A5089257846- Anesthesia and Sedative Agents
- Anesthesia and Neurotoxicity Research
- Cardiac, Anesthesia and Surgical Outcomes
- Congenital Heart Disease Studies
- Intensive Care Unit Cognitive Disorders
- Cardiac Structural Anomalies and Repair
- Mechanical Circulatory Support Devices
- Cardiac Arrhythmias and Treatments
- Cardiac Arrest and Resuscitation
- Coronary Artery Anomalies
- Congenital Diaphragmatic Hernia Studies
- Tracheal and airway disorders
- Respiratory Support and Mechanisms
- Cardiovascular Syncope and Autonomic Disorders
- Ultrasound in Clinical Applications
- Cardiovascular Function and Risk Factors
- Aortic Disease and Treatment Approaches
- Congenital heart defects research
- Cardiac pacing and defibrillation studies
- Cardiac electrophysiology and arrhythmias
- Magnesium in Health and Disease
- Transplantation: Methods and Outcomes
- Pneumothorax, Barotrauma, Emphysema
- Phonocardiography and Auscultation Techniques
- Cardiac Valve Diseases and Treatments
Miller Children's & Women's Hospital
2009-2020
Nemours Children's Clinic
2018-2020
University of Cyprus
2020
University of Thessaly
2015
Children's Hospital of Pittsburgh
2005-2013
Boston Children's Hospital
2012-2013
University of Pittsburgh
2009-2013
University of Pittsburgh Medical Center
2006-2012
ProMedica Toledo Hospital
2011
Magee-Womens Hospital
2011
Objective: In this report, we describe our experience with the use of dexmedetomidine in spontaneously breathing as well mechanically ventilated patients, after congenital cardiac and thoracic surgery. Design: Retrospective case series. Setting: University hospital, pediatric intensive care unit. Patients: Thirty-three five patients who received cardiothoracic Interventions: None. Measurements Main Results: Thirty-eight age 8 ± 1.1 yrs old weight 29 3.8 kg, were included. Seven (18%) <1 yr...
ObjectiveTo investigate the safety, efficacy, and pharmacokinetic profile of dexmedetomidine in preterm full-term neonates ≥28 to ≤44 weeks gestational age.Study designForty-two intubated, mechanically ventilated patients (n = 42) were grouped by age into group I 18), <36 weeks, II 24), ≥36 weeks. Within each group, there 3 escalating dose levels, including a loading (LD, μg/kg) followed maintenance (MD, μg·kg−1·h−1) for 6-24 hours: level 1, 0.05 LD/MD; 2, 0.1 3, 0.2 LD/MD. The primary...
Atrial and junctional tachyarrhythmias occur frequently during the perioperative period for congenital cardiac surgery can be a cause of increased morbidity mortality. These rhythm disturbances that may well tolerated in normal heart significant hemodynamic instability patients with defects, particularly postcardiopulmonary bypass period. Management these arrhythmias presents more challenge, since currently available antiarrhythmic drugs ineffective poorly tolerated. In this study, we...
Objective: To assess clinical response of dexmedetomidine alone or in combination with conventional sedatives/analgesics after cardiac surgery. Design: Retrospective study. Setting: Pediatric intensive care unit. Patients: Infants and neonates Measurements Main Results: We identified 80 patients including 14 neonates, at mean age weight 4.1 ± 3.1 months 5.5 2 kg, respectively, who received for 25 13 hours an average dose 0.66 0.26 μg·kg−1·hr−1. Overall normal sleep to moderate sedation was...
Objective: In this report, we describe the use of dexmedetomidine as primary sedative agent while performing invasive procedures in infants and toddlers with congenital heart disease who are breathing spontaneously. Design: Retrospective case review. Setting: University Hospital, pediatric cardiac intensive care unit. Patients: Six spontaneously children, five one toddler, all disease, received undergoing an procedure. Interventions: None. Measurements Main Results: patients age 3 days–29...
