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Krishnamurthy R, Suman G, Chan SS, Kirsch J, Iyer RS, Bolen MA, Brown RKJ, El-Sherief AH, Galizia MS, Hanneman K, Hsu JY, de Rosen VL, Rajiah PS, Renapurkar RD, Russell RR, Samyn M, Shen J, Villines TC, Wall JJ, Rigsby CK, Abbara S. ACR Appropriateness Criteria® Congenital or Acquired Heart Disease. J Am Coll Radiol 2023; 20:S351-S381. [PMID: 38040460 DOI: 10.1016/j.jacr.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 08/22/2023] [Indexed: 12/03/2023]
Abstract
Pediatric heart disease is a large and diverse field with an overall prevalence estimated at 6 to 13 per 1,000 live births. This document discusses appropriateness of advanced imaging for a broad range of variants. Diseases covered include tetralogy of Fallot, transposition of great arteries, congenital or acquired pediatric coronary artery abnormality, single ventricle, aortopathy, anomalous pulmonary venous return, aortopathy and aortic coarctation, with indications for advanced imaging spanning the entire natural history of the disease in children and adults, including initial diagnosis, treatment planning, treatment monitoring, and early detection of complications. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
| | - Garima Suman
- Research Author, Mayo Clinic, Rochester, Minnesota
| | | | - Jacobo Kirsch
- Panel Chair, Cleveland Clinic Florida, Weston, Florida
| | - Ramesh S Iyer
- Panel Chair, Seattle Children's Hospital, Seattle, Washington
| | | | - Richard K J Brown
- University of Utah, Department of Radiology and Imaging Sciences, Salt Lake City, Utah; Commission on Nuclear Medicine and Molecular Imaging
| | | | | | - Kate Hanneman
- Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Joe Y Hsu
- Kaiser Permanente, Los Angeles, California
| | | | | | | | - Raymond R Russell
- The Warren Alpert School of Medicine at Brown University, Providence, Rhode Island; American Society of Nuclear Cardiology
| | - Margaret Samyn
- Children's Hospital of Wisconsin, Milwaukee, Wisconsin; Society for Cardiovascular Magnetic Resonance
| | - Jody Shen
- Stanford University, Stanford, California
| | - Todd C Villines
- University of Virginia Health System, Charlottesville, Virginia; Society of Cardiovascular Computed Tomography
| | - Jessica J Wall
- University of Washington, Seattle, Washington; American College of Emergency Physicians
| | - Cynthia K Rigsby
- Specialty Chair, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Suhny Abbara
- Specialty Chair, University of Texas Southwestern Medical Center, Dallas, Texas
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Dauger S, Blanot S, Deho A, Beaux J, Bonnin F, Bordet F, Cremer R, Dupont S, Klusiewicz A, Lafargue A, Lemains M, Michel F, Quéré R, Blanquat LDS, Samyn M, Saulnier ML, Temper L, Merchaoui Z, Roux BGL. Organ donation by Maastricht-III pediatric patients: Recommendations of the Groupe Francophone de Réanimation et Urgences Pédiatriques (GFRUP) and Association des Anesthésistes Réanimateurs Pédiatriques d'Expression Française (ADARPEF). Part II: Specific organizational and technical considerations. Arch Pediatr 2022; 29:509-515. [PMID: 36055866 DOI: 10.1016/j.arcped.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/04/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
A panel of pediatric experts met to develop recommendations on the technical requirements specific to pediatric controlled donation after planned withdrawal of life-sustaining therapies (Maastricht category III). The panel recommends following the withdrawal of life-sustaining therapies protocol usually applied in each unit, which may or may not include immediate extubation. The organ retrieval process should be halted if death does not occur within 3 h of life-support discontinuation. Circulatory arrest is defined as loss of pulsatile arterial pressure and should be followed by a 5-min no-touch observation period. Death is declared based on a list of clinical criteria assessed by two senior physicians. The no-flow time should be no longer than 30, 45, and 90 min for the liver, kidneys, and lungs, respectively. At present, the panel does not recommend pediatric heart donation after death by circulatory arrest. The mean arterial pressure cutoff that defines the start of the functional warm ischemia (FWI) phase is 45 mmHg in patients older than 5 years and/or weighing more than 20 kg. The panel recommends normothermic regional perfusion in these patients. The FWI phase should not exceed 30 and 45 min for retrieving the pancreas and liver, respectively. There is no time limit to the FWI phase for the lungs and kidneys. The panel recommends routine sharing of experience with Maastricht-III donation among all healthcare institutions involved in order to ensure optimal outcome assessment and continuous discussion on the potential difficulties, notably those related to the management of normothermic regional perfusion in small children.
