TY - JOUR AB - Although the epidemiology of congenital heart disease (CHD) has been described, the authors believe changes in prenatal factors such as termination of pregnancy for fetal anomaly and prenatal vitamin supplementation have altered the birth prevalence of severe CHD. This population-based study reviewed the Nationwide Inpatient Sample (NIS) database and identified all cases with a severe CHD diagnosis among all live birth entries from 1999 to 2008. A time trend analysis then was performed for specific severe CHD diagnoses stratified by race, socioeconomic status, and geographic location. Overall, severe CHD prevalence was 147.4 per 100,000 live births, with a temporal decrease in prevalence from 168.9 per 100,000 in 1999 to 129.3 per 100,000 in 2008 (p = 0.03). Among the 12 severe CHD diagnoses included in our cohort, the prevalence of truncus arteriosus (p = 0.02), tetralogy of Fallot (p = 0.001), hypoplastic left heart syndrome (p = 0.001), and pulmonary atresia (p = 0.01) decreased significantly during the study period. The observed prevalence trends varied significantly by race (Caucasians), socioeconomic class (upper income quartiles), and geographic location (Northeast and West regions). The study findings showed a temporal decrease in severe CHD prevalence, which varied by race, socioeconomic status, and geographic location. The authors speculated that the observed trend might be due to increased termination of fetuses with prenatally diagnosed CHD. The impact of sociodemographic variables on the observed prevalence trend might be due to differences in access to specialized perinatal care and fetal heart programs or because of variability in termination of pregnancy. AU - Egbe, Alexander AU - Uppu, Santosh AU - Lee, Simon AU - Ho, Deborah AU - Srivastava, Shubhika DO - 10.1007/S00246-014-0921-7 IS - 7 KW - Alexander Egbe KW - Congenital / diagnosis KW - Congenital / epidemiology* KW - Databases KW - Factual KW - Female KW - Heart Defects KW - Humans KW - Infant KW - MEDLINE KW - Male KW - Multicenter Study KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Newborn KW - Population Surveillance / methods* KW - Prevalence KW - PubMed Abstract KW - Registries* KW - Retrospective Studies KW - Santosh Uppu KW - Severity of Illness Index KW - Shubhika Srivastava KW - Socioeconomic Factors KW - United States / epidemiology KW - doi:10.1007/s00246-014-0921-7 KW - pmid:24823884 PB - Pediatr Cardiol PY - 2014 SP - 1232 EP - 1238 TI - Changing prevalence of severe congenital heart disease: a population-based study T2 - Pediatric cardiology UR - https://pubmed.ncbi.nlm.nih.gov/24823884/ VL - 35 ER - TY - JOUR AB - Objective. To assess the correlation and accuracy of end-tidal PCO2 (PetCO2) sampled via nasal cannulae in pediatrie patients by comparison to the criterion standard PaCO2. and to identify sources of error during PetCO2 monitoring via nasal cannulae. Methods. PetCO2 was monitored continuously by sampling end-tidal gas through nasal cannulae that had been designed and manufactured for this purpose in spontaneously breathing children undergoing conscious or deep sedation during either cardiac catheterization (n = 43) or critical care (n = 54). When both the capnographic wave form and the PetCO2 value had been stable for at least 10 minutes, the PetCO2 value was recorded while blood was drawn from an indwelling arterial line for PaCO2 measurement. The effects of age, weight, respiratory rate, oxygen delivery system, airway obstruction, mouth breathing, and cyanotic heart disease were evaluated by linear regression analysis and calculation of absolute bias (PaCO2-PetCO2). Results. Mouth breathing, airway obstruction, oxygen delivery through the ipsilateral nasal cannula, and cyanotic heart disease adversely affected accuracy. In patients without those factors, PetCO2 correlated well with PaCO2 (R2 = 0.994), and absolute bias was 3.0 ±1.8 mmHg. Conclusions. Several factors - some controllable and all recognizable -affect the accuracy of PetCO2 monitored via nasal cannulae in pediatrie patients. When these factors are not present, PetCO2 correlates well with PaCO2 and appears to be a useful monitor of ventilatory status during conscious or deep sedation. © 1996 Kluwer Academic Publishers. AU - Friesen, Robert H. AU - Alswang, Martin DO - 10.1007/BF02078136/METRICS IS - 2 KW - Blood gases KW - Capnography. Monitoring KW - Carbon dioxide KW - Measurement techniques KW - Nasal cannulae KW - Pediatrics PB - Springer Netherlands PY - 1996 SP - 155 EP - 159 TI - End-tidal pc02 monitoring via nasal cannulae in pediatric patients: Accuracy and sources of error T2 - Journal of Clinical Monitoring UR - https://link.springer.com/article/10.1007/BF02078136 VL - 12 ER - TY - CHAP AB - To fully understand hemodynamics, one must first learn how to make proper measurements, calculate derived values, and interpret the results in relation to specific disease conditions. At the end of this chapter the readers will be able use appropriate hemodynamic study for specific clinical situations and scenarios. The cardiac performance and its determinants (preload, afterload, contractility, and heart rate) have been defined. The methods for the measurement or calculation of cardiac output and index, measurement and interpretation of intracardiac pressure tracing, vascular resistances, intraaortic balloon pump as well as hemodynamic assessment of heart failure and pulmonary hypertension have been fully described. AU - Naderi, Nasim DA - 2018/1// DO - 10.1016/B978-0-323-51149-0.00011-0 KW - cardiac performance KW - heart failure KW - hemodynamic study KW - pulmonary hypertension PB - Elsevier PY - 2018 SN - 978-0-323-51149-0 SP - 183 EP - 191 TI - Hemodynamic Study T2 - Practical Cardiology ER - TY - JOUR AB - Tokel K, Gümüş A, Ayabakan C, Varan B, Erdoğan İ. Complications of cardiac catheterization in children with congenital heart disease. Turk J Pediatr 2018; 60: 675-683. Catheterization procedures for congenital heart disease include a broad range of procedures with a large spectrum of potential adverse outcomes. We aimed to determine the incidence of various complications during pediatric cardiac catheterizations and to designate the relative risk factors for such complications. All pediatric patients undergoing cardiac catheterizations between January 2005-December 2010 were included. Data are collected prospectively by filling out computerized catheterization reports. Patient records were scanned for potential risk factors retrospectively. Groups were divided based on cardiac diagnosis; type of procedure. Adverse events were categorized into major or minor events. A total of 2662 cardiac catheterizations were performed during this period. The mean age of patients was 53.2±64.3 months. Diagnostic catheterizations were done for 1797 (67.5%) patients, and interventional procedures were done in 865 (32.5%) cases. Adverse events were observed in 688 patients (26%) during 941 procedures. Minor and major events were seen in 21.4% and 7.1% of the procedures respectively. Most frequent major complications were anesthesia related (6%), most frequent minor complications were vascular complications (45.2%). Complications were more frequent in younger patients (p=0.0001), during interventional procedures (p=0.0001). Thirteen patients died after a cardiac catheterization; they were younger and had longer procedures compared to those who survived (p=0.0001). Vascular complications were frequent among younger patients, with prolonged procedure time and vessel access (p<0.0001). Cyanotic patients had more complications (p<0.05; OR for major and minor complications: 3.5 and 2 respectively). Minor complications were 2.7 times more likely in ventricular outflow obstructions (p<0.05). The complication rates of cardiac catheterization in children are low, but not negligible. Defining risk factors will help anticipate adverse events, which will guide in preparation for rescue procedures and improvement of patient safety systems in catheterization laboratories. AU - Tokel, Kürşat AU - Gümüş, Ayten AU - Ayabakan, Canan AU - Varan, Birgül AU - Erdoğan, İlkay DO - 10.24953/TURKJPED.2018.06.008 IS - 6 KW - Ayten Gümüş KW - Kürşat Tokel KW - MEDLINE KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - PubMed Abstract KW - doi:10.24953/turkjped.2018.06.008 KW - pmid:31365204 KW - İlkay Erdoğan PB - Turk J Pediatr PY - 2018 SP - 675 EP - 683 TI - Complications of cardiac catheterization in children with congenital heart disease T2 - The Turkish journal of pediatrics UR - https://pubmed.ncbi.nlm.nih.gov/31365204/ VL - 60 ER - TY - JOUR AB - Background: This study aims to evaluate the frequency of and associated risk factors for adverse events caused by cardiac catheterization procedures in pediatric patients. Methods: Between January 2009 and January 2012, a total of 599 pediatric patients (320 males, 279 females; mean age 5.4±4.7 years; range, 1 day to 21 years) who underwent cardiac catheterization in our cardiac catheterization laboratory were retrospectively analyzed. Demographic and clinical data of the patients including the duration of the procedure, management of anesthesia, the American Society of Anesthesiologists class, and Catheterization Risk Score for Pediatrics, and procedure-related serious adverse events were recorded. Results: The incidence of procedure-related serious adverse events was 9.18%. Potential risk factors associated with serious adverse events were identified as interventional heart catheterization, high scores obtained from the Catheterization Risk Score for Pediatrics, the use of endotracheal tube in airway control, and prolonged procedural duration. Conclusion: Our study results suggest that prolonged duration of catheterization is a potential risk factor