Progress in pediatric cardiology
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Prog. Pediatr. Cardiol. · Mar 2021
Case ReportsPerforming an urgent neonatal cardiac intervention safely during the COVID-19 pandemic.
The current pandemic has driven the medical community to adapt quickly to unprecedented challenges. Among these challenges is the need to minimize staff exposure to COVID-19 during neonatal cardiac procedures. In this report, we describe measures we have taken to protect health care workers while ensuring successful outcomes. These measures include wearing appropriate personal protective equipment, physical distancing, designating separate delivery and transport teams, and limiting the number of providers in direct contact with any patient who is infected or whose infection status is unknown.
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Prog. Pediatr. Cardiol. · Sep 2020
Case ReportsSevere cardiac dysfunction in a patient with multisystem inflammatory syndrome in children associated with COVID-19: Retrospective diagnosis of a puzzling presentation. A case report.
We report one of the earliest known U. S. cases of multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C). This adolescent male presented prior to any known association between COVID-19 and immune mediated inflammatory syndrome in children. ⋯ Clinical features overlapped with Kawasaki disease, acute rheumatic fever, and toxic shock syndrome. After centers in Europe began reporting a multisystem inflammatory condition in children with COVID-19, the patient's clinical course and laboratory findings were revisited. He underwent newly available antibody testing and was diagnosed as one of the first known cases of MIS-C in the United States.
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Prog. Pediatr. Cardiol. · Jun 2016
Early detection of acute kidney injury after pediatric cardiac surgery.
Acute kidney injury (AKI) is increasingly recognized as a common problem in children undergoing cardiac surgery, with well documented increases in morbidity and mortality in both the short and the long term. Traditional approaches to the identification of AKI such as changes in serum creatinine have revealed a large incidence in this population with significant negative impact on clinical outcomes. However, the traditional diagnostic approaches to AKI diagnosis have inherent limitations that may lead to under-diagnosis of this pathologic process. ⋯ With these new diagnostic tools, a more consistent approach can be employed across centers that may facilitate a more accurate representation of the actual prevalence of AKI and more importantly, clinical investigation that may minimize the occurrence of AKI following pediatric cardiac surgery. A thoughtful management approach is necessary to mitigate the effects of AKI after cardiac surgery, which is best accomplished in close collaboration with pediatric nephrologists. Long-term surveillance for improvement in kidney function and potential development of chronic kidney disease should also be a part of the comprehensive management strategy.
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Prog. Pediatr. Cardiol. · Dec 2009
Towards improving the care of children with pulmonary hypertension: The rationale for developing a Pediatric Pulmonary Hypertension Network.
Pulmonary hypertension (PH) and related pulmonary vascular diseases contribute to high morbidity and mortality and treatment options remain limited. Despite the availability of new drug therapies, the long-term outcomes of patients with severe PH remain poor. This may be especially true for many children with PH. ⋯ Limitations regarding current translational approaches to children with PH are partly due to the relatively small numbers of patients with PH associated with specific pediatric disorders at each center; the small number of well-established, multidisciplinary programs in pediatric PH; little communication between translational and clinician-scientists; and limited interactions between existing PH programs. There is clearly a need to develop clinical infrastructure to better define the natural history and course of pediatric PH, to develop new strategies to identify at-risk patients early in their course, and to establish novel approaches to diagnose, monitor disease progression and treat children with PH. This article discusses the rationale, goals and initial steps in the establishment of an interactive network of investigators, care providers and multidisciplinary teams from several pediatric PH centers.