Congenital heart disease in the newborn requiring early intervention

Yun, Sin Weon

doi:10.3345/kjp.2011.54.5.183

Cited by 50 publications

(39 citation statements)

References 24 publications

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“…Las guías de manejo y la literatura médica sugieren (1,3) una dosis inicial de 0.05 µg/Kg/min de PGE1 . No obstante, como ya se mencionó, existen trabajos que demuestran que dosis bajas iniciales (< 0.020 µg/ Kg/min) serían igualmente efectivas y con menor (5) frecuencia de efectos adversos .…”

Section: Discussionunclassified

“…Síndrome de corazón izquierdo hipoplásico, coartación aórtica, interrupción del arco aórtico) y en el segundo tipo las lesiones obstructivas involucran al corazón derecho (por ej. la atresia pulmonar con septo interventricular íntegro, la tetralogía de Fallot con atresia pulmonar, la atresia tricuspídea con estenosis/atresia pulmonar y la transposición de (1) grandes arterias con septo íntegro) .…”

Section: Introductionunclassified

“…Dong Chin Suh , Milagros Vargas-Peña , Patricia Pereira Dick , Norma Panizza , Hulda (1) Renée Szwako …”

Section: Uso De Prostaglandina E1 En Cardiopatías Congénitas Ductus-dmentioning

confidence: 99%

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Uso de Prostaglandina E1 en cardiopatías congénitas ductus-dependientes

Suh

Vargas-Peña

Dick

et al. 2015

Pediatr. (Asunción)

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Los autores declaran que no existen conflictos de interés en el presente estudio. RESUMEN Introducción:Objetivos: Materiales y Métodos: Resultados:Conclusiones: Palabras clave:Las cardiopatías congénitas ductusdependientes son aquellas que necesitan de la permeabilidad del mismo para mantener la circulación sistémica o pulmonar y para ello se requiere del uso de Prostaglandina E1 (PGE1).Caracterizar la eficacia y seguridad de la PGE1 en las cardiopatías ductusdependientes y sus implicancias en el manejo de la vía respiratoria. Estudio observacional retrospectivo de portadores de cardiopatías ductus-dependientes internados en terapia intensiva cardiovascular del Hospital de Clínicas, Facultad de Ciencias Médicas, Universidad Nacional de Asunción de enero 2009 a diciembre 2013 y que hayan recibido PGE1.Fueron evaluados 44 pacientes, con una edad promedio de 9 días, en su mayoría recién nacidos a término y con buen peso. Las cardiopatías más frecuentes fueron la transposición de grandes arterias, la atresia pulmonar y el síndrome de corazón izquierdo hipoplásico. La dosis inicial y de mantenimiento fue en promedio de 0.045 µ/Kg/min y la duración media de la infusión fue de 5.5 días. El 56% de los pacientes presentó efectos secundarios, principalmente apnea (38%) y fiebre. La apnea fue la indicación de asistencia respiratoria mecánica en 31% de los pacientes. La PGE1 fue eficaz en 95% de los casos. La mortalidad fue de 10%.La PGE1 es efectiva en el manejo de cardiopatías ductus-dependientes; la apnea es el efecto secundario más frecuente y es causa de requerimiento de asistencia ventilatoria mecánica, probablemente relacionada a las dosis habitualmente utilizadas. Prostaglandina E1, PGE1, efectos adversos, cardiopatías congénitas, Recién Nacido. ABSTRACTIntroduction:

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Section: Discussionunclassified

Section: Introductionunclassified

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Uso de Prostaglandina E1 en cardiopatías congénitas ductus-dependientes

Suh

Vargas-Peña

Dick

et al. 2015

Pediatr. (Asunción)

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“…The ductus arteriosus is therefore extremely important in providing adequate systemic blood flow in several congenital cardiac anomalies. 12,13 In a retrospective study by Mallender M and Sunnegardh J out of 259 term infants with CCHD, 235 had duct dependent lesion. Infants with duct dependent systemic circulation were more often missed by neonatal screening than those with duct dependent pulmonary circulation.…”

Section: Discussionmentioning

confidence: 99%

Positive predictive value of pulse oximetry in the screening of critical congenital heart defects in term neonates