for procedure-related adverse events and the duration of the procedure needs to be included as a variable in the Catheterization Risk Score for Pediatrics scoring system for predicting procedure-related adverse events. AU - Şahin, Kübra Evren AU - Meşe, Timur DO - 10.5606/TGKDC.DERGISI.2020.19057 IS - 3 KW - Kübra Evren Şahin KW - MEDLINE KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - PMC7493605 KW - PubMed Abstract KW - Timur Meşe KW - doi:10.5606/tgkdc.dergisi.2020.19057 KW - pmid:32953209 PB - Turk Gogus Kalp Damar Cerrahisi Derg PY - 2020 SP - 467 EP - 473 TI - The effect of the duration of the procedure on the risk of complications during pediatric cardiac catheterization T2 - Turk gogus kalp damar cerrahisi dergisi UR - https://pubmed.ncbi.nlm.nih.gov/32953209/ VL - 28 ER - TY - JOUR AB - Objectives: To characterize the frequency and attributability of death among patients who died within 30 days of their cardiac catheterization (30-day mortality). Background: 30-day postprocedure mortality is commonly used as a quality outcome metric in national cardiac catheterization registries. It is unclear if this parameter is sufficiently specific to meaningfully capture mortality attributable to cardiac catheterization in patients with congenital heart disease (CHD). Methods: Multicenter cohort study with 3 participating centers. Records were retrospectively reviewed for patients who died within 30 days of catheterization (06/2007-06/2012). Attributability of death was assigned to each case. Results: A total of 14,707 cardiac catheterization procedures were performed during the study period. Death occurred within 30 days in 279/14,707 (1.9%) of cases. Among the patients who died, 53% of cases were emergent or urgent cases. The median age was 4 mos (1 day-45 years). Death was attributable to the catheterization procedure in 29/279 (10%) of cases. Death was attributable to cardiac surgery in 14%, precatheterization clinical status in 34%, postcatheterization clinical status in 22%, and noncardiac comorbidity in 19%. In 1%, death attributability could not be established. Conclusions: While valuable in adult settings, 30-day mortality is inadequate as a quality metric among patients with CHD undergoing cardiac catheterization. To derive the optimal benefit from catheterization registry data, more robust methodologies to capture procedure-related mortality are needed. AU - Backes, Carl H. AU - Bergersen, Lisa AU - Rome, Jonathan J. AU - Batlivala, Sarosh P. AU - Glatz, Andrew C. AU - Ovunc, Bugsu AU - David, Sthuthi AU - Rivera, Brian K. AU - Haque, Urbee AU - Kollins, Kevin AU - Yin, Han AU - Holzer, Ralf J. DA - 2015/1// DO - 10.1002/CCD.25683 IS - 1 KW - Adolescent KW - Adult KW - Cardiac Catheterization / adverse effects KW - Cardiac Catheterization / mortality* KW - Cardiac Catheterization / standards KW - Cardiac Surgical Procedures / adverse effects KW - Cardiac Surgical Procedures / mortality KW - Carl H Backes KW - Cause of Death KW - Child KW - Comorbidity KW - Congenital / diagnosis KW - Congenital / mortality KW - Congenital / therapy* KW - Female KW - Health Care* / standards KW - Heart Defects KW - Humans KW - Infant KW - Lisa Bergersen KW - MEDLINE KW - Male KW - Middle Aged KW - Multicenter Study KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Newborn KW - Predictive Value of Tests KW - Preschool KW - PubMed Abstract KW - Quality Indicators KW - Ralf J Holzer KW - Retrospective Studies KW - Risk Assessment KW - Risk Factors KW - Time Factors KW - Treatment Outcome KW - United States KW - Young Adult KW - doi:10.1002/ccd.25683 KW - pmid:25257572 PB - Catheter Cardiovasc Interv PY - 2015 SP - 104 EP - 110 TI - Quality metrics in cardiac catheterization for congenital heart disease: utility of 30-day mortality T2 - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions UR - https://pubmed.ncbi.nlm.nih.gov/25257572/ VL - 85 ER - TY - JOUR AB - Objective: To describe the prevalence of congenital heart disease in two hospitals of Cali in between 2011 and 2017. Method: A retrospective study of a cohort of 54,193 births was carried out in two hospitals of Cali, which included newborns from January 1, 2011 to December 31, 2017, captured through the surveillance program and monitoring of birth defects. Initially, a descriptive analysis of patients with congenital heart disease was performed, and the association of some variables with a chi-square (Χ2 ) with a p-value significance <0.05. Results: The prevalence in this cohort was 2.42 x 1,000 births. Of the 131 patients with congenital heart disease, 73 (55.73%) were male; 91 (69.47%) were born with adequate weight for gestational age and 31 (23.66%) were preterm. Of the mothers, 30.53% were between 25 and 29 years old and 42% were primigravid. Regarding CC, the most frequent was interventricular communication with 52 (32.30%) cases; 105 (80.15%) had only one congenital heart disease and 62 (47.33%) had isolated heart disease. The variables of weight for gestational age, maternal age and gestational age, showed a statistically significant association. Conclusions: Congenital cardiopathy is of great interest in public health, given their morbi-mortality and as a cause of death in children under 1 year old in Colombia. Therefore, we must continue to work on strategies that improve surveillance, as well as prenatal diagnosis, treatment and the level of complexity appropriate to each patient. AU - Ibáñez-Correa, Lina M. AU - Victoria, Salomé AU - Hurtado-Villa, Paula AU - Ibáñez-Correa, Lina M. AU - Victoria, Salomé AU - Hurtado-Villa, Paula DA - 2021/1// DO - 10.24875/RCCAR.M21000009 IS - 1 KW - Birth defects KW - Congenital heart defect KW - Low birth weight KW - Premature birth PB - Sociedad Colombiana de Cardiologia PY - 2021 SP - 53 EP - 59 TI - Prevalencia de cardiopatías congénitas en una cohorte de 54.193 nacimientos entre 2011-2017 T2 - Revista Colombiana de Cardiología UR - http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-56332021000100053&lng=en&nrm=iso&tlng=es UR - http://www.scielo.org.co/scielo.php?script=sci_abstract&pid=S0120-56332021000100053&lng=en&nrm=iso&tlng=es VL - 28 ER - TY - JOUR AB - Congenital heart disease (CHD) accounts for nearly one-third of all major congenital anomalies. CHD birth prevalence worldwide and over time is suggested to vary; however, a complete overview is missing. This systematic review included 114 papers, comprising a total study population of 24,091,867 live births with CHD identified in 164,396 individuals. Birth prevalence of total CHD and the 8 most common subtypes were pooled in 5-year time periods since 1930 and in continent and income groups since 1970 using the inverse variance method. Reported total CHD birth prevalence increased substantially over time, from 0.6 per 1,000 live births (95% confidence interval [CI]: 0.4 to 0.8) in 1930 to 1934 to 9.1 per 1,000 live births (95% CI: 9.0 to 9.2) after 1995. Over the last 15 years, stabilization occurred, corresponding to 1.35 million newborns with CHD every year. Significant geographical differences were found. Asia reported the highest CHD birth prevalence, with 9.3 per 1,000 live births (95% CI: 8.9 to 9.7), with relatively more pulmonary outflow obstructions and fewer left ventricular outflow tract obstructions. Reported total CHD birth prevalence in Europe was significantly higher than in North America (8.2 per 1,000 live births [95% CI: 8.1 to 8.3] vs. 6.9 per 1,000 live births [95% CI: 6.7 to 7.1]; p < 0.001). Access to health care is still limited in many parts of the world, as are diagnostic facilities, probably accounting for differences in reported birth prevalence between high- and low-income countries. Observed differences may also be of genetic, environmental, socioeconomical, or ethnic origin, and there needs to be further investigation to tailor the management of this global health problem. © 2011 American College of Cardiology Foundation. AU - Van Der Linde, Denise AU - Konings, Elisabeth E.M. AU - Slager, Maarten A. AU - Witsenburg, Maarten AU - Helbing, Willem A. AU - Takkenberg, Johanna J.M. AU - Roos-Hesselink, Jolien W. DA - 2011/11// DO - 10.1016/J.JACC.2011.08.025 IS - 21 KW - Confidence Intervals KW - Congenital / epidemiology* KW - Denise van der Linde KW - Elisabeth E M Konings KW - Female KW - Global Health KW - Heart Defects KW - Humans KW - Infant KW - Jolien W Roos-Hesselink KW - MEDLINE KW - Meta-Analysis KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Newborn KW - Prevalence KW - PubMed Abstract KW - Review KW - Systematic Review KW - doi:10.1016/j.jacc.2011.08.025 KW - pmid:22078432 PB - J Am Coll Cardiol PY - 2011 SP - 2241 EP - 2247 TI - Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis T2 - Journal of the American College of Cardiology UR - https://pubmed.ncbi.nlm.nih.gov/22078432/ VL - 58 ER - TY - JOUR AB - Different pharmacologic agents have been used for sedation in children undergoing invasive procedures. The authors prospectively compared the efficacy, the occurrence of adverse effects, cardiovascular parameters, oxygen saturation and induction, and recovery time in propofol with or without morphine versus midazolam/ketamine sedation for procedural sedation in children with malignancies and hematologic disorders. Fifty children received either propofol with or without morphine or ketamine/midazolam sedation for invasive procedures. Intravenous sedation consisted of 0.1 mg midazolam/kg and 1.0 mg ketamine/kg or 2 mg propofol/kg with or without 0.1 mg morphine/kg. Incremental dosages of ketamine or propofol were given, if necessary, to achieve or to maintain adequate sedation levels. Systolic and diastolic blood pressure, heart rate, oxygen saturation, time to induce sedation, recovery time, and adverse effects were recorded. All