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Kiekkas P, Kourtis G, Feizidou P, Igoumenidis M, Almpani E, Tzenalis A. Associations Between Core Temperature Disorders and Outcomes of Pediatric Intensive Care Unit Patients. Am J Crit Care 2023; 32:338-345. [PMID: 37652884 DOI: 10.4037/ajcc2023567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND The few studies of associations between fever and outcomes in pediatric intensive care unit (PICU) patients have conflicting findings. Associations between hypothermia and patient outcomes have not been studied. OBJECTIVE To investigate the incidence and characteristics of fever and hypothermia and their associations with adverse outcomes among PICU patients. METHODS Patients consecutively admitted to 2 PICUs in a 2-year period were prospectively studied. Core temperature was mainly measured by rectal or axillary thermometry. Fever and hypothermia were defined as core temperatures of greater than 38.0 °C and less than 36.0 °C, respectively. Prolonged mechanical ventilation, prolonged PICU stay, and PICU mortality were the adverse patient outcomes studied. Associations between patient outcomes and core temperature disorders were evaluated with univariate comparisons and multivariate analyses. RESULTS Of 545 patients enrolled, fever occurred in 299 (54.9%) and hypothermia occurred in 161 (29.5%). Both temperature disorders were independently associated with prolonged mechanical ventilation and prolonged PICU stay (P < .001) but not with PICU mortality. Late onset of fever (P < .001) and hypothermia (P = .009) were independently associated with prolonged mechanical ventilation, fever magnitude and duration (both P < .001) were independently associated with prolonged PICU stay, and fever magnitude (P < .001) and infectious cause of hypothermia (P= .01) were independently associated with higher PICU mortality. CONCLUSIONS These findings provide evidence that the manifestation and characteristics of fever and hypothermia are independent predictors of adverse outcomes in PICU patients.
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Affiliation(s)
- Panagiotis Kiekkas
- Panagiotis Kiekkas is a professor in the Nursing Department, University of Patras, Greece
| | - Grigorios Kourtis
- Grigorios Kourtis is a grade B registered nurse in the pediatric intensive care unit, General University Hospital of Patras
| | - Paraskevi Feizidou
- Paraskevi Feizidou is the head registered nurse in the pediatric intensive care unit, General Children's Hospital P. & A. Kyriakou, Athens, Greece
| | - Michael Igoumenidis
- Michael Igoumenidis is an assistant professor in the Nursing Department, University of Patras
| | - Eleni Almpani
- Eleni Almpani is an assistant professor in the Nursing Department, University of Patras
| | - Anastasios Tzenalis
- Anastasios Tzenalis is an assistant professor in the Nursing Department, University of Patras
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2
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Corno AF, Koerner TS, Salazar JD. Innovative treatments for congenital heart defects. World J Pediatr 2023; 19:1-6. [PMID: 36481963 DOI: 10.1007/s12519-022-00654-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/30/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Antonio F Corno
- McGovern Medical School, Children's Heart Institute, Memorial Hermann Children's Hospital, University of Texas Health Science Center in Houston, 6410 Fannin Street, MSB 6.274, Houston, TX, 77030, USA.
| | - Taylor S Koerner
- McGovern Medical School, Children's Heart Institute, Memorial Hermann Children's Hospital, University of Texas Health Science Center in Houston, 6410 Fannin Street, MSB 6.274, Houston, TX, 77030, USA
| | - Jorge D Salazar
- McGovern Medical School, Children's Heart Institute, Memorial Hermann Children's Hospital, University of Texas Health Science Center in Houston, 6410 Fannin Street, MSB 6.274, Houston, TX, 77030, USA
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3
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Wei S, Cao Y, Liu D, Zhang D. Cerebral infarction after cardiac surgery. IBRAIN 2022; 8:190-198. [PMID: 37786885 PMCID: PMC10528768 DOI: 10.1002/ibra.12046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/04/2022] [Accepted: 05/08/2022] [Indexed: 10/04/2023]
Abstract
Cerebral infarction, a common central nervous system complication after adult cardiac surgery, is one of the main factors leading to the poor prognosis of cardiac surgery patients besides cardiac insufficiency. However, there is currently no effective treatment for cerebral infarction. Therefore, early prevention and diagnosis of postoperative cerebral infarction are particularly important. There are many factors and mechanisms during and after cardiac surgery that play an important role in the occurrence of postoperative cerebral infarction, such as intraoperative embolism, systemic inflammatory response syndrome, atrial fibrillation, temperature regulation, blood pressure control, use of postoperative blood products, and so forth. The mechanism by which most risk factors act on the human body, leading to postoperative cerebral infarction, is not well understood, and further research is needed. Therefore, this paper aims to summarize and explain the relevant risk factors, mechanisms, clinical signs, imaging characteristics, and early diagnosis methods of cerebral infarction complications after cardiac surgery, and provides useful data for the establishment of related diagnosis and treatment standards.
