Articles: pediatrics.
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Recent studies suggest that adult cardiac surgery performed in the morning increases the risk of major adverse cardiac events, but it is unclear whether this association exists in pediatric cardiac surgery. This study aimed to determine whether the composite outcome of in-hospital mortality and low cardiac output syndrome (LCOS) differs between morning and afternoon pediatric cardiac surgeries. ⋯ Our study supports the selective afternoon scheduling of specific pediatric cardiac surgeries, but further investigation is needed in a multicenter cohort.KEY MESSAGESThis study reviewed 23,433 consecutive pediatric patients who underwent cardiac surgery between August 2014 and December 2021.This study suggested that afternoon surgery was associated with a lower risk of the composite outcomes of in-hospital mortality and low cardiac output syndrome.The above association was also determined in children aged 3 to 18 years, weighted between 6.1 and 8.7 kg, or more than 13 kg, and with STAT category 4-5 subgroups.The restricted cubic spline plot showed that the adjusted risk of the composite outcome decreased with a delay in the start time of surgery.Our findings support selective afternoon scheduling for specific pediatric cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Comparative Study Observational StudyA Retrospective Comparative Study of the Frequency of Hypotension in Pediatric Cardiac Catheterization under General Anesthesia: Remimazolam versus Sevoflurane.
To compare the incidence of hypotension between remimazolam and sevoflurane under general anesthesia for cardiac catheterization in patients with congenital heart disease. ⋯ Remimazolam was not associated with a lower incidence of hypotension compared to sevoflurane during pediatric cardiac catheterization for congenital heart disease while maintaining significantly higher blood pressure overall.
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Modified Delphi consensus study. ⋯ V-Expert opinion.
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Existing screening tools for sepsis in children are limited by suboptimal sensitivity. Our objective was to develop a new, more sensitive screening tool for pediatric septic shock by enhancing 2 aspects of the 4-point Liverpool quick Sequential Organ Failure Assessment (LqSOFA) tool. ⋯ The qPS4, with 2 enhancements to the LqSOFA, demonstrated overall improved sensitivity and specificity for pediatric septic shock.