invasive procedures were successfully completed, with satisfactory sedation levels in all 25 patients in the propofol group and 23 of the 25 patients in the ketamine group. In 14 of the 25 procedures in the propofol group and 4 of the 25 procedures in the ketamine group, sedation was associated with side effects, the most common being oxygen desaturation. There was a significant increase in diastolic blood pressure after ketamine medication and a significant decrease in systolic and diastolic blood pressure and heart rate in the propofol group. Induction and recovery times in the propofol group were significantly shorter. Both regimens for procedural sedation are efficacious in achieving satisfactory sedation levels for invasive procedures. Propofol offers a quicker onset of sedation and a faster, smoother recovery but is associated with a higher rate of side effects. Considering the substantial rate of adverse effects, these procedural sedations should be performed only by physicians trained in advanced airway management and life support. Copyright © 2005 by Lippincott Williams & Wilkins. AU - Gottschling, Sven AU - Meyer, Sascha AU - Krenn, Thomas AU - Reinhard, Harald AU - Lothschuetz, Daniela AU - Nunold, Holger AU - Graf, Norbert DA - 2005/10// DO - 10.1097/01.MPH.0000179238.37647.91 IS - 9 KW - Adolescent KW - Anesthetics KW - Child KW - Clinical Trial KW - Comparative Study KW - Conscious Sedation / methods* KW - Dissociative / administration & dosage* KW - Humans KW - Hypnotics and Sedatives / administration & dosage* KW - Ketamine / administration & dosage* KW - MEDLINE KW - Medical Oncology KW - Midazolam / administration & dosage* KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Neoplasms / therapy KW - Norbert Graf KW - Pain / prevention & control KW - Pediatrics KW - Preschool KW - Propofol / administration & dosage* KW - Prospective Studies KW - PubMed Abstract KW - Sascha Meyer KW - Sven Gottschling KW - doi:10.1097/01.mph.0000179238.37647.91 KW - pmid:16189439 PB - J Pediatr Hematol Oncol PY - 2005 SP - 471 EP - 476 TI - Propofol versus midazolam/ketamine for procedural sedation in pediatric oncology T2 - Journal of pediatric hematology/oncology UR - https://pubmed.ncbi.nlm.nih.gov/16189439/ VL - 27 ER - TY - JOUR AB - We investigated the effects of propofol and propofol-ketamine on hemodynamics, sedation level, and recovery period in pediatric patients undergoing cardiac catheterization. We performed a prospective, randomized, double-blind study. The study included 60 American Society of Anesthesiologists physical status II or III (age range, 1 month-13 years) undergoing cardiac catheterization for evaluation of congenital heart disease. Propofol and ketamine were prepared in 5% glucose solution to a final concentration of 5 and 1 mg/ml, respectively; similar injectors containing 5% glucose solution only were prepared. Fentanyl (1 μg/kg) and propofol (1.5 mg/kg) were given to both groups. Then, group 1 received 0.5 ml/kg of 5% glucose and group 2 0.5 ml/kg of ketamine solution by an anesthesiologist who was unaware of the groups of patients. Local anesthesia with 1% lidocaine was administered before intervention in all patients. The noninvasively measured mean arterial pressure, heart rate, respiratory rate, and peripheral oxygen saturation were recorded at the baseline, following drug administration, at 3, 5, 10, 15, 20, and 30 minutes and then at 15-minute intervals until the end of the procedure. Additional drug and fentanyl requirements to maintain a sedation level of 4 or 5 were recorded. After the procedure, the time to a Steward recovery score of 6 and adverse effects in the first 24 hours were recorded. The number of patients with more than a 20% decrease in mean arterial pressure was 11 in group 1 and 3 in group 2 (p < 0.05). The number of patients who experienced more than a 20% decrease in heart rate was 12 in group 1 and 5 in group 2 (p = 0.054). Ten patients in group 1 and 3 patients in group 2 required additional fentanyl doses (p = 0.057). The number of additional propofol doses was lower in group 2 (p < 0.05). Propofol combined with low-dose ketamine preserves mean arterial pressure better without affecting the recovery and thus is a good option in pediatric patients undergoing cardiac catheterization. © Springer Science+Business Media, Inc. 2005. AU - Akin, A. AU - Esmaoglu, A. AU - Guler, G. AU - Demircioglu, R. AU - Narin, N. AU - Boyaci, A. DA - 2005/10// DO - 10.1007/S00246-004-0707-4 IS - 5 KW - A Akin KW - A Boyaci KW - A Esmaoglu KW - Adolescent KW - Anesthetics KW - Blood Pressure / drug effects KW - Cardiac Catheterization* KW - Child KW - Congenital / diagnosis* KW - Congenital / physiopathology KW - Dissociative / administration & dosage* KW - Dose-Response Relationship KW - Double-Blind Method KW - Drug KW - Female KW - Heart Defects KW - Heart Rate / drug effects KW - Humans KW - Infant KW - Intravenous / administration & dosage* KW - Ketamine / administration & dosage* KW - MEDLINE KW - Male KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Preschool KW - Propofol / administration & dosage* KW - Prospective Studies KW - PubMed Abstract KW - Randomized Controlled Trial KW - Respiratory Physiological Phenomena / drug effects KW - doi:10.1007/s00246-004-0707-4 KW - pmid:16132313 PB - Pediatr Cardiol PY - 2005 SP - 553 EP - 557 TI - Propofol and propofol-ketamine in pediatric patients undergoing cardiac catheterization T2 - Pediatric cardiology UR - https://pubmed.ncbi.nlm.nih.gov/16132313/ VL - 26 ER - TY - JOUR AB - Sedation/anesthesia is critical to cardiac catheterization in the pediatric/congenital heart patient. We sought to identify current sedation/anesthesia practices, the serious adverse event rate related to airway, sedation, or anesthesia, and the rate of intra-procedural conversion from procedural sedation to the use of assisted ventilation or an artificial airway. Data from 13,611 patients who underwent catheterization at eight institutions were prospectively collected from 2007 to 2010. Ninety-four (0.69 %) serious sedation/airway-related adverse events occurred; events were more likely to occur in smaller patients (<4 kg, OR 4.4, 95 % CI 2.3–8.2, p < 0.001), patients with non-cardiac comorbidities (OR 1.7, 95 % CI 1.1–26, p < 0.01), and patients with low mixed venous oxygen saturation (OR 2.3, 95 % CI 1.4–3.6, p < 0.001). Nine thousand three hundred and seventy-nine (69 %) patients were initially managed with general endotracheal anesthesia, LMA, or tracheostomy, whereas 4232 (31 %) were managed with procedural sedation without an artificial airway, of which 75 (1.77 %) patients were converted to assisted ventilation/general anesthesia. Young age (<12 months, OR 5.2, 95 % CI 2.3–11.4, p < 0.001), higher-risk procedure (category 4, OR 10.1, 95 % CI 6.5–15.6, p < 0.001), and continuous pressor/inotrope requirement (OR 11.0, 95 % CI 8.6–14.0, p < 0.001) were independently associated with conversion. Cardiac catheterization in pediatric/congenital patients was associated with a low rate of serious sedation/airway-related adverse events. Smaller patients with non-cardiac comorbidities or low mixed venous oxygen saturation may be at higher risk. Patients under 1 year of age, undergoing high-risk procedures, or requiring continuous pressor/inotrope support may be at higher risk of requiring conversion from procedural sedation to assisted ventilation/general anesthesia. AU - Lin, C. Huie AU - Desai, Sanyukta AU - Nicolas, Ramzi AU - Gauvreau, Kimberlee AU - Foerster, Susan AU - Sharma, Anshuman AU - Armsby, Laurie AU - Marshall, Audrey C. AU - Odegard, Kirsten AU - DiNardo, James AU - Vincent, Julie AU - El-Said, Howaida AU - Spaeth, James AU - Goldstein, Bryan AU - Holzer, Ralf AU - Kreutzer, Jackie AU - Balzer, David AU - Bergersen, Lisa DA - 2015/10// DO - 10.1007/S00246-015-1167-8 IS - 7 KW - Adolescent KW - Anesthesia KW - C Huie Lin KW - Cardiac Catheterization / methods* KW - Child KW - Congenital / therapy* KW - Conscious Sedation / adverse effects* KW - Extramural KW - Female KW - General / adverse effects* KW - Heart Defects KW - Humans KW - Infant KW - Lisa Bergersen KW - MEDLINE KW - Male KW - Multicenter Study KW - Multivariate Analysis KW - N.I.H. KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Newborn KW - Non-U.S. Gov't KW - Pediatrics KW - Preschool KW - Prospective Studies KW - PubMed Abstract KW - Research Support KW - Sanyukta Desai KW - Severity of Illness Index KW - doi:10.1007/s00246-015-1167-8 KW - pmid:25991570 PB - Pediatr Cardiol PY - 2015 SP - 1363 EP - 1375 TI - Sedation and Anesthesia in Pediatric and Congenital Cardiac Catheterization: A Prospective Multicenter Experience T2 - Pediatric cardiology UR - https://pubmed.ncbi.nlm.nih.gov/25991570/ VL - 36 ER - TY - JOUR AB - Hemodynamic changes during three techniques for induction of halothane anesthesia were studied in 90 healthy infants aged 5 to 26 weeks who were randomly divided into three groups of 30 patients each. In group I, anesthesia was induced using halothane in concentrations that were increased to 3%. In group II, atropine, 0.02 mg/kg, was given intramuscularly before induction, followed by induction as in group I. In group III, halothane in concentrations that were increased to 1.25% was followed by intramuscular succinylcholine, 2 mg/kg, 90 seconds after the start of induction. In all three groups N2O 32 L/min and O2 2 L/min were employed using a non-rebreathing system. Heart rate (HR) and blood pressure (BP) were recorded at 1-minuted intervals for 20 minutes. HR decreased 30% in group I, 18% in group II (p<0.01), and 29% in group III. BP decreased 50% in group I (p<0.01), 34% in group II, and 33% in group III. During halothane induction in infants, bradycardia can be minimized with preoperative