Postoperative Inhaled Nitric Oxide Does Not Decrease Length of Stay in Pediatric Cardiac Surgery Admissions

AbstractPulmonary hypertension is one of the most challenging complications in congenital heart surgery. The purpose of this study was to characterize inhaled nitric oxide administration in children with and without pulmonary hypertension who underwent congenital heart surgery and to describe the effect of nitric oxide administration on admission outcomes. This is a cross-sectional study utilizing data from the Pediatric Health Information System (PHIS) and PHIS  + databases from 2004 to 2015. Pediatric patients with a congenital heart disease diagnosis were included and divided into groups with pulmonary hypertension that received and not received inhaled nitric oxide and patients without diagnosis of pulmonary hypertension who received and did not rec eive inhaled nitric oxide. For all admissions, the following were captured: age of admission, gender, year of admission, length of stay, billed charges, inpatient mortality, the presence of specific congenital malformations of the heart, specific cardiac surgeries, and comorbidities. Comparisons bet ween groups were completed using a Mann–Whitney-U test and Fisher ’s exact test. Outcomes evaluation was completed using univariate and regression analyses. A total of 40,194 pediatric cardiac surgical admissions without pulmonary hypertension were identified. Of these, 726 (1.8%) received inhaled nitric oxide. Regression analyses demonstrated that inhaled nitri c oxide was independently associated with in...
Source: Pediatric Cardiology - Category: Cardiology Source Type: research

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The objective of this study is to evaluate if the diagnosis of a complex congenital heart disease (CHD) was missed in a patient with Down syndrome (DS) who had a fetal echocardiogram that was read as normal. Secondary goal of this study was to determine if any CHD was missed postnatally when a fetal echocardiogram was read as normal. A retrospective chart review of children with DS at Nationwide Children ’s Hospital whose birthdates were between 1/1/2010 and 12/31/2017 was performed. Patients were included if they had a fetal echocardiogram that was read as normal and also had a postnatal echocardiogram performed. On...
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research
Pulmonary hypertension, defined as a resting mean pulmonary artery pressure greater than or equal to 25 mmHg, results from a myriad of conditions. The Fifth World Symposium on Pulmonary Hypertension proposed a classification system that organizes pulmonary hypertension into five groups based on common hemodynamic, pathophysiologic, and therapeutic parameters.1 This review focuses on pulmonary arterial hypertension (Group 1 pulmonary hypertension), a disease in which progressive pulmonary vascular obstruction, remodeling, and destruction lead to increased right ventricular afterload and hypertrophy, right heart failure, and...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
Publication date: Available online 11 September 2019Source: JACC: Heart FailureAuthor(s): Karen Sliwa, Lucia Baris, Christoph Sinning, Elvin Zengin-Sahm, Lina Gumbiene, Israa F. Yaseen, Ghada Youssef, Mark Johnson, Hasan Al-Farhan, Malgorzata Lelonek, Roger Hall, Jolien Roos-HesselinkAbstractBackgroundGlobally, congenital heart disease (CHD) is an important cause of maternal morbidity and mortality in women reaching reproductive stage. There is lack of data from larger cohorts of women with uncorrected CHD.ObjectivesTo study maternal and fetal outcome of women with uncorrected CHD.MethodsAn analysis of 10-year data from th...
Source: JACC: Heart Failure - Category: Cardiology Source Type: research
Authors: Jany B, Bals R, Dreher M, Held M, Jany L, Rembert Koczulla A, Pfeifer M, Randerath W, Watz H, Wilkens H, Steinkamp G Abstract When caring for patients with respiratory diseases, always think of the heart! This is especially important for COPD patients, but also for a variety of other disorders of the respiratory system. At the workshop "Luftschlösser", held once more at Wiesbaden, Germany in February 2019 the many and important interactions of the lungs and the heart as well as the therapeutic implications were discussed. Based on pathophysiology, the psycho-social consequences of dyspnea, t...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research
We describe a female infant with incontinentia pigmenti complicated by severe pulmonary arterial hypertension that was markedly improved by tadalafil administration. The infant was referred to our institution because of neonatal seizures and generalized skin rash at the age of 1 day. She was diagnosed with incontinentia pigmenti on skin biopsy findings. In addition to incontinentia pigmenti, she had pulmonary arterial hypertension without structural heart disease. The pulmonary hypertension rapidly worsened at the age of 2 months and was confirmed by cardiac catheterization. The pulmonary artery pressure was equal to syste...
Source: European Journal of Medical Genetics - Category: Genetics & Stem Cells Authors: Tags: Eur J Med Genet Source Type: research
Authors: Yokokawa T, Sugimoto K, Yoshihisa A, Goto T, Misaka T, Oikawa M, Kobayashi A, Yamaki T, Kunii H, Nakazato K, Ishida T, Takeishi Y Abstract Heart failure causes increased venous pressure, leading to liver dysfunction. The fibrosis-4 index is a simple index for liver fibrosis and has been reported to be useful for predicting prognosis in heart failure; however, its impact on patients with pulmonary hypertension due to left heart disease (PH-LHD) has not yet been fully elucidated.We enrolled consecutive 230 hospitalized patients who had been diagnosed as having PH-LHD. The fibrosis-4 index was calculated as f...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
We reported a 35-year-old woman with a single atrium, patent ductus arteriosus, pulmonary hypertension, and ES who developed infective endocarditis on her left ventricular outflow tract and complicated cerebral abscess and who underwent challenged medical treatment. Intervention: Infection was successfully controlled after 4-time change in antibiotics over 4 months. However, surgery is complicated for her. Outcomes: The patient presented a relatively good outcome during follow-up for>6 months. Lessons: This case report suggests that patients with complex CHD should accept surgery therapy earlier before deve...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Publication date: Available online 23 August 2019Source: Journal of Cardiology CasesAuthor(s): Vincenzo De Simone, Paola Guarise, Gabriele Zanotto, Giorgio MorandoAbstractPulmonary hypertension due to left heart disease (PH-LHD) frequently complicates heart failure with reduced ejection fraction (HFrEF). Specific therapies for PH have not offered an advantage in patients with PH-LHD. The combined angiotensin receptor blocker–neprilysin inhibitor (ARNI), sacubitril/valsartan, is a novel therapy that can increase levels of natriuretic peptides (NPs). The resulting action on natriuresis and vasodilation may play an impo...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
Abstract BACKGROUND: At the recent 6th World Symposium on Pulmonary Hypertension (PH), the definition of PH was redefined to include lower pulmonary artery pressures in the setting of an elevated pulmonary vascular resistance (PVR). However, the relevance of this change to subjects with PH due to left heart disease as well as the pre-operative assessment of heart transplant (HT) recipients is unknown. METHODS: The UNOS database was queried to identify adult recipients who underwent primary HT from 1996-2015. Recipients were subdivided into those with mPAP
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Publication date: Available online 20 August 2019Source: Anaesthesia &Intensive Care MedicineAuthor(s): Amanda Zacharzewski, Ross MacnabAbstractCardiac disease is a significant cause of maternal mortality. In the UK in the last maternal mortality report, it was the leading cause of indirect maternal deaths (2.39 deaths per 100,000 maternities). The overall rate of maternal mortality from cardiac disease has significantly increased over the last three decades, with this increase being mostly attributable to deaths from ischaemic heart disease, myocardial infarction and peripartum cardiomyopathy. Conditions such as pulmo...
Source: Anaesthesia and intensive care medicine - Category: Anesthesiology Source Type: research
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