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Affiliation(s)
- S Dauger
- Service de Médecine Intensive-Réanimation Pédiatriques, Hôpital Robert-Debré, Assistance Publique-Hôpitaux de Paris, Université de Paris, France; Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Centre Hospitalier Universitaire de Lille, Université de Lille, France.
| | - S Blanot
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université de Paris, France; Service d'Anesthésie-Réanimation Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université de Paris-Cité, France
| | - A Deho
- Service de Médecine Intensive-Réanimation Pédiatriques, Hôpital Robert-Debré, Assistance Publique-Hôpitaux de Paris, Université de Paris, France; Coordination Hospitalière de Prélèvements d'Organes, Hôpital Robert-Debré, Assistance Publique-Hôpitaux de Paris, Université de Paris-Cité, France
| | - J Beaux
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Université de Marseille, France
| | - F Bonnin
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université de Paris, France
| | - F Bordet
- Service de Réanimation Médico-Chirurgicale Pédiatrique, Hôpital Femme-Mère-Enfant, Hôpitaux Civils de Lyon, Université de Lyon, France
| | - R Cremer
- Espace de réflexion éthique régional des Hauts-de-France, Centre Hospitalier Universitaire de Lille, Université de Lille, France; Service de Réanimation et Surveillance Continue Pédiatriques, Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Université de Lille, France
| | - S Dupont
- Coordination Hospitalière de Prélèvements d'Organes, Hôpital Robert-Debré, Assistance Publique-Hôpitaux de Paris, Université de Paris-Cité, France
| | - A Klusiewicz
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université de Paris-Saclay, France
| | - A Lafargue
- Service d'Anesthésie Réanimation Pédiatrique, Hôpital Jeanne de Flandres, Centre Hospitalier Régional Universitaire de Lille, Université de Lille, France
| | - M Lemains
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université de Paris-Saclay, France
| | - F Michel
- Service d'Anesthésie Réanimation Pédiatrique, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Université de Marseille, France
| | - R Quéré
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université de Paris, France
| | - L de Saint Blanquat
- Service de Réanimation Médico-Chirurgicale Pédiatrique, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université de Paris-Cité, France
| | - M Samyn
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université de Paris-Saclay, France
| | - M-L Saulnier
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Nantes, Université de Nantes, France
| | - L Temper
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Université de Lyon, France
| | - Z Merchaoui
- Coordination Hospitalière de Prélèvements d'Organes et de Tissus, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université de Paris-Saclay, France; Service de Réanimation Pédiatrique et de Médecine Néonatale, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université de Paris-Saclay, France
| | - B Gaillard-Le Roux
- Service de Réanimation Médico-Chirurgicale Pédiatrique, Hôpital Mère-Enfant, Centre Hospitalier Universitaire de Nantes, Université de Nantes, France
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Gaillard-Le Roux B, Cremer R, de Saint Blanquat L, Beaux J, Blanot S, Bonnin F, Bordet F, Deho A, Dupont S, Klusiewicz A, Lafargue A, Lemains M, Merchaoui Z, Quéré R, Samyn M, Saulnier ML, Temper L, Michel F, Dauger S. Organ donation by Maastricht-III pediatric patients: Recommendations of the Groupe Francophone de Réanimation et Urgences Pédiatriques (GFRUP) and Association des Anesthésistes Réanimateurs Pédiatriques d'Expression Française (ADARPEF) Part I: Ethical considerations and family care. Arch Pediatr 2022; 29:502-508. [DOI: 10.1016/j.arcped.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/04/2022] [Accepted: 06/18/2022] [Indexed: 11/27/2022]
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Rogers TP, Samyn M, Gudausky TM. Electrocardiographic evidence of ischemia in a young male with anomalous origin of a coronary artery from the opposite sinus. Progress in Pediatric Cardiology 2019. [DOI: 10.1016/j.ppedcard.2019.101127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Affiliation(s)
- A Dhawan
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - M Samyn
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - D Joshi
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
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Vidal E, Van Stralen KJ, Schaefer F, Adams B, Bjerre A, Dusunsel R, Emirova KM, Esteves Da Silva JE, Herthelius M, Holmberg C, Jankauskiene A, Mache CJ, Miteva P, Sanchez-Moreno A, Trivelli A, Zurowska A, Groothoff JW, Jager K, Verrina E, Basu B, Pandey R, Mondal N, Schaefer F, Melhem N, Shroff R, Samyn M, Van'T Hoff W. PAEDIATRIC NEPHROLOGY. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chaves AH, Hoffman GM, Cava J, Simpson P, Samyn M. Infant cardiac MRI using oscillatory ventilation: safe and effective. J Cardiovasc Magn Reson 2012. [PMCID: PMC3304988 DOI: 10.1186/1532-429x-14-s1-p122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Abstract
The majority of transplant centers around the world face an ethical debate whether to retransplant a young non-adherent patient. Non-adherence to lifelong immunosuppressants presents a significant risk for graft loss, yet rates remain consistently high. Despite a number of these patients presenting for retransplantation, there is little evidence to guide professionals in their decision-making. This paper aims to provide such guidance, by systematically reviewing the existing outcome data for retransplantation in patients who are known to be non-adherent to their immunosuppressants. This review searched for original papers that addressed retransplantation of a solid organ and included quantitative data on adherence or graft function. Only one original research paper was found to meet the inclusion criteria. This paper is reviewed, and details of the protocol to determine eligibility for retransplantation are summarized. The findings are discussed within the ethical context that transplant professionals work within, and the arguments for and against retransplantation are considered. The need for effective integration of adherence management into routine practice is highlighted, with an emphasis on reliable measurement of adherence throughout the patient's life. Examples of good practice are discussed, favoring prevention over cure.
