The Need for Specialized Pediatric Cardiac Critical Care Training Program in Limited Resource Settings

Murni, Indah K; Musa, Ndidiamaka

doi:10.3389/fped.2018.00059

Cited by 19 publications

(25 citation statements)

References 29 publications

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“…The extension of use of tele-echocardiography in fetal diagnosis of cardiac malformations would allow early diagnosis for planning care and interventions already at delivery time at the specialized center. Moreover, the telemedicine network, now focused on pediatric cardiology, could be extended to other medical pathologies, also in adults just providing remote specialized medical care around the region [24][25][26][27][28][29].…”

Section: Resultsmentioning

confidence: 99%

Telemedicine Network in Pediatric Cardiology: The Case of Tuscany Region in Italy

Taddei¹,

Festa²,

Conforti³

et al. 2021

Recent Advances in Digital System Diagnosis and Management of Healthcare

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Four years ago, a telemedicine project in diagnosis and care of congenital cardiac malformations was developed in Tuscany interconnecting the Heart Hospital of Gabriele Monasterio Tuscany Foundation (FTGM) in Massa with main clinical centers around the region. Both live and store-and-forward tele-echocardiography were implemented, while the FTGM medical record system was applied for collaborative reporting. Mobile medical-grade carts, equipped with videoconferencing and computer units, were installed at main neonatology/pediatric centers throughout the Tuscany region. Today, 13 hospitals are connected to the network, while the MEYER Pediatric University Hospital (MEYER) in Firenze has recently adhered to the project, as HUB center jointly with FTGM, so enabling H24 telemedicine service in pediatric cardiology throughout the region. So far, more than 200 patients were diagnosed and followed by telemedicine.

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Section: Resultsmentioning

confidence: 99%

Telemedicine Network in Pediatric Cardiology: The Case of Tuscany Region in Italy

Taddei¹,

Festa²,

Conforti³

et al. 2021

Recent Advances in Digital System Diagnosis and Management of Healthcare

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“…Successful outcomes have been reported by teams operating in low-resource countries; however, this was true only when surgeons shied away from performing neonatal, adult congenital, and complex surgeries (7,13). Cost considerations can also push surgeons away from practice guidelines, resorting to less expensive palliative surgeries, with less stormy postoperative courses, which may cause clinical harm in the long run, and ultimately, additional financial losses (8,9,13).…”

Section: Discussionmentioning

confidence: 99%

“…Dedicated pediatric cardiac intensive care units are still scarce in emerging nations, and most of the programs, are part of an adult cardiac surgical ICU or a general pediatric ICU (7). Dedicated pediatric cardiac ICUs are not yet universally present, even in the developed world.…”

Section: Discussionmentioning

confidence: 99%

“…Most reports coming from the third world, describe the negative aspects of congenital heart surgery, with challenges unfamiliar to the developed world. The service is rarely a vital government priority; it is often just an appendage to an adult service ( 2 ), and the results and outcomes are inferior to those of developed countries ( 5 – 7 ). There are even negative comments concerning patient management, with cost considerations leading to deviation from standard practice guidelines ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

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Establishing a High-Quality Congenital Cardiac Surgery Program in a Developing Country: Lessons Learned

et al. 2020

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Background: Developing countries are profoundly affected by the burden of congenital heart disease (CHD) because of limited resources, poverty, cost, and inefficient governance. The outcome of pediatric cardiac surgery in developing countries is suboptimal, and the availability of sustainable programs is minimal. Aim: This study describes the establishment of a high quality in-situ pediatric cardiac surgery program in Lebanon, a limited resource country. Methods: We enrolled all patients operated for CHD at the Children's Heart Center at the American University of Beirut between January 2014 and December 2018. Financial information was obtained. We established a partnership between the state, private University hospital, and philanthropic organizations to support the program. Results: In 5 years, 856 consecutive patients underwent 993 surgical procedures. Neonates and infants constituted 22.5 and 22.6% of our cohort, respectively. Most patients (82.6%) underwent one cardiac procedure. Our results were similar to those of the Society of Thoracic Surgeons (STS) harvest and to the expected mortalities in RACHS-1 scores with an overall mortality of 2.8%. The government (Public) covered 43% of the hospital bill, the Philanthropic organizations covered 30%, and the Private hospital provided a 25% discount. The parents' out-of-pocket contribution included another 2%. The average cost per patient, including neonates, was $19,800. Conclusion: High standard pediatric cardiac surgery programs can be achieved in limited-resource countries, with outcome measures comparable to developed countries. We established a viable financial model through a tripartite partnership between Public, Private, and Philanthropy (3P system) to provide high caliber care to children with CHD.

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“…This issue is even more substantial when the precarious situation of medical research in Latin America is taken into account. 42 To our knowledge, few, if any, studies have been conducted to assess the epidemiological characteristics of cardiomyopathies in the Latin American paediatric population. In the past few years, great attention has been given to adult cardiomyopathies and their epidemiological characteristics.…”

Section: Discussionmentioning

confidence: 99%

Paediatric cardiomyopathies: echocardiographic diagnosis, clinical profile, and demographic characteristics: the experience of a tertiary referral centre for Latin American paediatric cardiology

et al. 2020

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Background:Although multiple studies have been conducted in the adult population, there is a vast knowledge gap regarding the epidemiologic characteristics of cardiomyopathies in the paediatric population. This issue is even more crucial when the precarious situation of medical research in Latin America is considered. Given the potential impact that these disorders could have on Latin American health systems, a comprehensive epidemiologic study regarding the clinical profile and sociodemographic characteristics of these patients will influence the way we approach paediatric cardiomyopathies.Methods:An observational retrospective study was conducted at a tertiary referral centre for Colombian and Latin American paediatric cardiology. We analysed all cases of primary cardiomyopathies in children younger than 18 years of age who presented at our institution between 2010 and 2016. Cases of cardiomyopathies were classified according to World Health Organization guidelines.Results:From a total of 29,533 children who attended our institution during the study period, 89 new cases of primary cardiomyopathies were identified. The median age at diagnosis was 11 years (interquartile range 4–9). Dilated cardiomyopathy accounted for 57.3% (n = 51) of cases; hypertrophic cardiomyopathy, 12.3% (n = 11); restrictive cardiomyopathy, 8.9% (n = 8); non-compacted cardiomyopathy, 7.8% (n = 7); arrhythmogenic ventricular cardiomyopathy, 6.7% (n = 6); and unspecified cardiomyopathy, 6.7% (n = 6). Heart failure was observed in 53.93% of the patients. The overall mortality was 12.36% (n = 11), which included two of eight patients who underwent cardiac transplantation.

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The Need for Specialized Pediatric Cardiac Critical Care Training Program in Limited Resource Settings

Cited by 19 publications

References 29 publications

Telemedicine Network in Pediatric Cardiology: The Case of Tuscany Region in Italy

Telemedicine Network in Pediatric Cardiology: The Case of Tuscany Region in Italy

Establishing a High-Quality Congenital Cardiac Surgery Program in a Developing Country: Lessons Learned

Paediatric cardiomyopathies: echocardiographic diagnosis, clinical profile, and demographic characteristics: the experience of a tertiary referral centre for Latin American paediatric cardiology

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