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Affiliation(s)
- Shan Wei
- Department of Cardiovascular SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Yi‐Ran Cao
- Department of Cardiovascular SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Da‐Xing Liu
- Department of Cardiovascular SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Deng‐Shen Zhang
- Department of Cardiovascular SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
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4
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Corno AF, LaPar DJ, Li W, Salazar JD. A narrative review of modern approach and outcomes evaluation in congenital heart defects. Transl Pediatr 2021; 10:2114-2122. [PMID: 34584882 PMCID: PMC8429879 DOI: 10.21037/tp-21-163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/23/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The purpose of this review is to highlight critical advances and innovative approaches to the most challenging clinical situations in congenital heart surgery, to establish a new perspective from which to evaluate current clinical practice patterns and contemporary United States program ranking systems. BACKGROUND The past decades have witnessed substantial advances in the treatment of congenital heart defects. New strategies are deeply rooted in calculated risk-taking innovations. Pioneer surgeons developed, improved and refined critical operative skills and techniques to optimize cardiovascular physiology, decrease operative mortality and improve clinical outcomes. METHODS Unfortunately, in the modern surgical era, supportive environments to allow surgeons to make similar gains and innovative contributions remain scarce. In the current practice, overall procedure volume is prioritized to safeguard quality metrics, including hospital survival and length of stay, surgical complications, and neurocognitive outcomes. As a result, exceptional surgical results have become translated and defined by public ranking systems such as the US News and World Report Best Children's Hospital National Ranking (USNWR) and the Congenital Heart Surgery Database of the Society for Thoracic Surgeons (CHSD-STS), primary based upon early post-operative mortality. This reality places surgeons in a vulnerable position where pressure to achieve a high clinical ranking contrasts with a surgeon definition of "acceptable" surgical risk. Currently, the most frequently used risk stratification tools do not factor in important differences in strategies, such as staged palliation versus complete repair, or bi-ventricular versus uni-ventricular physiology. This favors hospitals pursuing multistage surgical approaches, even if the result is worse long-term morbidity, mortality and increased resource utilization. This economy of ranking-based decision-making causes surgeons either avoid operating altogether or accept less advantageous multi-staged treatment strategies for patients with elevated expected mortality. Such an environment also might present much farther-reaching negative impacts on the growth and development of junior surgeons and trainees, as well as on the pursuit of new surgical innovations to aid future generations of patients. CONCLUSIONS Risk aversive surgical behavior is creating an environment not favorable for the children born with truly complex congenital heart defects. KEYWORDS Biventricular conversion; congenital heart surgery; multidisciplinary approach; risk-stratification; surgical outcomes.