Shenoy

Rao

2017

Int J Contemp Pediatr

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Background: Critical congenital heart defects (CCHD) are associated with poor patient outcome due to delay in diagnosis. Clinical examination alone has low positive predictive value (PPV). Pulse oximetry examination is suggested as supplemental screening tool. Aim of this study was to screen term neonates for CCHD by clinical and pulse oximetry evaluations and estimate their PPV separately and combined.Methods:Cross-sectional study of 278 term neonates weighing ≥2500g excluding those with antenatal diagnosis of congenital heart defects and/or requiring intensive care. Sample size calculated using EpiInfo version 7 taking 20,000 as population size, 7% expected frequency, 5% confidence limits and 99.9% confidence level. Ethical clearance and informed consent obtained. Clinical examination was performed within 24 hours of life followed by pre-ductal and post-ductal oxygen saturation (SpO2) recording, using standardized hand-held probe, between 24-48 hours. Neonates categorized as screen positive or negative based on an adapted algorithm. Screen positives were confirmed by echocardiography. SPSS version 16 was used for statistical analysis.Results: Mean age at clinical examination was 7.72 ± 0.32 hours during which none screened positive. Mean age at SpO2 screening was 31.93 ± 0.32 hours and a single non-syndromic, acyanotic male newborn, weighing 2550g screened positive. He was found to have severe pulmonary outflow obstruction, with ductus-dependent flow on echocardiography. PPV for pulse oximetry screening alone was 100%.Conclusions:Ductus dependent lesions missed on clinical examination may be picked up by pulse oximetry screening. Echocardiography may be used selectively to confirm diagnosis on screen positive.

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“…According to the data of the European Congenital Heart Diseases Committee, it is predicted that CHD requiring early intervention will develop in 0,4% of newborn babies (2). Intervention is needed in the neonatal period in 15-20% of the subjects with congential heart disease (4,5). Studies have proposed that identification of CHD in the prenatal period will facilitate performance of necessary interventions timely and under appropriate conditions and thus reduce the rate of neonatal mortality due to CHD from 2-3/1 000 to 0.6-0.8/ 1 000 (2, 3).…”

Section: Introductionmentioning

confidence: 99%

Problems of the neonates with congenital heart disease requiring early interventions: a regional report

et al. 2015

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Aim: In this study, it was aimed to determine the problems of the neonates who were diagnosed with congenital heart disease requiring early intervention in our hospital. Material and Methods:The files of the newborn babies with congenital heart disease requiring early intervention who were admitted to the neonatal intensive care unit of our hospital between January 2011 and January 2013 were evaluated retrospectively. In all cases, echocardiography and ''Score for Neonatal Acute Physiology-II" (SNAP-II) scoring were performed within the first day of admission. The data were interpreted using Number Cruncher Statistical System 2007 software. The statistical significance was set at p<0.05. Results: A total of 83 babies were included in the study. Forty six of the patients were male (55%), and 37 (45%) were female. Sixty eight percent of the patients were referred from the neighboring provinces and 32% were transferred from the centers within the city. The age range was between 0 and 28 (5.6±6.4 day) days. The SNAP-II scores upon admission ranged between 0 and 90 (mean: 20±20.3). None of the patients was diagnosed prenatally. The most common diagnoses included transposition of the great arteries (33.7%) and pulmonary atresia (19.3%). Nineteen (22%) patients were lost in the neonatal intensive care unit. There was a significant relationship between the mortality and the SNAP-II scores (p=0.0001) and use of vasopressors (p=0.004). The diagnosis, gender, use of alprostadil and age were not related to mortality. Three patients were discharged following planning of elective surgery and 60 patients were referred to a tertiary center by air ambulance. Conclusions:The results of our study indicated that prenatal diagnosis could not be made in neonates with congenital heart disease requiring intervention in our region. The mortality rates of these patients were related to the severity of the clinical status at presentation rather than to the age, gender and type of congenital heart disease. The mortality was much higher in the patients who developed circulatory failure. Most of the patients who survived were sent by air ambulance to the centers where the intervention was to be performed. (Turk Pediatri Ars 2015; 50: 158-62)

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Congenital heart disease in the newborn requiring early intervention

Cited by 50 publications

References 24 publications

Uso de Prostaglandina E1 en cardiopatías congénitas ductus-dependientes

Uso de Prostaglandina E1 en cardiopatías congénitas ductus-dependientes

Positive predictive value of pulse oximetry in the screening of critical congenital heart defects in term neonates

Problems of the neonates with congenital heart disease requiring early interventions: a regional report

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