bims-hylehe Biomed news
on Hypoplastic left heart syndrome
Issue of 2018‒12‒30
nine papers selected by
Richard James
University of Pennsylvania

  1. Circulation. 2018 Aug 16. CIR0000000000000603
    Stout KK, Daniels CJ, Aboulhosn JA, Bozkurt B, Broberg CS, Colman JM, Crumb SR, Dearani JA, Fuller S, Gurvitz M, Khairy P, Landzberg MJ, Saidi A, Valente AM, Van Hare GF.
    Keywords:  AHA Scientific Statements; arrhythmias; cardiac catheterization; cardiac defects; congenital heart disease; congenital heart surgery; unoperated/repaired heart defect
  2. Circulation. 2018 Aug 16. CIR0000000000000604
    Zaragoza-Macias E, Zaidi AN, Dendukuri N, Marelli A.
    Keywords:  AHA Scientific Statements; Evidence Review Committee; adults; angiotensin-converting enzyme; beta blockers; congenital heart disease; congenitally corrected transposition of the great arteries; dextro-transposition of the great arteries; heart failure; meta-analysis; systemic right ventricle
  3. Clin Neuropsychol. 2018 Dec 26. 1-19
    Cassidy AR, Bernstein JH, Bellinger DC, Newburger JW, DeMaso DR.
      OBJECTIVE: To determine whether visual-spatial processing style is associated with psychopathology in a large sample of adolescents with critical congenital heart disease (CHD). Local (part-oriented) style was hypothesized to increase risk for internalizing (but not externalizing) forms of psychopathology.METHOD: Participants included 278 adolescents with critical CHD (dextro-transposition of the great arteries = 134, tetralogy of Fallot = 58, single-ventricle cardiac anatomy requiring the Fontan procedure = 86). Visual-spatial processing style was indexed using Copy Style Ratings from the Rey-Osterrieth Complex Figure-Developmental Scoring System. The Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present & Lifetime Version was used to determine presence/absence of diagnosable DSM-IV psychiatric disorder(s). Processing style and psychopathology were assessed concurrently.
    RESULTS: Thirty-three percent of the sample had a part-oriented processing style. In multivariable binary logistic regression models, part-orientation was associated with more than twice the odds of having an anxiety disorder (lifetime: OR = 2.2, p = .02, 95% CI = 1.1-4.1; current: OR = 2.7, p = .03, 95% CI = 1.1-6.5) but was not associated with an increased risk for ADHD, disruptive behavior, or mood disorders (ps > .05).
    CONCLUSIONS: Adolescents with critical CHD who approach complex visual-spatial materials in a local, part-oriented fashion are more likely to meet criteria for an anxiety disorder than those who approach complexity more holistically. Part-orientation may make it more difficult for individuals to judge the relative importance of isolated details and engage in more adaptive perspective-taking.
    Keywords:  ADHD; anxiety; cardiac; cognitive style; pediatric
  4. Circulation. 2018 Aug 16. CIR0000000000000605
    Oster M, Bhatt AB, Zaragoza-Macias E, Dendukuri N, Marelli A.
    Keywords:  AHA Scientific Statements; Evidence Review Committee; adults; atrial septal defects; congenital heart disease; intervention
  5. Am J Cardiol. 2018 Dec 04. pii: S0002-9149(18)32138-6. [Epub ahead of print]
    Chan J, Collins RT, Hall M, John A.
      We sought to analyze the trends and resource utilization of adult congenital heart disease (ACHD)-related heart failure admissions at children's hospitals. Heart failure admissions in patients with ACHD continue to rise at both pediatric and adult care facilities. Data from the Pediatric Health Information Systems database (2005 to 2015) were used to identify patients (≥18 years) admitted with congenital heart disease (745.xx-747.xx) and principal diagnosis of heart failure (428.xx). High resource use (HRU) admissions were defined as those over the 90th percentile. There were 562 admissions (55.9% male) across 39 pediatric hospitals. ACHD-related heart failure admissions increased from 4.1% in 2006 to 6.3% in 2015 (p = 0.015). Median hospital charge for ACHD-related heart failure admissions was $59,055 [IQR $26,633 to $156,846]. Total charges increased with more complex anatomic category (p = 0.049). Though HRU admissions represented 10% of ACHD-related heart failure admissions, they accounted for >66% of the total charges. The median total hospital charges for HRU admissions were $1,018,656 [IQR $722,574 to $1,784,743], compared with $58,890 [IQR $26,456 to $145,890] for non-HRU admissions (p < 0.001). Inpatient mortality rate (26.3% vs 4.0%) and the presence of ≥2 comorbidities (68% vs 31%) were higher for HRU admissions (p < 0.001). On multivariable analysis, technology dependence (aOR: 4.4, p < 0.001) and renal comorbidities (aOR: 3.0, p = 0.04) were associated with HRU. In conclusion, heart failure-related ACHD admissions in pediatric hospitals are increasing. Compared with non-HRU, HRU admissions had higher inhospital mortality and greater comorbidities. Additional care strategies to reduce resource use among these patients and improve overall quality of care merits further study.
