Plasma concentrations of cefazolin in pediatric patients undergoing cardiac surgery

Lapmahapaisan, Saowaphak; Maisat, Wiriya; Tantiwongkosri, Kriangkrai; Jutasompakorn, Pinpilai; Sisan, Waraphorn

doi:10.4103/aca.aca_106_19

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…The lower face, neck, and anterior chest is prepped and draped in standard sterile fashion. Prophylactic cefazolin is administered prior to the operation and continued for 24 hours post-operation ( 9 , 10 ).…”

Section: Case Presentationmentioning

confidence: 99%

Partial upper median sternotomy for anterior aortopexy for innominate artery compression syndrome: a case series

Sainathan,

Meshulami,

Shah

et al. 2024

Transl Pediatr

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Background Innominate artery compression syndrome (IAS) is caused by an abnormally originating innominate artery compressing the trachea anteriorly. One option to relieve such compression is an anterior aortopexy (AA). We describe our technique of an AA via a partial upper median sternotomy. Case Description Nine consecutive patients underwent AA for IAS via a partial upper median sternotomy from July 2017 to November 2020 at two US teaching hospitals. The median age was 9 months [interquartile range (IQR), 3–16.5 months]. The male to female ratio was 1.25. All patients had >70% compression by flexible bronchoscopy. Two patients had previous surgeries. The median follow-up was 6 months (IQR, 4–8.5 months). The indications for the operation were: acute life-threatening events (ALTEs) (4/9 patients), recurrent intubation (4/9), and severe stridor with >70% luminal reduction (1/9). Technical success (defined as ≤20% residual stenosis) was achieved in 78% (7/9) of the patients. The two patients with unsuccessful AAs required either a tracheal resection or an innominate artery reimplantation. Both achieved full symptom resolution. Overall, 78% (7/9) of patients experienced full symptom resolution. Of the two patients without full symptom resolution, one had mild stridor at 6 months post-operation. The other patient without full resolution is awaiting further vocal cord surgery for an associated glottic pathology. Conclusions A partial upper sternotomy provides a very versatile approach to an AA for IAS. In addition to facilitating an adequate AA, a partial upper sternotomy provides options for direct tracheal surgery or an innominate artery reimplantation in case an optimal result is not obtained by an AA.

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Section: Case Presentationmentioning

confidence: 99%

Partial upper median sternotomy for anterior aortopexy for innominate artery compression syndrome: a case series

Sainathan,

Meshulami,

Shah

et al. 2024

Transl Pediatr

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“…A subset of DAMPs has been reported in the setting of trauma, sepsis, and adult cardiac surgery [16][17][18][19] . They are recognized by pattern recognition receptors (PRRs) such as TLR2 and TLR4 on innate immune cells and platelets 13 .…”

Section: Introductionmentioning

confidence: 99%

Neutrophil extracellular traps formation is associated with postoperative complications in neonates and infants undergoing congenital cardiac surgery

Maisat,

Hou,

Sandhu

et al. 2023

Preprint

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Pediatric patients with congenital heart diseases (CHD) often undergo surgical repair on cardiopulmonary bypass (CPB). Despite a significant medical and surgical improvement, the mortality of neonates and infants remains high. Damage-associated molecular patterns (DAMPs) are endogenous molecules released from injured/damaged tissues as danger signals. We examined 101 pediatric patients who underwent congenital cardiac surgery on CPB. The mortality rate was 4.0%, and the complication rate was 31.6%. We found that neonates/infants experienced multiple complications most, consistent with the previous knowledge. Neonates and infants in the complication group had received more transfusion intraoperatively than the non-complication arm with lower maximum amplitude (MA) on rewarming CPB thromboelastography (TEG). Despite TEG profiles were comparable at ICU admission between the two groups, the complication arm had higher postoperative chest tube output, requiring more blood transfusion. The complication group showed greater neutrophil extracellular traps (NETs) formation at the end of CPB and postoperatively. Plasma histones and high mobility group box 1 (HMGB1) levels were significantly higher in the complication arm. Both induced NETsin vitroandin vivo. As histones and HMGB1 target Toll-like receptor (TLR)2 and TLR4, their mRNA expression in neutrophils was upregulated in the complication arm. Taken together, NETs play a major role in postoperative complication in pediatric cardiac surgery and would be considered a target for intervention.Key pointsNeonates and infants showed highest postoperative complications with more upregulation of inflammatory transcriptomes of neutrophils.Neonates and infants with organ dysfunction had more NETs formation with higher plasma histones and HMGB1 levels.

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Perioperative Cefazolin Prophylaxis in Pediatric Cardiac Surgery: A Prospective, Cohort Study

Suna

Moloney

Marathe

et al. 2022

The Annals of Thoracic Surgery

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Plasma concentrations of cefazolin in pediatric patients undergoing cardiac surgery

Cited by 5 publications

References 17 publications

Partial upper median sternotomy for anterior aortopexy for innominate artery compression syndrome: a case series

Partial upper median sternotomy for anterior aortopexy for innominate artery compression syndrome: a case series

Neutrophil extracellular traps formation is associated with postoperative complications in neonates and infants undergoing congenital cardiac surgery

Perioperative Cefazolin Prophylaxis in Pediatric Cardiac Surgery: A Prospective, Cohort Study

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