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Affiliation(s)
- F Dobbels
- Center for Health Services and Nursing Research, Katholieke Universiteit Leuven, Leuven, Belgium.
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Wyatt H, Fitzpatrick E, Bartlett F, Samyn M. Change in prevalence of liver parenchyma ultrasound abnormalities in children with cystic fibrosis. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60308-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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LaDisa JF, Cava J, Dholakia R, Wendell DC, Krolikowski M, Samyn M. Computational simulations from cardiac magnetic resonance imaging reveal altered hemodynamics in coarctation patients previously treated by patch aortoplasty. J Cardiovasc Magn Reson 2009. [DOI: 10.1186/1532-429x-11-s1-p211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
OBJECTIVES The aim of this study was to investigate the clinical and radiologic features, predisposing risk factors, and complications of children with pyogenic liver abscess (PLA) referred to a tertiary pediatric hepatology center. METHODS We analyzed our database of all children referred to our unit over a 10 year period and performed a case note review of all patients with a radiologically proven PLA. RESULTS PLA was diagnosed in 15 children (7 boys), 0.5% of all referrals. They presented at a median age of 10 years (range 2 months-15 years). In three children (2 boys), PLA was the first manifestation of chronic granulomatous disease. Among the others, five had radiologic evidence of other intra-abdominal pathology (1 with subsequently proven appendicitis), and four developed portal vein thrombosis with portal hypertension. The commonest isolated pathogen was Staphylococcus aureus. Combined treatment with guided aspiration and prolonged intravenous antibiotics was successful in all patients. CONCLUSION PLA is a rare diagnosis in children in the developed world. It may be caused by primary neutrophil disorders even in the absence of a previous history of infection. Co-existent appendicitis, intra-abdominal sepsis, and ascending pylephlebitis must be sought because these children are at risk of developing portal vein obstruction and portal hypertension. Prolonged intravenous antibiotic treatment guided by microbiologic sensitivities is highly effective.
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Affiliation(s)
- M Muorah
- Department of Child Health, King's College Hospital, Denmark Hill, London SE5 9RS, United Kingdom
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Haller MJ, Samyn M, Nichols WW, Brusko T, Wasserfall C, Schwartz RF, Atkinson M, Shuster JJ, Pierce GL, Silverstein JH. Radial artery tonometry demonstrates arterial stiffness in children with type 1 diabetes. Diabetes Care 2004; 27:2911-7. [PMID: 15562206 DOI: 10.2337/diacare.27.12.2911] [Citation(s) in RCA: 126] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine if children with type 1 diabetes have increased arterial stiffness by estimating augmentation index with the simple noninvasive technique of radial artery tonometry. RESEARCH DESIGN AND METHODS We studied 98 type 1 diabetic children and 57 healthy control subjects, ages 10-18 years, matched for age, sex, race, and BMI, generating 43 matched pairs. Radial artery tonometry was performed, and blood was collected for analysis of fasting lipids, HbA1c, glucose, and cytokines in all children. RESULTS Children with diabetes had a significantly higher augmentation index corrected to a heart rate of 75 (AI75) than their matched control subjects. Mean AI75 in type 1 diabetic subjects was 1.11 +/- 10.15 versus -3.32 +/- 10.36 in control subjects. The case-control difference was 5.20 +/- 11.02 (P=0.0031). CONCLUSIONS Children with type 1 diabetes have increased arterial stiffness compared with healthy control subjects. Radial artery tonometry is a simple noninvasive technique that could be added to the armamentarium of tests used to provide cardiovascular risk stratification in children with type 1 diabetes.
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Affiliation(s)
- Michael J Haller
- Pediatric Endocrinology, P.O. Box 100296, Gainesville, FL 32610, USA.
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Samyn M, Hadzic N, Davenport M, Verma A, Karani J, Portmann B, Mieli-Vergani G. Peliosis hepatis in childhood: case report and review of the literature. J Pediatr Gastroenterol Nutr 2004; 39:431-4. [PMID: 15448437 DOI: 10.1097/00005176-200410000-00024] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- M Samyn
- Department of Child Health, King's College Hospital, Denmark Hill, London, United Kingdom.
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