atropine; the degree of hypotension can be diminished with either preoperative atropine or the use of intramuscular succinylcholine combined with lower concentrations of halothane. AU - Friesen, R. H. AU - Lichtor, J. L. DO - 10.1097/00132586-198212000-00036 IS - 1 KW - Anesthesia KW - Atropine KW - Blood Pressure / drug effects KW - Chemical KW - Clinical Trial KW - Depression KW - Halothane / adverse effects* KW - Heart Rate / drug effects KW - Hemodynamics / drug effects* KW - Humans KW - Infant KW - Inhalation / methods* KW - J L Lichtor KW - MEDLINE KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Nitrous Oxide KW - Oxygen KW - Preanesthetic Medication KW - PubMed Abstract KW - R H Friesen KW - Randomized Controlled Trial KW - Succinylcholine KW - pmid:7198413 PB - Anesth Analg PY - 1982 SP - 42 EP - 45 TI - Cardiovascular depression during halothane anesthesia in infants: study of three induction techniques T2 - Anesthesia and analgesia UR - https://pubmed.ncbi.nlm.nih.gov/7198413/ VL - 61 ER - TY - JOUR AB - Fourteen children with congenital heart disease and associated pulmonary hypertension (preoperative mean pulmonary artery pressure (MPAP) 48 mm Hg ±1 SEM were examined to determine the effect of arterial carbon dioxide tension (Paco2) and pH on pulmonary and systemic hemodynamics after surgical repair. Baseline measurements were obtained with hyperventilation to Paco2 20 to 30 mm Hg (pH 7.56±0.01 mm Hg). The addition of carbon dioxide to inspired gas to achieve a Paco2 40 to 45 mm Hg (pH 7.35±0.01) resulted in a significant increase in MPAP, from 32±5 mm Hg to 47±8 mm Hg (p<0.05). An increase in mean cardiac index (CI) from 2.7±0.3 L/min/m2 to 3.3±0.3 L/min/m2 (p<0.05) explained in part the associated increase in MPAP. For a subgroup of eight patients with postoperative MPAP>30 mm Hg (at pH 7.35 to 7.40), pulmonary vascular resistance index (PVRI) also significantly increased (p<0.05) as Paco2 was increased, implying a direct pulmonary vasodilating effect of alkalosis. Removal of carbon dioxide from inspired gas returned hemodynamic values to baseline. The higher the MPAP at physiologic pH the greater the absolute amount of MPAP reduction and PVRI reduction (p<0.05) with alkalosis. No complications from alkalosis were seen. We suggest that a trial of hypocarbic alkalosis in the child with severe residual pulmonary hypertension after surgical repair of congenital heart disease is warranted to reduce right ventricular afterload. © 1988 The C.V. Mosby Company. AU - Morray, Jeffrey P. AU - Lynn, Anne M. AU - Mansfield, Peter B. DO - 10.1016/S0022-3476(88)80631-0 IS - 3 KW - A M Lynn KW - Adolescent KW - Alkalosis KW - Carbon Dioxide / blood* KW - Child KW - Congenital / blood KW - Congenital / complications KW - Congenital / physiopathology* KW - Congenital / surgery KW - Female KW - Heart Defects KW - Hemodynamics* KW - Humans KW - Hydrogen-Ion Concentration KW - Hypertension KW - Infant KW - J P Morray KW - MEDLINE KW - Male KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - P B Mansfield KW - P.H.S. KW - Postoperative Period KW - Preschool KW - PubMed Abstract KW - Pulmonary / blood KW - Pulmonary / congenital KW - Pulmonary / physiopathology* KW - Pulmonary / surgery KW - Pulmonary Circulation* KW - Pulmonary Gas Exchange KW - Research Support KW - Respiratory / physiopathology KW - U.S. Gov't KW - doi:10.1016/s0022-3476(88)80631-0 KW - pmid:3137318 PB - J Pediatr PY - 1988 SP - 474 EP - 479 TI - Effect of pH and PCO2 on pulmonary and systemic hemodynamics after surgery in children with congenital heart disease and pulmonary hypertension T2 - The Journal of pediatrics UR - https://pubmed.ncbi.nlm.nih.gov/3137318/ VL - 113 ER - TY - JOUR AB - BACKGROUND: Pulmonary arterial hypertension (PAH) can lead to significant cardiac dysfunction and is considered to be associated with an increased risk of perioperative cardiovascular complications. METHODS: We reviewed the medical records of children with PAH who underwent anesthesia or sedation for noncardiac surgical procedures or cardiac catheterizations from 1999 to 2004. The incidence, type, and associated factors of complications occurring intraoperatively through 48 h postoperatively were examined. RESULTS: Two hundred fifty-six procedures were performed in 156 patients (median age 4.0 yr). PAH etiology was 56% idiopathic (primary), 21% congenital heart disease, 14% chronic lung disease, 4% chronic airway obstruction, and 4% chronic liver disease. Baseline pulmonary artery pressure was subsystemic in 68% patients, systemic in 19%, and suprasystemic in 13%. The anesthetic techniques were 22% sedation, 58% general inhaled, 20% general IV. Minor complications occurred in eight patients (5.1% of patients, 3.1% of procedures). Major complications, including cardiac arrest and pulmonary hypertensive crisis, occurred in seven patients during cardiac catheterization procedures (4.5% of patients, 5.0% of cardiac catheterization procedures, 2.7% of all procedures). There were two deaths associated with pulmonary hypertensive crisis (1.3% of patients, 0.8% of procedures). Baseline suprasystemic PAH was a significant predictor of major complications by multivariate logistic regression analysis (OR = 8.1, P = 0.02). Complications were not significantly associated with age, etiology of PAH, type of anesthetic, or airway management. CONCLUSION: Children with suprasystemic PAH have a significant risk of major perioperative complications, including cardiac arrest and pulmonary hypertensive crisis. © 2007 by International Anesthesia Research Society. AU - Carmosino, Mario J. AU - Friesen, Robert H. AU - Doran, Aimee AU - Ivy, Dunbar D. DA - 2007/3// DO - 10.1213/01.ANE.0000255732.16057.1C IS - 3 KW - Adolescent KW - Adult KW - Anesthesia / adverse effects KW - Cardiac Catheterization / methods* KW - Child KW - Cohort Studies KW - Dunbar D Ivy KW - Extramural KW - Female KW - Heart Arrest / chemically induced KW - Humans KW - Hypertension KW - Infant KW - MEDLINE KW - Male KW - Mario J Carmosino KW - N.I.H. KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Newborn KW - PMC1934984 KW - Perioperative Care KW - Preschool KW - PubMed Abstract KW - Pulmonary / complications* KW - Pulmonary / surgery KW - Pulmonary Artery / pathology KW - Research Support KW - Retrospective Studies KW - Robert H Friesen KW - doi:10.1213/01.ane.0000255732.16057.1c KW - pmid:17312201 PB - Anesth Analg PY - 2007 SP - 521 EP - 527 TI - Perioperative complications in children with pulmonary hypertension undergoing noncardiac surgery or cardiac catheterization T2 - Anesthesia and analgesia UR - https://pubmed.ncbi.nlm.nih.gov/17312201/ VL - 104 ER - TY - JOUR AB - To examine whether CPB influences pulmonary vascular sensitivity to CO2, we compared the effect of slight induced hypocarbia and hypercarbia on pulmonary circulation before and after CPB in ten mechanically ventilated patients undergoing CABG. Hypocarbia was produced by increasing tidal volume slightly and hypercarbia was then induced by adding CO2 to the inspired gas mixture. In another ten patients, hypercarbia was produced after CPB by decreasing ventilator rate and the cardiopulmonary responses to hypercarbia, produced by the two methods of CO2 elevation, were compared. Slight respiratory acidosis induced by CO2 inhalation did not change PVR before CPB but effected a 50 percent increase after CPB. Hypercarbia induced by alveolar hypoventilation after CPB increased PVR by 40 percent. During the increased CO2 production after hypothermic CPB, pulmonary vasoconstriction would be expected to occur and impair right ventricular performance. Therefore, tight control of PaCO2 with appropriate adjustment of ventilatory support is mandatory. AU - Viitanen, A. AU - Salmenpera, M. AU - Heinonen, J. AU - Hynynen, M. DO - 10.1378/CHEST.95.4.773 IS - 4 KW - A Viitanen KW - Carbon Dioxide / physiology* KW - Cardiopulmonary Bypass* KW - Comparative Study KW - Coronary Artery Bypass KW - Humans KW - M Hynynen KW - M Salmenperä KW - MEDLINE KW - Middle Aged KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Non-U.S. Gov't KW - PubMed Abstract KW - Pulmonary Artery / physiology* KW - Pulmonary Circulation* KW - Pulmonary Veins / physiology* KW - Research Support KW - Vascular Resistance KW - doi:10.1378/chest.95.4.773 KW - pmid:2494021 PB - Chest PY - 1989 SP - 773 EP - 778 TI - Pulmonary vascular resistance before and after cardiopulmonary bypass. The effect of PaCO2 T2 - Chest UR - https://pubmed.ncbi.nlm.nih.gov/2494021/ VL - 95 ER - TY - JOUR AB - No specific regimen has been universally accepted as ideal for sedation during cardiac catheterization in infants and children. We evaluated a combination of ketamine and dexmedetomidine for sedation during cardiac catheterization in children with congenital heart disease. The study design included a retrospective analysis of data sheets and hospital records. The protocol for sedation was standardized and data collected prospectively for an ongoing quality assurance project. Heart rate, blood pressure, and oxygen saturation were recorded every 1 minute for the first 5 minutes and then at 5-minute intervals. The efficacy of sedation was judged by the need for supplemental ketamine doses. The study cohort included 16 infants and children undergoing either diagnostic or therapeutic cardiac catheterization. Sedation was initiated with a bolus dose of ketamine (2 mg/kg) and dexmedetomidine (1 μg/kg) administered over 3 minutes followed by a continuous infusion of dexmedetomidine (2 μg/kg per hour for the initial 30 minutes followed by 1 μg/kg per hour for the duration of the case). Supplemental analgesia/sedation was provided by ketamine (1 mg/kg) as needed. The baseline heart rate was 103 ± 21 beats/minute. After the bolus dose of ketamine