World journal for pediatric & congenital heart surgery
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World J Pediatr Congenit Heart Surg · Jan 2013
Randomized Controlled TrialComparison of cardioprotective effects of volatile anesthetics in children undergoing ventricular septal defect closure.
Volatile anesthetic agents may precondition the myocardium and protect against ischemia and infarction. Preconditioning by volatile anesthetic agents is well documented in adults but is underinvestigated in children. The present study compares the effect of preconditioning in children by three volatile anesthetic agents along with several other variables associated with cardioprotection. ⋯ Volatile anesthetic appear to provide definite cardioprotection to pediatric myocardium. No conclusion can be drawn regarding the best preconditioning agent among isoflurane, sevoflurane, and desflurane.
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World J Pediatr Congenit Heart Surg · Jan 2013
Case ReportsCardiopulmonary bypass in an infant with a recent history of malaria.
Severe malarial infection is associated with impaired cardiac function. We report a child who underwent repair of tetralogy of Fallot two weeks after being treated for malaria. The postoperative course was complicated by impaired left ventricular function. The pathogenesis of malaria is discussed as well as the potential complications of cardiopulmonary bypass (CPB).
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World J Pediatr Congenit Heart Surg · Oct 2012
Conservative management of iatrogenic esophageal perforation during neonatal cardiac surgery.
Esophageal perforation is a rare, but life threatening, entity in children. The most common iatrogenic causes include nasogastric tube insertion, stricture dilation, or endotracheal intubation. ⋯ The safety of TEE in children is still controversial and complications such as airway obstruction, hemodynamic compromise, and esophageal injury have been reported. We recently experienced a case of esophageal perforation caused by TEE probe insertion during neonatal cardiac surgery; two weeks of conservative management resulted in complete resolution of the injury.
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World J Pediatr Congenit Heart Surg · Oct 2012
Thromboelastography in the assessment of bleeding following surgery for congenital heart disease.
Perioperative bleeding is common in pediatric cardiac surgery patients. Traditional laboratory tests do not adequately characterize coagulation derangements in patients with bleeding. We sought to establish preoperative thromboelastography parameters in children prior to cardiopulmonary bypass, to compare thromboelastography assessment with standard coagulation parameters postoperatively, and to assess thromboelastography in children with significant hemorrhage. ⋯ Pediatric patients with significant postoperative bleeding after surgery are more likely to have abnormal thromboelastography early after cessation of cardiopulmonary bypass. Thromboelastography illustrates derangements in the coagulation system and may aid in the treatment of postoperative bleeding.
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World J Pediatr Congenit Heart Surg · Jul 2012
Controlling oxygenation during initiation of cardiopulmonary bypass: can it improve immediate postoperative outcomes in cyanotic children undergoing cardiac surgery? A prospective randomized study.
Cardiopulmonary bypass (CPB) initiated with high oxygen levels may expose cyanotic children to reoxygenation injury. The ideal method of initiation of bypass to prevent this phenomenon still remains largely unproven. This study tested the hypothesis that controlling oxygenation during initiation of CPB improves early postoperative outcomes. ⋯ A controlled oxygenation protocol was associated with significantly lower postoperative CPK-MB levels. Evaluation of other end points including ventilation times requires a study with larger sample size for validation.