic newborn population must address these factors. Until such a study demonstrates acceptable sensitivity and clinical value, universal screening should not be instituted.
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Pediatric cardiology · Sep 2008
Case ReportsCardiac arrest secondary to long QT(C )in a child with propionic acidemia.
In 2006 a case report was published in this journal of a child with known propionic acidemia being diagnosed with the long QT(C) syndrome. This following case documents the first reported case of a child with this condition suffering a life-threatening event from the associated long QT(C) syndrome.
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Pediatric cardiology · Jul 2008
Medication dosing and renal insufficiency in a pediatric cardiac intensive care unit: impact of pharmacist consultation.
Pediatric patients who have undergone cardiac surgery are at risk for renal insufficiency. The impact of pharmacist consultation in the pediatric cardiac intensive care unit (ICU) has yet to be defined. Patients admitted to the pediatric cardiac ICU at our institution from January through March of 2006 were included. ⋯ The monetary impact of pharmacist interventions, in doses saved, was approximately $12,000. Pharmacist consultation can result in improved dosing of medications and cost savings. The youngest patients are most at risk for inappropriate dosing.
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Pediatric cardiology · May 2008
Impact of postoperative hyperglycemia following surgical repair of congenital cardiac defects.
The objective of this study was to determine the prevalence of postoperative hyperglycemia in pediatric patients following surgery for congenital cardiac defects and its impact on morbidity and mortality. It was designed as a retrospective cohort study in a pediatric intensive care unit of a university-affiliated free-standing children's hospital. A cohort of 213 patients who underwent 237 surgical procedures for repair or palliation of congenital cardiac defects comprised the study. ⋯ Duration of hyperglycemia was independently associated with morbidity [odds ratio (OR): 1.95; p < 0.001] and mortality (OR: 1.41; p = 0.03) by multivariate logistic regression. Hyperglycemia is common in children following surgical repair or palliation of congenital cardiac defects. Postoperative hyperglycemia is associated with increased morbidity and mortality in these patients.