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Affiliation(s)
- Antonio F Corno
- Pediatric and Congenital Cardiac Surgery, Houston Children's Heart Institute, Memorial Hermann Children's Hospital, University of Texas Health, McGovern Medical School, Houston, Texas, USA
| | - Damien J LaPar
- Pediatric and Congenital Cardiac Surgery, Houston Children's Heart Institute, Memorial Hermann Children's Hospital, University of Texas Health, McGovern Medical School, Houston, Texas, USA
| | - Wen Li
- Division of Clinical and Translational Sciences, Department of Internal Medicine, University of Texas Health, McGovern Medical School, Houston, Texas, USA
| | - Jorge D Salazar
- Pediatric and Congenital Cardiac Surgery, Houston Children's Heart Institute, Memorial Hermann Children's Hospital, University of Texas Health, McGovern Medical School, Houston, Texas, USA
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5
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Xiong T, Pu L, Ma YF, Zhu YL, Cui X, Li H, Zhan X, Li YX. Safety of Normothermic Cardiopulmonary Bypass in Pediatric Cardiac Surgery: A System Review and Meta-Analysis. Front Pediatr 2021; 9:757551. [PMID: 34970516 PMCID: PMC8712704 DOI: 10.3389/fped.2021.757551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/24/2021] [Indexed: 01/14/2023] Open
Abstract
Objectives: Hypothermic cardiopulmonary bypass (HCPB) has been used successfully in cardiac surgery for more than half a century, although adverse effects have been reported with its use. Many studies on temperature management during CPB published to date have shown that normothermic CPB (NCPB) provides more benefits to children undergoing cardiac surgery. The present meta-analysis investigated the effect of NCPB on clinical outcomes based on results of randomized controlled trials and observational studies on pediatric cardiac surgery. Methods: Databases such as PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Clinical Trials.gov were searched from inception to May 2021 to identify relevant studies published in English. Results: The present meta-analysis included 13 studies characterizing a total of 837 pediatric patients. The random effects model exhibited that the NCPB group had reduced revision for postoperative bleeding [odds ratio (OR): 0.11; 95% confidence interval (CI): 0.01-0.89; I 2 = 0%, P = 0.04], serum lactate 2-4 h after CPB (mean difference: -0.60; 95% CI: -1.09 to -0.11; I 2 = 82%, P = 0.02), serum creatinemia 24 h after CPB (mean difference: -2.73; 95% CI: -5.06 to -0.39; I 2 = 83%, P = 0.02), serum creatinemia 48 h after CPB (mean difference: -2.08; 95% CI: -2.78 to -1.39; I 2 = 0%, P < 0.05), CPB time (mean difference: -19.10, 95% CI: -32.03 to -6.18; I 2 = 96%, P = 0.04), and major adverse events (OR: 0.37; 95% CI: 0.15-0.93; Z = 2.12, P = 0.03) after simple congenital surgery compared with the HCPB group. Conclusion: NCPB is as safe as HCPB in pediatric congenital heart surgery. Moreover, NCPB provides more advantages than HCPB in simple congenital heart surgery.
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Affiliation(s)
- Tao Xiong
- Department of Cardiac Surgery, Kunming Yan'an Hospital, Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lei Pu
- Department of Cardiac Surgery, Kunming Yan'an Hospital, Affiliated Hospital of Kunming Medical University, Kunming, China.,Cardiovascular Surgery, Institution of Yunnan, Kunming, China
| | - Yuan-Feng Ma
- Department of Cardiac Surgery, Kunming Yan'an Hospital, Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yun-Long Zhu
- Department of Cardiac Surgery, Kunming Yan'an Hospital, Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xu Cui
- Department of Cardiac Surgery, Kunming Yan'an Hospital, Affiliated Hospital of Kunming Medical University, Kunming, China.,Cardiovascular Surgery, Institution of Yunnan, Kunming, China
| | - Hua Li
- Department of Cardiac Surgery, Kunming Yan'an Hospital, Affiliated Hospital of Kunming Medical University, Kunming, China.,Cardiovascular Surgery, Institution of Yunnan, Kunming, China
| | - Xu Zhan
- Department of Cardiac Surgery, Kunming Yan'an Hospital, Affiliated Hospital of Kunming Medical University, Kunming, China.,Cardiovascular Surgery, Institution of Yunnan, Kunming, China
| | - Ya-Xiong Li
- Department of Cardiac Surgery, Kunming Yan'an Hospital, Affiliated Hospital of Kunming Medical University, Kunming, China.,Cardiovascular Surgery, Institution of Yunnan, Kunming, China
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6
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Zhu S, Sai X, Lin J, Deng G, Zhao M, Nasser MI, Zhu P. Mechanisms of perioperative brain damage in children with congenital heart disease. Biomed Pharmacother 2020; 132:110957. [PMID: 33254442 DOI: 10.1016/j.biopha.2020.110957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 11/15/2022] Open
Abstract
Congenital heart disease, particularly cyanotic congenital heart disease (CCHD), may lead to a neurodevelopmental delay through central nervous system injury, more unstable central nervous system development, and increased vulnerability of the nervous system. Neurodevelopmental disease is the most serious disorder of childhood, affecting the quality of life of children and their families. Therefore, the monitoring and optimization of nerve damage treatments are important. The factors contributing to neurodevelopmental disease are primarily related to preoperative, intraoperative, postoperative, genetic, and environmental causes, with intraoperative causes being the most influential. Nevertheless, few studies have examined these factors, particularly the influencing factors during early postoperative care. Children with congenital heart disease may experience brain damage during early heart intensive care due to unstable haemodynamics and total body oxygen transfer, particularly early postoperative inflammatory reactions in the brain, blood glucose levels, and other factors that potentially influence long-term neural development. This study analyses the forms of structural and functional brain damage in the early postoperative period, along with the recent evolution of research on its contributing factors.
