Cardiac ICU neuromonitoring in infants with CHD leads to early arterial ischaemic stroke recognition: a single centre experience
Koerner TS, Farley M, Tien A, Baust T, Commander B, Guzman C, Cummings D, Gazit A and Lin JI
Evaluate the utility of comprehensive neuromonitoring to allow for early identification of arterial ischaemic strokes in high-risk critically ill infants with CHD.
Impact of impaired foetal maternal environment on neonates with CHD: are we ready for the mother-baby dyad?
Savla J, Schumacher K, Mikesell K, Banerjee M, Ball M, Bhat P, Bhat A, Bhatt S, Chan T, Chaudhry P, Frank DU, Killen S, Krishnan A, Mistry K, Neumayr TM, Patel A, Savorgnan F, Son S, Zakaria D, Tabbutt S and Steurer M
Emerging evidence suggests that an impaired foetal environment-defined as maternal factors such as hypertensive disorders and diabetes-might contribute to outcomes in neonates with CHD. With this multicentre study, we prospectively collected data regarding impaired foetal environment to assess the impact on mortality in two ventricle and single ventricle neonates with CHD.
Early Neurodevelopmental Outcomes in Children With Congenital Heart Disease
Seed M, Ilardi D, Rofeberg V, Ortinau C, Goldberg C, Reichle G, Bush L, Elhoff J, Lisanti AJ, Butcher J, Rollins C, Van Bergen A, Peyvandi S, Bucholz E, Cox S, Hampton L, Sanz J, Monteiro S, Tewar S, Allen K, Lee C, Glotzbach K, Alexander N, Bear L, Anton C, Sananes R, Ly L, Boucher G, Wolfe K, Edwards L, Willen E, Tan A, Ortega C, Sood E, Sadhwani A, Plant KC, Quigley L, Pliego J, Valles E, Hines A, Wypij D and Miller T
Neurodevelopmental impairments are common in children with congenital heart disease.
The Use of Inhaled Nitric Oxide After Pediatric Cardiac Surgery
Diddle JW, Patregnani J, Algaze CA, Banerjee M, Berger J, Reichle G, Louis JS, Sasaki J, Schumacher KR, Sinton J, Stigall W, Wolovits J, Zhang W and Tabbutt S
Inhaled nitric oxide (iNO) lowers pulmonary vascular resistance and improves pulmonary gas exchange. It has become a common therapy following pediatric cardiac surgery, but there are limited data on its current use or clinical impact in this population. This retrospective analysis reviewed all patients within the Pediatric Cardiac Critical Care Consortium (PC) clinical registry, representing 63 North American cardiac intensive care units (CICU), who underwent cardiac surgery from August 2014 to August 2023, to describe contemporary iNO use and its relationship to patient characteristics and outcomes. We also investigated the relationship between timing of iNO therapy for postoperative pulmonary hypertension (PH) and mortality. Of 63,582 non-neonatal patients admitted to the CICU following cardiac surgery, 12.2% received iNO, with 34.8% of those receiving it for PH. Of 17,792 neonates who underwent cardiac surgery, 26.6% received iNO, with 29.3% of those receiving it for PH. Single ventricle surgeries and heart transplant were the most common operations associated with iNO use. iNO use has increased over time, and utilization varies widely across centers, ranging from 0% to 65% of neonates, and 4% to 47% of infants. In a multivariable logistic regression model of patients who received iNO postoperatively for PH, initiation of therapy during the CICU stay, as compared to at CICU admission, was associated with increased mortality (odds ratio 1.54). Using contemporary multicenter registry data, we identify patient and operative characteristics associated with iNO use. Variations by center and by timing suggest opportunities to optimize use of the therapy.
Role of Home Monitoring in Reducing Disparities in the Interstage Mortality of Infants with Single Ventricle
El-Magharbel Y, Goldberg CS, Yu S, Valentini A, Uzark K, Romano JC, Fifer CG, Afton KM, Lowery R, Duimstra A and Balasubramanian S
To determine whether the interstage (between Norwood and stage 2 palliation) home monitoring program (IHMP) has reduced disparities in interstage survival and growth outcomes in patients with single-ventricle heart disease.