and dexmedetomidine, the heart rate increased by 7 ± 5 beats/minute. The greatest increase was 15 beats/minute. The low heart rate after the bolus dose of ketamine/dexmedetomidine or during the subsequent dexmedetomidine infusion was 91 ± 20 beats/minute (P < 0.001 compared with baseline) and the high heart rate was 110 ± 25 beats/minute (P < 0.01 compared with baseline). In two patients, the dexmedetomidine infusion was decreased from 2 to 1 μg/kg per hour at 12 to 15 minutes instead of 30 minutes as a result of a decreased heart rate. No clinically significant changes in blood pressure or respiratory rate were noted. Two patients developed upper airway obstruction, which responded to repositioning of the airway. No apnea was noted. During the procedure, the PaCO2 varied from 37.5 to 48 mm Hg and was ≥45 mm Hg in seven patients. No patient responded to local infiltration of the groin and placement of the arterial and venous cannulae. Three patients required a supplemental dose of ketamine (1 mg/kg) during the procedure. In two of these patients, this was required before changing the cannulae. Our preliminary data suggest that a combination of ketamine and dexmedetomidine provides effective sedation for cardiac catheterization in infants and children without significant effects on cardiovascular or ventilatory function. © 2008 Lippincott Williams & Wilkins, Inc. AU - Mester, Robert AU - Easley, R. Blaine AU - Brady, Kenneth M. AU - Chilson, Kelly AU - Tobias, Joseph D. DA - 2008/1// DO - 10.1097/MJT.0B013E3180A72255 IS - 1 KW - Adolescent KW - Anesthetics KW - Blood Gas Analysis KW - Blood Pressure / drug effects KW - Cardiac Catheterization / methods* KW - Child KW - Combination KW - Dexmedetomidine / adverse effects KW - Dexmedetomidine / therapeutic use* KW - Dissociative / adverse effects KW - Dissociative / therapeutic use* KW - Drug Therapy KW - Female KW - Heart Rate / drug effects KW - Humans KW - Hypnotics and Sedatives / adverse effects KW - Hypnotics and Sedatives / therapeutic use* KW - Infant KW - Joseph D Tobias KW - Ketamine / adverse effects KW - Ketamine / therapeutic use* KW - MEDLINE KW - Male KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Preschool KW - PubMed Abstract KW - R Blaine Easley KW - Respiration / drug effects KW - Retrospective Studies KW - Robert Mester KW - doi:10.1097/MJT.0b013e3180a72255 KW - pmid:18223350 PB - Am J Ther PY - 2008 SP - 24 EP - 30 TI - Monitored anesthesia care with a combination of ketamine and dexmedetomidine during cardiac catheterization T2 - American journal of therapeutics UR - https://pubmed.ncbi.nlm.nih.gov/18223350/ VL - 15 ER - TY - JOUR AU - Kleinbaum, D. G., Kupper, L. L., Morgenstern, H. PB - Wiley PY - 1982 SN - 978-0-471-28985-2 SP - 529 EP - 529 TI - Epidemiologic research: principles and methods UR - https://www.wiley.com/en-no/Epidemiologic+Research%3A+Principles+and+Quantitative+Methods-p-9780471289852 ER - TY - JOUR AB - Background: Children undergoing cardiac catheterization usually need general anesthesia or deep sedation. Objective: This study was performed to compare the effects of propofol/dexmedetomidine and propofol/ketamine combinations on recovery time and hemodynamic parameters in pediatric patients undergoing transcatheter atrial septal defect (ASD) closure. Methods: This was a prospective randomized study. Pediatric patients with ASD were randomly assigned into 2 groups to receive propofol/dexmedetomidine or propofol/ketamine. The dexmedetomidine group received an infusion over 10 minutes of dexmedetomidine 1 μg/kg and propofol 2.0 to 2.5 mg/kg bolus for induction, then an infusion of dexmedetomidine 0.5 μg/kg/h and propofol 4 to 6 mg/kg/h for maintenance. In the ketamine group, patients received the same dose of propofol and ketamine 1 mg/kg for induction and 0.5 mg/kg/h by infusion for maintenance. The procedure was performed using both fluoroscopy and transesophageal echocardiography. Hemodynamic data, respiratory rate, and oxygen saturation were recorded before and after induction, 1 and 5 minutes after intubation, every 10 minutes thereafter during the procedure, and after extubation by researchers blinded to the study drugs. Recovery time, the primary outcome, was evaluated by a modified Steward score; a score of ≥6 means that the patient is awake or responds to verbal stimuli, has purposeful motor activity, and coughs on command. The time to reach a modified Steward score of ≥6 was recorded. The secondary outcome was the effects on the hemodynamic variables. Creatine kinase musclebrain subunit, myoglobin, cardiac troponin I, and brain natriuretic peptide were the biochemical variables measured. Patients were monitored for respiratory (changes in oxygen status) and hemodynamic adverse effects (heart rate changes, blood pressure changes) until the second hour in the intensive care unit after the operation was concluded. Results: Nine patients each were randomly assigned to propofol/dexmedetomidine and propofol/ketamine. The demographic and clinical parameters were not significantly different between groups. In the dexmedetomidine group, 5 of the patients were male, mean (SD) age was 12.5 (10.4) years, and mean weight was 40.8 (27.8) kg. In the ketamine group, 3 patients were male, mean age was 10.1 (4.5) years, and mean weight was 30.0 (15.2) kg. The recovery time was significantly longer in the ketamine group than in the dexmedetomidine group (10.5 [3.4] vs 5.7 [0.8] minutes; P = 0.01). Systolic and diastolic blood pressure values were not significantly different between groups in any study period. Heart rate values were significantly higher in the ketamine group at 5 minutes after intubation (106.6 vs 84.2 beats/min), 10 minutes (111.8 vs 87.4 beats/min) and 30 minutes (110.0 vs 89.6 beats/min) perioperatively, and after extubation (126.8 vs 92.2 beats/min) (all, P < 0.05). In the dexmedetomidine group, one patient experienced shivering and one reported nausea; in the ketamine group, one patient reported nausea. Neither respiratory depression nor severe hypotension (ie, >20% change over baseline or requiring intervention) was observed in any patient. One patient developed agitation in the ketamine group. Conclusions: In this small study, both dexmedetomidine and ketamine in combination with propofol were well tolerated in these pediatric patients who required ASD closure. The recovery period was significantly shorter in the dexmedetomidine group. © 2010 Excerpta Medica Inc. AU - Koruk, Senem AU - Mizrak, Ayse AU - Kaya Ugur, Berna AU - Ilhan, Osman AU - Baspinar, Osman AU - Oner, Unsal DA - 2010/4// DO - 10.1016/j.clinthera.2010.04.010 IS - 4 KW - Atrial septal defect KW - Dexmedetomidine KW - Ketamine KW - Propofol KW - Transcatheter closure PY - 2010 SP - 701 EP - 709 TI - Propofol/dexmedetomidine and propofol/ketamine combinations for anesthesia in pediatric patients undergoing transcatheter atrial septal defect closure: A prospective randomized study T2 - Clinical Therapeutics VL - 32 ER - TY - JOUR AB - Background: The ideal anaesthetic technique for management of paediatric patients scheduled to undergo cardiac catheterisation is still not standardised. Aim: To compare the effects of ketamine-propofol and ketamine-dexmedetomidine combinations on hemodynamic parameters and recovery time in paediatric patients undergoing minor procedures and cardiac catheterisation under sedation for various congenital heart diseases. Material and Methods: 60 children of either sex undergoing cardiac catheterisation were randomly assigned into two groups Dexmedetomidine-ketamine group (DK) and Propofol-ketamine (PK) of 30 patients each. All patients were premedicated with glycopyrrolate and midazolam (0.05mg/kg) intravenously 5-10 min before anaesthetic induction. Group 'DK'received dexmedetomidineiv infusion 1 μg/kg over 10 min + ketamine1mg/kg bolus, followed by iv infusion of dexmedetomidine 0.5μg/kg/hr and of ketamine1 mg/kg/hr. Group 'PK' received propofol 1mg/kg and ketamine 1mg/kg/hr for induction followed by iv infusion of propofol 100 μg/kg/hr and ketamine 1 mg/kg/hr for maintenance. Haemodynamic parameters and recovery time was recorded postoperatively. Statistical Analysis: Independent sample t test was used to compare the statistical significance of continuous variables of both the groups.Chi square test was used for numerical data like gender.Fischer exact test was applied for non parametric data like ketamine consumption. Results: We observed that heart rate in dexmedetomidine (DK) group was significantly lower during the initial 25 mins after induction compared to the propofol (PK) group. Recovery was prolonged in the DK group compared to the PK group (40.88 vs. 22.28 min). Even ketamine boluses consumption was higher in DK group. Conclusion: Use of dexmedetomidine-ketamine combination is a safe alternative, without any hemodynamic orrespiratory effects during the cardiac catheterization procedure but with some delayed recovery. AU - Joshi, Vidya Sagar AU - Kollu, Sandeep S. AU - Sharma, Ram Murti DA - 2017/10// DO - 10.4103/ACA.ACA_16_17 IS - 4 KW - Anesthesia Recovery Period KW - Anesthetics KW - Blood Pressure / drug effects KW - Cardiac Catheterization / methods* KW - Cardiac Surgical Procedures / methods* KW - Child KW - Comparative Study KW - Congenital / surgery KW - Conscious Sedation / methods* KW - Dexmedetomidine* KW - Dissociative* KW - Female KW - Heart Defects KW - Heart Rate / drug effects KW - Hemodynamics KW - Humans KW - Hypnotics and Sedatives* KW - Infant KW - Ketamine* KW - MEDLINE KW - Male KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - PMC5661311 KW - Preschool KW - Propofol* KW - Prospective Studies KW - PubMed Abstract KW - Ram Murti Sharma KW - Randomized Controlled Trial KW - Sandeep S Kollu KW - Vidya Sagar Joshi