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Affiliation(s)
- Shuoji Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China
| | - Xiyalatu Sai
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianxin Lin
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China
| | - Gang Deng
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China
| | - Mingyi Zhao
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China.
| | - M I Nasser
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China.
| | - Ping Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China.
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7
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Okada A, Okada Y, Narumiya H, Ishii W, Kitamura T, Osamura T, Iiduka R. Association of body temperature with in-hospital mortality among paediatric trauma patients: an analysis of a nationwide observational trauma database in Japan. BMJ Open 2020; 10:e033822. [PMID: 33168548 PMCID: PMC7654136 DOI: 10.1136/bmjopen-2019-033822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To examine the association between body temperature (BT) on hospital arrival and in-hospital mortality among paediatric trauma patients. DESIGN A retrospective cohort study. SETTING Japan Trauma Data Bank (JTDB, which is a nationwide, prospective, observational trauma registry with data from 235 hospitals). PARTICIPANTS Paediatric trauma patients <16 years old who were transferred directly from the scene of injury to the hospital and registered in the JTDB from January 2004 to December 2017 were included. We excluded patients >16 years old and those who developed cardiac arrest before or on hospital arrival. PRIMARY OUTCOME The association between BT on hospital arrival and in-hospital mortality. We conducted multivariate logistic regression analyses to calculate the adjusted ORs, with their 95% CIs, of the association between BT and in-hospital mortality. RESULTS A total of 9012 patients were included (median age: 9 years (IQR, 6.0-13.0 years), mortality: 2.5% (mortality number was 226 in total 9012 patients)). In the multivariate logistic regression analysis, the corresponding adjusted ORs of BT <36.0°C and BT ≥37.0°C, relative to a BT of 36°C-36.9°C, for in-hospital mortality were 2.83 (95% CI: 1.85 to 4.33) and 0.93 (95% CI: 0.53 to 1.63), respectively. CONCLUSIONS In paediatric patients with hypothermia (BT <36.0°C) on hospital arrival, a clear association with in-hospital mortality was observed; no such association was observed between higher BT values (≥37.0°C) and outcomes.
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Affiliation(s)
- Asami Okada
- Emergency and Critical Care Medicine, Kyoto Daini Sekijuji Byoin, Kyoto, Japan
| | - Yohei Okada
- Primary Care and Emergency Medicine, Kyoto University, Kyoto, Japan
| | - Hiromichi Narumiya
- Emergency and Critical Care Medicine, Kyoto Daini Sekijuji Byoin, Kyoto, Japan
| | - Wataru Ishii
- Emergency and Critical Care Medicine, Kyoto Daini Sekijuji Byoin, Kyoto, Japan
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Osaka University, Suita, Japan
| | - Toshio Osamura
- Department of Pediatrics, Kyoto Daini Sekijuji Byoin, Kyoto, Japan
| | - Ryoji Iiduka
- Emergency and Critical Care Medicine, Kyoto Daini Sekijuji Byoin, Kyoto, Japan
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8
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White matter injury and neurodevelopmental disabilities: A cross-disease (dis)connection. Prog Neurobiol 2020; 193:101845. [PMID: 32505757 DOI: 10.1016/j.pneurobio.2020.101845] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 05/19/2020] [Accepted: 06/01/2020] [Indexed: 12/13/2022]
Abstract
White matter (WM) injury, once known primarily in preterm newborns, is emerging in its non-focal (diffused), non-necrotic form as a critical component of subtle brain injuries in many early-life diseases like prematurity, intrauterine growth restriction, congenital heart defects, and hypoxic-ischemic encephalopathy. While advances in medical techniques have reduced the number of severe outcomes, the incidence of tardive impairments in complex cognitive functions or psychopathology remains high, with lifelong detrimental effects. The importance of WM in coordinating neuronal assemblies firing and neural groups synchronizing within multiple frequency bands through myelination, even mild alterations in WM structure, may interfere with the cognitive performance that increasing social and learning demands would exploit tardively during children growth. This phenomenon may contribute to explaining longitudinally the high incidence of late-appearing impairments that affect children with a history of perinatal insults. Furthermore, WM abnormalities have been highlighted in several neuropsychiatric disorders, such as autism and schizophrenia. In this review, we gather and organize evidence on how diffused WM injuries contribute to neurodevelopmental disorders through different perinatal diseases and insults. An insight into a possible common, cross-disease, mechanism, neuroimaging and monitoring, biomarkers, and neuroprotective strategies will also be presented.
