Neonatal Heart Surgery: Evaluation of Risk Factors

Ithuralde, Mariano; Neirotti, Rodolfo A.

doi:10.1542/neo.12-5-e252

Cited by 5 publications

(6 citation statements)

References 29 publications

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“…The assessment of the RACHS-1 as a predictor of hospital mortality by ROC curve showed area of 0.860 95% CI 0.818 to 0.902 with P <0.0001 and statistically significant and comparable to that found in the literature [9] (Fig. 2].…”

Section: Fig 1 -Linear Regression Between Expected and Observed Mortsupporting

confidence: 82%

“…In linear regression between the RACHS-1 risk classification and hospital mortality it is clearly demonstrated that there are statistically significant correlation and that is a valid instrument for use in our country [9].…”

Section: Fig 1 -Linear Regression Between Expected and Observed Mortmentioning

confidence: 79%

“…Brazil has several developments within cardiac surgery [7], but when comparing to other countries, shows a deficit of surgery for correction of congenital heart disease estimated at around 65%, depending on the region, with the northern region (93.5%) and Northeast (77.4%) with the major deficits [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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Heart defects treatment in Sergipe: propose of resources' rationalization to improve care

Leite¹,

Mendonça²,

Cipolotti³

et al. 2012

Rev Bras Cir Cardiovasc

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Objective: This study aims evaluate the treatment of congenital heart disease conducted from 2000 to 2009.Methods: The sample consisted of all patients undergoing surgical correction for congenital heart disease for ten years in Sergipe, Brazil. The patients were operated in three hospitals located in the city of Aracaju, capital of the state of Sergipe (Brazil). The study was divided into two periods defined by the start date of centralization of surgery. The variables collected were: age, sex, postoperative diagnosis, destination, type of surgery and hospital where the procedure was performed and the classification RACHS -1.Results: In the period I, the estimate deficit of surgery was 69% decrease occurring in the period II to 55.3%. The postoperative diagnosis was more frequent closure of the interventricular communication (20.5%), closure of patent ductus arteriosus (20.2%) and atrial septal defect (19%). There was a statistically significant correlation between the expected mortality RACHS-1 and observed in the sample. The evaluation of RACHS-1 as a predictor of hospital mortality by ROC curve showed area of 0.860 95% CI 0.818 to 0.902 with P <0.0001. Conclusion:The results of this study indicate that the centralization and organization of existing resources are needed to improve the performance of surgical correction of congenital heart diseases. Descriptors 225Leite DCF, et al. -Heart defects treatment in Sergipe: propose of resources' rationalization to improve careRev Bras Cir Cardiovasc 2012;27(2):224-30

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Section: Fig 1 -Linear Regression Between Expected and Observed Mortsupporting

confidence: 82%

Section: Fig 1 -Linear Regression Between Expected and Observed Mortmentioning

confidence: 79%

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Heart defects treatment in Sergipe: propose of resources' rationalization to improve care

Leite¹,

Mendonça²,

Cipolotti³

et al. 2012

Rev Bras Cir Cardiovasc

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“…However, with this improved survival rate, an increase in morbidity due to surgical and post-surgical complications has been seen [3] .…”

Section: Introductionmentioning

confidence: 99%

In-Vitro Evaluation of Two Types of Neonatal Oxygenators in Handling Gaseous Microemboli and Maintaining Optimal Hemodynamic Stability During Cardiopulmonary Bypass

Marupudi¹,

Wang²,

Canêo³

et al. 2016

Brazilian Journal of Cardiovascular Surgery

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ObjectiveUsually only FDA-approved oxygenators are subject of studies by the international scientific community. The objective of this study is to evaluate two types of neonatal membrane oxygenators in terms of transmembrane pressure gradient, hemodynamic energy transmission and gaseous microemboli capture in simulated cardiopulmonary bypass systems.MethodsWe investigated the Braile Infant 1500 (Braile Biomédica, São José do Rio Preto, Brazil), an oxygenator commonly used in Brazilian operating rooms, and compared it to the Dideco Kids D100 (Sorin Group, Arvada, CO, USA), that is an FDA-approved and widely used model in the USA. Cardiopulmonary bypass circuits were primed with lactated Ringer's solution and packed red blood cells (Hematocrit 40%). Trials were conducted at flow rates of 500 ml/min and 700 ml/min at 35ºC and 25ºC. Real-time pressure and flow data were recorded using a custom-based data acquisition system. For gaseous microemboli testing, 5cc of air were manually injected into the venous line. Gaseous microemboli were recorded using the Emboli Detection and Classification Quantifier.ResultsBraile Infant 1500 had a lower pressure drop (P<0.01) and a higher total hemodynamic energy delivered to the pseudopatient (P<0.01). However, there was a higher raw number of gaseous microemboli seen prior to oxygenator at lower temperatures with the Braile oxygenator compared to the Kids D100 (P<0.01).ConclusionBraile Infant 1500 oxygenator had a better hemodynamic performance compared to the Dideco Kids D100 oxygenator. Braile had more gaseous microemboli detected at the pre-oxygenator site under hypothermia, but delivered a smaller percentage of air emboli to the pseudopatient than the Dideco oxygenator.

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“…Although we have had occasional articles on surgical topics (eg, "The EXIT Strategy" in 2005, [1] "Minimal Access Surgery in the Neonate" in 2006, [2] and "Neonatal Heart Surgery: Evaluation of Risk Factors" in 2011, [3] with the most recent example being the article titled "Neonatal Airway Obstruction: An Overview of Diagnosis and Treatment" in the March 2013 issue [4]), this month we focus on neonatal surgery.…”

mentioning

confidence: 99%

Commentary

Philip¹

2013

NeoReviews

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Surgery b http://neoreviews.aappublications.org/cgi/collection/neonatology_su Neonatology nfant_sub http://neoreviews.aappublications.org/cgi/collection/fetus:newborn_i Fetus/Newborn Infant following collection(s): This article, along with others on similar topics, appears in the Permissions & Licensing http://neoreviews.aappublications.org/site/misc/Permissions.xhtml in its entirety can be found online at: Information about reproducing this article in parts (figures, tables) or Reprints http://neoreviews.aappublications.org/site/misc/reprints.xhtml Information about ordering reprints can be found online: at University of Connecticut on June 24, 2015 http://neoreviews.aappublications.org/ Downloaded from

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Neonatal Heart Surgery: Evaluation of Risk Factors

Cited by 5 publications

References 29 publications

Heart defects treatment in Sergipe: propose of resources' rationalization to improve care

Heart defects treatment in Sergipe: propose of resources' rationalization to improve care

In-Vitro Evaluation of Two Types of Neonatal Oxygenators in Handling Gaseous Microemboli and Maintaining Optimal Hemodynamic Stability During Cardiopulmonary Bypass

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