KW - doi:10.4103/aca.ACA_16_17 KW - pmid:28994677 PB - Ann Card Anaesth PY - 2017 SP - 422 EP - 426 TI - Comparison of dexmedetomidine and ketamine versus propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterization laboratory T2 - Annals of cardiac anaesthesia UR - https://pubmed.ncbi.nlm.nih.gov/28994677/ VL - 20 ER - TY - JOUR AB - Advances in technology over the last couple of decades have caused a shift in pediatric cardiac catheterization from a primary focus on diagnostics to innovative therapeutic interventions. These improvements allow patients a wider range of nonsurgical options for treatment of congenital heart disease. However, these therapeutic modalities can entail higher risk in an already complex patient population, compounded by the added challenges inherent to the environment of the cardiac catheterization suite. Anesthesiologists caring for children with congenital heart disease must understand not only the pathophysiology of the disease but also the effects the anesthetics and interventions have on the patient in order to provide a safe perioperative course. It is the aim of this article to review the latest catheterization modalities offered to patients with congenital heart disease, describe the unique challenges presented in the cardiac catheterization suite, list the most common complications encountered during catheterization and finally, to review the literature regarding different anesthetic drugs used in the catheterization lab. AU - Lam, Jennifer E. AU - Lin, Erica P. AU - Alexy, Ryan AU - Aronson, Lori A. DA - 2015/2// DO - 10.1111/PAN.12551 IS - 2 KW - Anesthesia / methods* KW - Cardiac Catheterization / methods* KW - Child KW - Congenital / therapy* KW - Erica P Lin KW - Heart Defects KW - Humans KW - Jennifer E Lam KW - Lori A Aronson KW - MEDLINE KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Pediatrics / methods* KW - PubMed Abstract KW - Review KW - doi:10.1111/pan.12551 KW - pmid:25331288 PB - Paediatr Anaesth PY - 2015 SP - 127 EP - 134 TI - Anesthesia and the pediatric cardiac catheterization suite: a review T2 - Paediatric anaesthesia UR - https://pubmed.ncbi.nlm.nih.gov/25331288/ VL - 25 ER - TY - JOUR AB - © 2016 Bentham Science Publishers. Although the utility of diagnostic cardiac catheterization in the clinical setting has diminished over the last years, due to the emergence of noninvasive imaging modalities, such as echocardiography, magnetic resonance imaging and computed tomography, catheterization for diagnostic reasons still constitutes a valuable tool in certain parts in the workup of pediatric heart disease. As a result, awareness of the main aspects of diagnostic catheterization is of great importance for the clinical cardiologist. In this article, the main variables measured and the main actions performed during diagnostic cardiac catheterization in children are discussed. AU - Moustafa, Giannis A. AU - Kolokythas, Argyrios AU - Charitakis, Konstantinos AU - Avgerinos, Dimitrios V. DA - 2016/3// DO - 10.2174/1573403X12666160301120955 IS - 2 KW - Cardiac KW - catheterization KW - children KW - diagnostic KW - heart KW - pediatric PB - Bentham Science Publishers PY - 2016 SP - 155 EP - 155 TI - Diagnostic Cardiac Catheterization in the Pediatric Population T2 - Current Cardiology Reviews UR - /pmc/articles/PMC4861944/ UR - /pmc/articles/PMC4861944/?report=abstract UR - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4861944/ VL - 12 ER - TY - JOUR AU - Nasr, Vivian G. AU - Twite, Mark D. AU - Walker, Scott G. AU - Kussman, Barry D. AU - Motta, Pablo AU - Mittnacht, Alexander J.C. AU - Mossad, Emad B. DA - 2018/8// DO - 10.1053/J.JVCA.2018.03.027 IS - 4 KW - cardiac catheterization KW - cerebral oximetry KW - congenital heart disease KW - pediatric KW - pediatric cardiac anesthesia KW - ventricular assist device PB - W.B. Saunders PY - 2018 SP - 1546 EP - 1555 TI - Selected 2017 Highlights in Congenital Cardiac Anesthesia T2 - Journal of Cardiothoracic and Vascular Anesthesia VL - 32 ER - TY - JOUR AB - Congenital heart disease (CHD) is the most commonly diagnosed congenital disorder in newborns. The incidence and mortality of CHD vary worldwide. A detailed understanding of the global, regional, and national distribution of CHD is critical for CHD prevention.We collected the incidence and mortality data of CHD from the Global Burden of Disease study 2017 database. Average annual percentage change was applied to quantify the temporal trends of CHD incidence and mortality at the global, regional, and national level, 1990-2017. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility.The incidence of CHD was relatively high in developing countries located in Africa and Asia, while low in most developed countries. Between 1990 and 2017, the CHD incidence rate remained stable at the global level, whereas increased in certain developed countries, such as Germany and France. The age-standardized mortality rate of CHD declined substantially over the last 3 decades, regardless of sex, age, and SDI region. The decline was more prominent in developed countries. We also detected a significant positive correlation between CHD incidence and CHD mortality in both 1990 and 2017, by SDI.The incidence of CHD remained stable over the last 3 decades, suggesting little improvement in CHD prevention strategies and highlighting the importance of etiological studies. The mortality of CHD decreased worldwide, albeit the greatly geographical heterogeneity. Developing countries located in Africa and Asia deserve more attention and priority in the global CHD prevention program. AU - Wu, Weiliang AU - He, Jinxian AU - Shao, Xiaobo DO - 10.1097/MD.0000000000020593 IS - 23 KW - Adolescent KW - Adult KW - Aged KW - Child KW - Congenital / classification KW - Congenital / mortality* KW - Female KW - Global Health / statistics & numerical data* KW - Heart Defects KW - Humans KW - Incidence KW - Infant KW - Jinxian He KW - MEDLINE KW - Male KW - Middle Aged KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Newborn KW - Observational Study KW - PMC7306355 KW - Preschool KW - PubMed Abstract KW - Weiliang Wu KW - Xiaobo Shao KW - Young Adult KW - doi:10.1097/MD.0000000000020593 KW - pmid:32502030 PB - Medicine (Baltimore) PY - 2020 TI - Incidence and mortality trend of congenital heart disease at the global, regional, and national level, 1990-2017 T2 - Medicine UR - https://pubmed.ncbi.nlm.nih.gov/32502030/ VL - 99 ER - TY - JOUR AB - Background: Congenital heart disease (CHD) is the leading cause of morbidity and mortality from birth defects worldwide. We report an overview of trends in CHD mortality in 204 countries and territories over the past 30 years and associations with age, period, and birth cohort. Methods: Cause-specific CHD mortality estimates were derived from the Global Burden of Disease 2019 study. We utilised an age-period-cohort model to estimate overall annual percentage changes in mortality (net drifts), annual percentage changes from 0 to 4 to 65–69 years (local drifts), period and cohort relative risks (period/cohort effects) between 1990 and 2019. This approach allows for the examination and differentiation of age, period, and cohort effects in the mortality trends, with the potential to identify disparities and treatment gaps in cardiac care. Findings: CHD is the leading cause of deaths from non-communicable diseases (NCDs) in those under 20 years. Global CHD deaths in 2019 were 217,000 (95% uncertainty interval 177,000–262,000). There were 129 countries with at least 50 deaths. India, China, Pakistan, and Nigeria had the highest mortality, accounting for 39.7% of deaths globally. Between 1990 and 2019, the net drift of CHD mortality ranged from –2.41% per year (95% confidence interval [CI] –2.55, –2.67) in high Socio-demographic Index (SDI) countries to –0.62% per year (95% CI: –0.82, –0.42) in low-SDI countries. Globally, there was an emerging transition in the age distribution of deaths from paediatric to adult populations, except for an increasing trend of mortality in those aged 10–34 years in Mexico and Pakistan. During the past 30 years, favourable mortality reductions were generally found in most high-SDI countries like South Korea (net drift = –4.0% [95% CI –4.8 to –3.1] per year) and the United States (–2.3% [–2.5 to –2.0]), and also in many middle-SDI countries like Brazil (–2.7% [–3.1 to 2.4]) and South Africa (–2.5% [–3.2 to –1.8]). However, 52 of 129 countries had either increasing trends (net drifts ≥0.0%) or stagnated reductions (≥–0.5%) in mortality. The relative risk of mortality generally showed improving trends over time and in successively younger birth cohorts amongst high- and high-middle-SDI countries, with the exceptions of Saudi Arabia and Kazakhstan. 