  6. JPEN J Parenter Enteral Nutr. 2018 Dec 26.
    Tume LN, Valla FV, Floh AA, Goday P, Jotterand Chaparro C, Larsen B, Lee JH, Moreno YMF, Pathan N, Verbruggen S, Mehta NM.
      BACKGROUND: Widespread variation exists in pediatric critical care nutrition practices, largely because of the scarcity of evidence to guide best practice recommendations.OBJECTIVE: The objective of this paper was to develop a list of topics to be prioritized for nutrition research in pediatric critical care in the next 10 years.
    METHODS: A modified 3-round Delphi process was undertaken by a newly established multidisciplinary group comprising 11 international researchers in the field of pediatric critical care nutrition. Items were ranked on a 5-point Likert scale.
    RESULTS: Forty-five research topics (with a mean priority score >3(0-5) were identified within the following 10 domains: the pathophysiology and impact of malnutrition in critical illness; nutrition assessment: nutrition risk assessment and biomarkers; accurate assessment of energy requirements in all phases of critical illness; the role of protein intake; the role of pharmaco-nutrition; effective and safe delivery of enteral nutrition; enteral feeding intolerance: assessment and management; the role of parenteral nutrition; the impact of nutrition status and nutrition therapies on long-term patient outcomes; and nutrition therapies for specific populations. Ten top research topics (that received a mean score >4(0-5) were identified as the highest priority for research.
    CONCLUSIONS: This paper has identified important consensus-derived priorities for clinical research in pediatric critical care nutrition. Future studies should determine topics that are a priority for patients and parents. Research funding should target these priority areas and promote an international collaborative approach to research in this field, with a focus on improving relevant patient outcomes.
    Keywords:  child; children; enteral nutrition; intensive care; parenteral nutrition
  7. Indian Heart J. 2018 Nov - Dec;70(6):pii: S0019-4832(17)30576-X. [Epub ahead of print]70(6): 872-878
    Allam LE, Nabih MA, El-Missiry MA.
      BACKGROUND: This study assessed anxiety and depression in children with permanent pacemakers (PPM) and quality of life of their parents.METHODS: Ninety children (63.3% males and 36.6% females) and their parents were included in the study and were divided into three groups. The control group (Group 1) included 30 normal healthy children (57% males and 43% females), the PPM group (Group 2) included 30 age-matched children (70% males and 30% females) with PPM and structurally normal heart, while the Group 3 included 30 children (63% males and 37% females) with PPM and congenital heart disease (PPM+CHD). Psychological assessment of children and their parents was carried out using an interview-based questionnaires.
    RESULTS: Psychiatric disorders were more prevalent in PPM+CHD group including depression (P=0.04), anxiety (P=0.02) and lower parents' QoL (P=0.01). The PPM group had higher depression and lower parents' QoL than the control group. Family income was independent factor for depression (r2=-6.3, with P<0.05). Sex of the child and CCU admission were independent factors for anxiety (r2=-9.5, P<0.05 & r2=10.5, P=0.001) in PPM group.
    CONCLUSION: Children with pacemakers have higher psychiatric disorders and their parents have lower QoL.
    Keywords:  Anxiety; Cardiac devices; Depression; Pacemakers; Pediatrics
  8. Nurs Womens Health. 2018 Dec 24. pii: S1751-4851(18)30235-6. [Epub ahead of print]
    Pados BF.
      Advances in neonatal care have allowed for the increasing survival of critically ill infants. These infants experience significant stress related to painful procedures and physical separation from their parents. The purpose of this article is to describe the physiologic stress mechanisms that contribute to mortality and morbidity in infants in the NICU and the physiologic mechanisms by which skin-to-skin care (SSC) acts on the stress response system. Findings from current literature supporting the use of SSC and barriers and facilitators to implementation are reviewed. SSC is a safe and effective intervention to reduce stress for infants and their parents. Nurses play a key role in facilitating SSC to optimize outcomes of care in the NICU.
    Keywords:  NICU; kangaroo care; neonatal intensive care unit; pain; skin-to-skin; stress