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9
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Luo Q, Su Z, Jia Y, Liu Y, Wang H, Zhang L, Li Y, Wu X, Liu Q, Yan F. Risk Factors for Prolonged Mechanical Ventilation After Total Cavopulmonary Connection Surgery: 8 Years of Experience at Fuwai Hospital. J Cardiothorac Vasc Anesth 2020; 34:940-948. [DOI: 10.1053/j.jvca.2019.10.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/21/2019] [Accepted: 10/26/2019] [Indexed: 02/07/2023]
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10
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Hannon CE, Osman Z, Grant C, Chung EML, Corno AF. Part II. Comparison of Neurodevelopmental Outcomes Between Normothermic and Hypothermic Pediatric Cardiopulmonary Bypass. Front Pediatr 2019; 7:447. [PMID: 31750278 PMCID: PMC6848377 DOI: 10.3389/fped.2019.00447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/15/2019] [Indexed: 12/02/2022] Open
Abstract
Objectives: In the previous study we demonstrated that normothermic cardiopulmonary bypass (N-CPB, ≥35°C) provided better early clinical outcomes compared to mild/moderate hypothermic cardiopulmonary bypass (H-CPB, 28-34°C) for congenital heart surgery. In this follow-up study we compare early neurodevelopmental outcomes 2-3 years post-surgery. Methods: In this retrospective, non-randomized observational study, the medical notes of children from our previous cohort were reviewed after 2-3 years. Demographic and neurodevelopmental outcomes were tabulated to enable blinded statistical analysis comparing outcomes between N-CPB and H-CPB surgery for congenital heart defects. Multivariate logistic regression models were developed to identify any differences in outcomes after adjustment for confounders. Results: Ninety-five children who underwent H-CPB (n = 50) or N-CPB (n = 45) were included. The proportions of patients with one or more adverse neurodevelopmental outcomes 2-3 years later were 14/50 (28.0%) in the H-CPB group and 11/45 (24.4%) in N-CPB, which was not significantly different between groups (p = 0.47). The two CPB groups were balanced for demographic and surgical risk factors, with the exception of genetic conditions. A higher incidence of H-CPB patients acquired learning difficulties [23.1% compared to 2.56% for N-CPB (p = 0.014)] and neurological deficits [30.8% compared to 7.69% for N-CPB (p = 0.019)], but these differences were not robust to adjustment for genetic syndromes. Conclusions: Our study did not reveal any significant differences in early neurodevelopmental outcomes between H-CPB or N-CPB surgery for congenital heart defects. The most important factor in predicting outcomes was, as expected, the presence of a genetic syndrome. We found no evidence that CPB temperature affects early neurodevelopmental outcomes.
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Affiliation(s)
- Claire E Hannon
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Zachary Osman
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Cathy Grant
- Department of Paediatric Neuropsychology, Nottingham University Hospital NHS Trust, Nottingham, United Kingdom
| | - Emma M L Chung
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.,NIHR Leicester Cardiovascular Research Centre, Leicester, United Kingdom.,Department of Medical Physics, University of Leicester, Leicester, United Kingdom
| | - Antonio F Corno
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.,East Midlands Congenital Heart Centre, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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