14 middle-SDI countries such as Ecuador and Mexico, and 16 low-middle-SDI countries including India and 20 low-SDI countries including Pakistan, had unfavourable or worsening risks for recent periods and birth cohorts. Interpretation: CHD mortality is a useful and accessible indicator of trends in the provision of congenital cardiac care both in early childhood and across later life. Improvements in the treatment of CHD should reduce the risk for successively younger cohorts and shift the risk for all age groups over time. Although there were gains in CHD mortality globally over the past three decades, unfavourable period and cohort effects were found in many countries, raising questions about adequacy of their health care for CHD patients across all age groups. These failings carry significant implications for the likelihood of achieving the Sustainable Development Goal targets for under-5 years and NCD mortality. Funding: Supported by the National Natural Science Foundation of China (81525002, 31971048, 82073573 to ZZ and HZ), Shanghai Outstanding Medical Academic Leader program (2019LJ22 to HZ), and Collaborative Innovation Program of Shanghai Municipal Health Commission (2020CXJQ01 to HZ), the Bill & Melinda Gates Foundation for the Global Burden of Disease Project (to NJK) and NHMRC fellowship administered through the University of Melbourne (to GCP). AU - Su, Zhanhao AU - Zou, Zhiyong AU - Hay, Simon I. AU - Liu, Yiwei AU - Li, Shoujun AU - Chen, Huiwen AU - Naghavi, Mohsen AU - Zimmerman, Meghan S. AU - Martin, Gerard R. AU - Wilner, Lauren B. AU - Sable, Craig A. AU - Murray, Christopher J.L. AU - Kassebaum, Nicholas J. AU - Patton, George C. AU - Zhang, Hao DA - 2022/1// DO - 10.1016/J.ECLINM.2021.101249 KW - age-period-cohort KW - congenital heart disease KW - health disparities KW - mortality PB - Elsevier PY - 2022 SP - 101249 EP - 101249 TI - Global, regional, and national time trends in mortality for congenital heart disease, 1990–2019: An age-period-cohort analysis for the Global Burden of Disease 2019 study T2 - eClinicalMedicine VL - 43 ER - TY - JOUR AB - Sedation for pediatric cardiac catheterization is a common requirement in many institutions. As the field of cardiac catheterization has evolved, the provision of sedation for these procedures has been varied. Increasingly the demand is for dedicated personnel focused on monitoring and delivery of sedation while in the catheterization suite. This article describes the considerations one must use when undertaking these cases. © P.A. Bernard et al. AU - Bernard, Philip A. AU - Ballard, Hubert AU - Schneider, Douglas DA - 2011/6// DO - 10.4081/PR.2011.E23 IS - 3 KW - Congenital heart disease KW - Dexmedetomidine KW - Etomidate KW - Ketamine KW - Midazolam KW - Pediatric cardiac catheterization KW - Propofol KW - Sedation PB - Multidisciplinary Digital Publishing Institute (MDPI) PY - 2011 SP - 93 EP - 96 TI - Current approaches to pediatric heart catheterizations T2 - Pediatric Reports UR - /pmc/articles/PMC3207311/ UR - /pmc/articles/PMC3207311/?report=abstract UR - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3207311/ VL - 3 ER - TY - JOUR AB - Background: This prospective observational study compared endtidal carbon dioxide (PECO2) with blood gas carbon dioxide (PaCO 2) values in children sedated by nonanesthesiologists for cardiac catheterization. Methods: A nasal cannula designed to obtain gas sampling simultaneously from over the mouth and nares was taped into place after assuring a good waveform. Patients' cardiac lesions, site of blood gas sampling and PECO2 were recorded. Results: Two hundred and one blood/PECO2 pairs were measured in 59 patients from 4 days to 18 years of age. Linear regression, Pearson correlation, and Bland-Altman analysis revealed a reasonable relationship (r = 0.493, P < 0.01, bivariate Pearson correlation) for all blood/expired CO2 pairs even when the blood sample was obtained from an area of the circulation with shunting. There was no significant difference in the accuracy of the blood/PECO 2 pairs between infants who weighed ≤15 kg compared with children who weighed >15 kg. Thirteen children were diagnosed with partial or complete airway obstruction. Conclusions: Endtidal CO2 measurement provides a reasonable reflection of blood CO2 values if the expired gas-sampling catheter is taped in place after assuring a good waveform. The veracity of the data was the same throughout the patient size range. Expired CO2 monitoring is useful for assessing the adequacy of respirations and the patency of the airway in children 3-89 kg. © 2007 The Authors. AU - Coté, Charles J. AU - Wax, David F. AU - Jennings, Melissa A. AU - Gorski, Carla L. AU - Kurczak-Klippstein, Kimberly DA - 2007/7// DO - 10.1111/J.1460-9592.2007.02193.X IS - 7 KW - Adolescent KW - Airway Obstruction / metabolism KW - Blood Gas Analysis KW - Carbon Dioxide / analysis* KW - Carbon Dioxide / blood KW - Cardiac Catheterization* KW - Charles J Coté KW - Child KW - Congenital / blood* KW - Conscious Sedation* KW - David F Wax KW - Female KW - Heart Defects KW - Humans KW - Infant KW - Intraoperative KW - Kimberly Kurczak-Klippstein KW - Linear Models KW - MEDLINE KW - Male KW - Monitoring KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Preschool KW - PubMed Abstract KW - doi:10.1111/j.1460-9592.2007.02193.x KW - pmid:17564648 PB - Paediatr Anaesth PY - 2007 SP - 661 EP - 666 TI - Endtidal carbon dioxide monitoring in children with congenital heart disease during sedation for cardiac catheterization by nonanesthesiologists T2 - Paediatric anaesthesia UR - https://pubmed.ncbi.nlm.nih.gov/17564648/ VL - 17 ER - TY - JOUR AB - The purpose of this observational study was to determine whether hypercarbia or oxygen desaturation occurred during our current regimens of deep sedation or general anaesthesia of infants and children undergoing cardiac catheterization. Data were gathered prospectively from 50 consecutive infants and children aged 4 months to 12 years undergoing cardiac catheterization. Several anaesthetists used the following regimens, which were not randomized: 1) propofol. 1.5-2.0 mg·kg-1 and fentanyl 1 μg·kg-1 IV over 2 min for induction, followed by propofol infusion of 100-150 μg·kg-1·min-1; 2) fentanyl 2-3 μg·kg-1 and midazolam 0.1-0.2 mg·kg-1 IV over 10-15 min; 3) ketamine 8 mg·kg-1 IM, or 4) same as regimens 1 or 2, plus pancuronium, intubation and controlled ventilation. Regimens 1, 2, and 3 were associated with spontaneous ventilation through the natural airway. End-tidal carbon dioxide tension (Petco2), Spo2, and respiratory rate were monitored for 60 min. The three regimens employing spontaneous ventilation through the natural airway were associated with both statistically and clinically significant increases in Petco2 and decreases in Spo2. This raises the possibility that acute exacerbation of PAP and PVR may occur in pulmonary hypertensive patients. In contrast, Petco2 and Spo2 did not change significantly from baseline in the controlled ventilation group. AU - Friesen, Robert H. AU - Alswang, Martin DO - 10.1111/J.1460-9592.1996.TB00346.X IS - 1 KW - Anesthesia KW - Anesthetics KW - Artificial KW - Blood Pressure KW - Carbon Dioxide / blood* KW - Cardiac Catheterization* KW - Child KW - Dissociative / administration & dosage KW - Fentanyl / administration & dosage KW - Humans KW - Hypertension KW - Hypnotics and Sedatives / administration & dosage* KW - Infant KW - Intratracheal KW - Intravenous / administration & dosage* KW - Intravenous* KW - Intubation KW - Ketamine / administration & dosage KW - M Alswang KW - MEDLINE KW - Midazolam / administration & dosage KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Neuromuscular Nondepolarizing Agents / administration & dosage KW - Oxygen / blood* KW - Pancuronium / administration & dosage KW - Preschool KW - Propofol / administration & dosage KW - Prospective Studies KW - PubMed Abstract KW - Pulmonary / blood KW - Pulmonary / physiopathology KW - Pulmonary Artery KW - R H Friesen KW - Respiration KW - Tidal Volume KW - Vascular Resistance KW - doi:10.1111/j.1460-9592.1996.tb00346.x KW - pmid:8839083 PB - Paediatr Anaesth PY - 1996 SP - 15 EP - 20 TI - Changes in carbon dioxide tension and oxygen saturation during deep sedation for paediatric cardiac catheterization T2 - Paediatric anaesthesia UR - https://pubmed.ncbi.nlm.nih.gov/8839083/ VL - 6 ER - TY - JOUR AB - Hypercarbia during the postoperative period following repair of congenital heart defects in children has been associated with acute pulmonary hypertension. Because decreases in respiratory rate (RR) and digital pulse oximetry (SPO2) have been observed after preanesthetic medication of similar children, it is possible that hypercarbia and pulmonary hypertension may be unappreciated risks in premedicated children during the preoperative period. As the first step in addressing this question, changes in transcutaneous and end-tidal PCO2 (PtcCO2 and PetCO2) were examined after preanesthetic medication of children prior to cardiac surgery. Forty-four children were randomly assigned to receive either intramuscular morphine, 0.2 mg/kg, and scopolamine, 0.01 mg/kg, or oral midazolam, 0.75 mg/kg, 1 hour before anesthetic induction. PtcCO2, PetCO2, SPO2, RR, and sedation score were monitored. Significant sedation occurred after both premedication regimens. Following morphine/scopolamine, PtcCO2 increased from 36 ± 4 (mean ± SD) to 43 ± 6 mmHg (P < 0.01), PetCO2 increased from 35 ± 3 to 40 ± 5 mmHg (P < 0.01), SPO2 decreased from 93 ± 2 to 91 ± 4% (P < 0.01), and RR decreased from 30 ± 10 to 24 ± 7 breaths/minute (P < 0.01). After midazolam, PtcCO2 increased from 35 ± 4 to 40 ± 6 mmHg (P < 0.01), PetCO2 increased from 34 ± 5 to 39 ± 3 mmHg (P < 0.01), SPO2 decreased from 93 ± 6 to 90 ± 7% (), and RR decreased from 33 ± 13 to 30 ± 13 breaths/minute (P < 0.01). Clinically significant increases in PtcCO2 (>45 mmHg) occurred in nine patients, including five with pulmonary hypertension. Clinically significant decreases in SPO2 (<90% in acyanotic patients; decrease of >5 absolute % in cyanotic patients) occurred in eight patients, including six with pulmonary hypertension. Although the data were obtained by noninvasive techniques, they suggest that hypercarbia following premedication may pose a risk to children with congenital heart disease and pulmonary hypertension. © 1994. AU - Alswang, Martin AU - Friesen, Robert H. AU - Bangert, Patricia DO - 10.1016/1053-0770(94)90280-1 IS - 4 KW - Blood Gas Monitoring KW - Blood Pressure / drug effects KW - Carbon Dioxide / blood* KW - Carbon Dioxide / metabolism KW - Child KW - Clinical Trial KW - Congenital / blood* KW - Congenital / physiopathology KW - Conscious Sedation KW - Cyanosis / blood KW - Cyanosis / physiopathology KW - Heart Defects