Pediatric cardiology
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Pediatric cardiology · May 2003
Comparative StudyUse of low-dose ketamine and/or midazolam for pediatric cardiac catheterization.
Ketamine and midazolam are commonly used in children undergoing cardiac catheterization. However, there is controversy regarding the safety of administering these agents in the absence of an anesthesiologist. We retrospectively reviewed pediatric cardiac catheterization procedures at our institution between 1996 and 1997. ⋯ However, there was significant difference between the two regarding the need for supporting drugs (3/21 vs 3/184, p = 0.02) or oxygen treatment (7/21 vs 26/184, p = 0.014). No patients in group B required intubation, whereas 14% and 1.6% required oxygen therapy and supporting drugs, respectively. We conclude that low-dose ketamine and midazolam can be administered safely to most pediatric patients by the cardiologist, who can safely predict the need for an anesthesiologist.
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Pediatric cardiology · May 2003
Comparative StudySinus node dysfunction after intraatrial lateral tunnel and extracardiac conduit fontan procedures.
This study compares the effects of two techniques for the Fontan procedure-intraatrial lateral tunnel (IALT) and extracardiac conduit (ECC) -on sinus node dysfunction. Between January 1992 and December 1998, 54 patients underwent a total cavopulmonary connection Fontan procedure. Of these, 36 had follow-up 24-hour Holter recordings, and they constitute the population for this study. ⋯ The incidence of sinus node dysfunction was higher in the ECC group, which may have been due to longer follow-up in this group. Atrial tachycardia was not observed in either group. Although the IALT group had less sinus node dysfunction than the ECC group and appeared to require less permanent pacing, these data may be too limited to serve as the criteria for choosing between these two techniques for performing the Fontan procedure.
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Pediatric cardiology · May 2003
Editorial Comment Comparative StudyHeavy sedation versus general anesthesia for pediatric invasive cardiology: a Grayer shade of blue versus a pinker shade of pale?
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Pediatric cardiology · Mar 2003
Comparative StudyRegional racial and ethnic differences in mortality for congenital heart surgery in children may reflect unequal access to care.
The objective of this study was to explore racial differences in mortality for congenital heart surgery. We performed a population-based retrospective cohort study using hospital discharge abstract data from four states in 1996. The outcome measure was risk-adjusted in-hospital mortality. ⋯ Adding insurance type to models did not eliminate racial differences. In risk-adjusted analyses, non-white groups had a higher risk of dying after congenital heart surgery than whites. Inconsistent effects among regions suggest that differential mortality is due to unequal access to care rather than biology.