Objectives. Abnormal diaphragmatic motion secondary to phrenic nerve injury is not uncommon after pediatric cardiothoracic surgery. Fluoroscopy the most frequent method of diagnosis but it carries risks associated with transportation critically ill children and exposure ionizing radiation. Ultrasonography, a reliable diagnostic in adults, eliminates both concerns. Since cardiac intensivists are trained echocardiography, we tested hypothesis that chest ultrasound performed by intensivist...
In Brief BACKGROUND: Dexmedetomidine is a highly selective α2-adrenoceptor agonist with sedative, anxiolytic, and analgesic properties that has minimal effects on respiratory drive. Its sedative hypotensive are mediated via central α2A imidazoline type 1 receptors while activation of peripheral α2B-adrenoceptors result in an increase arterial blood pressure systemic vascular resistance. this randomized, prospective, clinical study, we attempted to quantify the short-term hemodynamic...
The current drug of choice for reentrant supraventricular tachycardia (SVT) is adenosine followed by verapamil or diltiazem. Although limitations and significant adverse events have been encountered over the years, an alternative effective safe agent has not available. Dexmedetomidine recently shown to potential antiarrhythmic effects, here we describe our experience in acute termination SVT.Retrospective case series.Quaternary University Children's Hospital, Cardiac Intensive Care...
To characterize the effects of dexmedetomidine on pulmonary artery pressure in patients after congenital cardiac surgery.Prospective observational pilot study.Pediatric intensive care unit at a university hospital.Twenty-two who received cardiothoracic surgery.None.An echocardiogram was performed three time points: 1) baseline (T0); 2) 6 mins loading (T1); and 3) 1 hr initiation infusion (T2). Transthoracic echocardiography used to estimate based tricuspid regurgitant velocity (4 x...
To characterize the neurodevelopmental outcomes and identify factors associated with poor in pediatric patients undergoing cardiac extracorporeal membrane oxygenation (ECMO).Five year retrospective review, including demographics, lesion, surgical complexity, reason for ECMO, ECMO complications, status at discharge latest follow-up. Neurodevelopmental was determined through Pediatric Overall Performance Category Cerebral Scales.Overall survival 73% hospital 66% a t Most underwent...
Objective. Infants with critical congenital heart disease (CHD) can have genetic and other extracardiac malformations, which add to the short- long-term risk of morbidity perhaps mortality. We sought examine our center's practice screening for anomalies determine yield these tests among specific cardiac diagnostic categories. Design. Retrospective review infants admitted intensive care unit a new diagnosis CHD. Subjects were categorized into six groups: septal defects (SD), conotruncal...
Abstract Background Thromboembolic events are a serious complication occurring in critically ill children admitted to the cardiac intensive care unit. Although enoxaparin is one of current anticoagulants choice, dosages extrapolated from adult guidelines. Recent data suggest that this population may need higher dose than what currently recommended achieve target anti-factor Xa levels. The purpose study was evaluate whether less 2 years old unit require Methods Retrospective chart review...
Abstract Objective Efficient diagnosis of an underlying genetic aetiology in a patient with congenital heart disease is essential to optimising clinical care. Copy number variants are one disease; the majority identifiable by targeted fluorescence situ hybridisation or array comparative genomic hybridisation, not classical cytogenetic analysis. This study assessed utility as first-tier diagnostic test for neonates disease. Study design A prospective chart review Cardiac Intensive Care Unit...
Single ventricle with apicocaval juxtaposition (ACJ) is a rare, complex anomaly, in which the optimal position of conduit for completion total cavopulmonary connection (TCPC) still controversial. The purpose this study was to identify preoperative method using IVC anatomy and computational fluid dynamics (CFD). Twenty-four patients ACJ (5.3 ± 5.7 years) who underwent TCPC were enrolled. A placed ipsilateral cardiac apex each 11 patients, 9 intra-atrial 2 extracardiac (group A) and, further...
Kounis syndrome is coronary vasospasm because of mast cell degranulation in the context an allergic reaction. The has known associations with several drugs used during anesthesia, including rocuronium and isoflurane. In this case report, we discuss a 2-year-old patient who developed signs symptoms acute soon after anesthesia for atrial septal defect repair. A diagnostic angiography episode revealed diffusely small arteries. Subsequent clinical improvement showed essentially normal anatomy....