KW - Heart Rate / drug effects KW - Humans KW - Hypertension KW - Infant KW - M Alswang KW - MEDLINE KW - Midazolam / administration & dosage KW - Midazolam / pharmacology KW - Morphine / administration & dosage KW - Morphine / pharmacology KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Oximetry KW - Oxygen / blood* KW - P Bangert KW - Preanesthetic Medication* KW - Preschool KW - PubMed Abstract KW - Pulmonary / blood KW - Pulmonary / physiopathology KW - R H Friesen KW - Randomized Controlled Trial KW - Respiration / drug effects KW - Scopolamine / administration & dosage KW - Scopolamine / pharmacology KW - Tidal Volume KW - Transcutaneous KW - doi:10.1016/1053-0770(94)90280-1 KW - pmid:7948797 PB - J Cardiothorac Vasc Anesth PY - 1994 SP - 415 EP - 419 TI - Effect of preanesthetic medication on carbon dioxide tension in children with congenital heart disease T2 - Journal of cardiothoracic and vascular anesthesia UR - https://pubmed.ncbi.nlm.nih.gov/7948797/ VL - 8 ER - TY - JOUR AB - BACKGROUND:: Cardiac catheterization for patients with congenital heart disease has shifted from diagnostic to predominantly interventional procedures because of advances in catheter-based technologies. Children undergoing therapeutic catheterization may be at higher risk of adverse events, and the purpose of our study was to determine the incidence of cardiac arrest (CA) in patients with congenital heart disease undergoing cardiac catheterization at a large pediatric tertiary referral center. METHODS:: All CAs from January 2004 through December 2009 occurring in the cardiac catheterization laboratory were reviewed. A CA was defined as an event in which cessation of circulation required chest compressions. Procedure, patient, practitioner, and system-related factors were examined. RESULTS:: Over the study period, during 7289 catheterization procedures, 70 procedures were associated with a CA (0.96 [99% confidence interval, 0.7-1.3] per 100 procedures); 48 events (69%) were successfully resuscitated to a perfusing rhythm, 18 events (26%) resulted in need for extracorporeal membrane oxygenation, and 4 events (6%) resulted in unsuccessful resuscitation. Sudden onset of cardiac arrhythmia led to CA during 38 events (54%). The duration of resuscitation after CA was ≤11 minutes in 71%. Occurrence of CA was associated with interventional procedures (P < 0.001) and younger age (P < 0.001). A change in systems for scheduling and communication of cases was associated with a significant reduction in the incidence of CA (1.5% vs 0.7%; P = 0.002). CONCLUSIONS:: The incidence of CA in children undergoing cardiac catheterization is high compared with pediatric noncardiac surgery. Procedural and system factors were associated with occurrence of CA in this cohort. These issues highlight the need for close communication, anticipation, and preparation. © 2013 International Anesthesia Research Society. AU - Odegard, Kirsten C. AU - Bergersen, Lisa AU - Thiagarajan, Ravi AU - Clark, Laura AU - Shukla, Avinash AU - Wypij, David AU - Laussen, Peter C. DA - 2014/1// DO - 10.1213/ANE.0B013E3182908BCB IS - 1 KW - Adolescent KW - Cardiac Catheterization / adverse effects* KW - Child KW - Cohort Studies KW - Congenital / diagnosis* KW - Congenital / epidemiology* KW - Congenital / therapy KW - Databases KW - Factual KW - Female KW - Heart Arrest / diagnosis* KW - Heart Arrest / epidemiology* KW - Heart Defects KW - Humans KW - Infant KW - Kirsten C Odegard KW - Lisa Bergersen KW - MEDLINE KW - Male KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Newborn KW - Peter C Laussen KW - Preschool KW - PubMed Abstract KW - Treatment Outcome KW - doi:10.1213/ANE.0b013e3182908bcb KW - pmid:23749445 PB - Anesth Analg PY - 2014 SP - 175 EP - 182 TI - The frequency of cardiac arrests in patients with congenital heart disease undergoing cardiac catheterization T2 - Anesthesia and analgesia UR - https://pubmed.ncbi.nlm.nih.gov/23749445/ VL - 118 ER - TY - JOUR AB - Current practice of sedation and anesthesia for patients undergoing pediatric and congenital cardiac catheterization laboratory (PCCCL) procedures is known to vary among institutions, a multi-society expert panel with representatives from the Congenital Heart Disease Council of the Society for Cardiovascular Angiography and Interventions, the Society for Pediatric Anesthesia and the Congenital Cardiac Anesthesia Society was convened to evaluate the types of sedation and personnel necessary for procedures performed in the PCCCL. The goal of this panel was to provide practitioners and institutions performing these procedures with guidance consistent with national standards and to provide clinicians and institutions with consensus-based recommendations and the supporting references to encourage their application in quality improvement programs. Recommendations can neither encompass all clinical circumstances nor replace the judgment of individual clinicians in the management of each patient. The science of medicine is rooted in evidence, and the art of medicine is based on the application of this evidence to the individual patient. This expert consensus statement has adhered to these principles for optimal management of patients requiring sedation and anesthesia. What follows are recommendations for patient monitoring in the PCCCL regardless of whether minimal or no sedation is being used or general anesthesia is being provided by an anesthesiologist. AU - Odegard, Kirsten C. AU - Vincent, Robert AU - Baijal, Rahul G. AU - Daves, Suanne M. AU - Gray, Robert G. AU - Javois, Alexander J. AU - Love, Barry A. AU - Moore, Philip AU - Nykanen, David AU - Riegger, Lori Q. AU - Walker, Scott G. AU - Wilson, Elizabeth C. DA - 2016/11// DO - 10.1213/ANE.0000000000001608 IS - 5 KW - Anesthesia KW - Anesthesiology / methods KW - Anesthesiology / standards KW - Cardiac Catheterization / standards* KW - Child KW - Congenital / diagnosis KW - Congenital / therapy* KW - Conscious Sedation / methods KW - Conscious Sedation / standards* KW - Consensus KW - Elizabeth C Wilson KW - General / methods KW - General / standards* KW - Heart Defects KW - Humans KW - Kirsten C Odegard KW - MEDLINE KW - Medical / standards* KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Practice Guidelines as Topic / standards* KW - PubMed Abstract KW - Review KW - Robert Vincent KW - Societies KW - doi:10.1213/ANE.0000000000001608 KW - pmid:27749349 PB - Anesth Analg PY - 2016 SP - 1201 EP - 1209 TI - SCAI/CCAS/SPA Expert Consensus Statement for Anesthesia and Sedation Practice: Recommendations for Patients Undergoing Diagnostic and Therapeutic Procedures in the Pediatric and Congenital Cardiac Catheterization Laboratory T2 - Anesthesia and analgesia UR - https://pubmed.ncbi.nlm.nih.gov/27749349/ VL - 123 ER - TY - RPRT AB - Anaesthesia for children with complex cardiac disease in the remote environment of a cath lab can be challenging. Ketamine is a key drug for patients with impaired cardiac function. Recurrent chest infections are common in children with cardiac disease, especially in those with excess pulmonary blood flow. Respiratory infections should be treated before proceeding with elective cases. Fasting should be kept to a minimum and dehydration avoided. It is very easy for the child to get cold. Maintain normothermia with active warming. AU - Mohammed, Hussein Talib AU - Cohen, Marc AU - Walker, Isabeau AU - Bradley, Anthony DA - 2017/7// PY - 2017 TI - Anaesthesia for children in the cardiac catheterisation laboratory : WFSA - Resources UR - https://resources.wfsahq.org/atotw/anaesthesia-for-children-in-the-cardiac-catheterisation-laboratory/ ER - TY - JOUR AB - Purpose of review The focus of cardiac catheterization has changed from principally a diagnostic procedure to providing therapeutic options at various stages of childhood and adult congenital heart disease. The paediatric cardiac catheterization laboratory functions as a 'satellite' operating room. Combined ('hybrid') procedures with interventional cardiologists and cardiac surgeons present additional challenges for anaesthesia. The increased patient and procedure complexity represents higher risk for anaesthesia-related adverse events. Recent findings This review concentrates on the recent efforts to determine these patient and procedure-related risks. Multicentre registries have been developed, generating information regarding adverse events and patient outcomes. Standardized adverse events ratios allow comparisons between institutions and providers. Models to identify high-risk groups have been developed. Summary Advances in paediatric cardiac catheterization have created significant challenges for delivering anaesthesia in this environment. Anaesthetists need to have an integral role in the cardiac catheterization team, understanding and anticipating the risks for patients and leading the organization of workflow. Techniques used to improve systems in the operating room have been introduced to the cardiac catheterization laboratory to promote patient safety. AU - Taylor, Katherine L. AU - Laussen, Peter C. DA - 2015/8// DO - 10.1097/ACO.0000000000000206 IS - 4 KW - Ambulatory Surgical Procedures* KW - Cardiac Catheterization* KW - Child KW - Humans KW - Katherine L Taylor KW - MEDLINE KW - NCBI KW - NIH KW - NLM KW - National Center for Biotechnology Information KW - National Institutes of Health KW - National Library of Medicine KW - Pediatrics* KW - Peter C Laussen KW - PubMed Abstract KW - Review KW - doi:10.1097/ACO.0000000000000206 KW - pmid:26087272 PB - Curr Opin Anaesthesiol PY - 2015 SP - 453 EP - 457 TI - Anaesthesia outside of the operating room: the paediatric cardiac catheterization laboratory T2 - Current opinion in anaesthesiology UR - https://pubmed.ncbi.nlm.nih.gov/26087272/ VL - 28 ER -