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Wernovsky G, Wypij D, Jonas RA, et al. Postoperative course and hemodynamic profile after the arterial switch operation in neonates and infants. A comparison of low-flow cardiopulmonary bypass and circulatory arrest. Circulation 1995;92:2226-35. ▶ Landmark paper demonstrating that cardiac output reaches a nadir at 9-12 h after surgery.
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Wernovsky G, Wypij D, Jonas RA, et al. Postoperative course and hemodynamic profile after the arterial switch operation in neonates and infants. A comparison of low-flow cardiopulmonary bypass and circulatory arrest. Circulation 1995;92:2226-35. ▶ Landmark paper demonstrating that cardiac output reaches a nadir at 9-12 h after surgery.
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2
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65749117217
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The monitoring of venous saturations of oxygen in children with congenitally malformed hearts
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Martin J, Shekerdemian LS. The monitoring of venous saturations of oxygen in children with congenitally malformed hearts. Cardiol Young 2009;19:34-9.
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Martin, J.1
Shekerdemian, L.S.2
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3
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33845945963
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Stocker CF, Shekerdemian LS, Norgaard MA, et al. Mechanisms of a reduced cardiac output and the effects of milrinone and levosimendan in a model of infant cardiopulmonary bypass. Crit Care Med 2007;35:252-9. ▶ This laboratory study demonstrated the importance of increased afterload in the pathophysiology of the low output state early after CPB. Milrinone and levosimendan similarly prevented the onset of a low output, when compared to controls receiving dopamine. Levosimendan, not milrinone, exerted beneficial effects on contractility.
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Stocker CF, Shekerdemian LS, Norgaard MA, et al. Mechanisms of a reduced cardiac output and the effects of milrinone and levosimendan in a model of infant cardiopulmonary bypass. Crit Care Med 2007;35:252-9. ▶ This laboratory study demonstrated the importance of increased afterload in the pathophysiology of the low output state early after CPB. Milrinone and levosimendan similarly prevented the onset of a low output, when compared to controls receiving dopamine. Levosimendan, not milrinone, exerted beneficial effects on contractility.
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4
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0037250721
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Risk factors for long intensive care unit stay after cardiopulmonary bypass in children
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Brown KL, Ridout DA, Goldman AP, et al. Risk factors for long intensive care unit stay after cardiopulmonary bypass in children. Crit Care Med 2003;31:28-33.
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Brown, K.L.1
Ridout, D.A.2
Goldman, A.P.3
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5
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Wright GE, Crowley DC, Charpie JR, et al. High systemic vascular resistance and sudden cardiovascular collapse in recovering Norwood patients. Ann Thorac Surg 2004;77:48-52. ▶ This paper describes a series of infants who experienced unexpected circulatory collapse associated with systemic hypertension and metabolic acidosis, while recovering from stage 1 palliation for hypoplastic left heart syndrome. These observations support the recommendation for use of systemic vasodilators and the importance of avoiding any factors such as pain or stress that may additionally provoke acute increases in systemic vascular resistance in this high risk population.
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Wright GE, Crowley DC, Charpie JR, et al. High systemic vascular resistance and sudden cardiovascular collapse in recovering Norwood patients. Ann Thorac Surg 2004;77:48-52. ▶ This paper describes a series of infants who experienced unexpected circulatory collapse associated with systemic hypertension and metabolic acidosis, while recovering from stage 1 palliation for hypoplastic left heart syndrome. These observations support the recommendation for use of systemic vasodilators and the importance of avoiding any factors such as pain or stress that may additionally provoke acute increases in systemic vascular resistance in this high risk population.
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6
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Hoffman TM, Wernovsky G, Atz AM, et al. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 2003;107:996-1002. ▶ This well designed prospective, randomised, placebo controlled study investigated the role of milrinone in 227 children early after biventricular repair for CHD. The study concluded that a low output state was present in just over one quarter of patients receiving placebo (despite catecholamines), and that prophylactic high dose milrinone, given in the intensive care unit after surgery, reduced the incidence of a low output state to 12%.
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Hoffman TM, Wernovsky G, Atz AM, et al. Efficacy and safety of milrinone in preventing low cardiac output syndrome in infants and children after corrective surgery for congenital heart disease. Circulation 2003;107:996-1002. ▶ This well designed prospective, randomised, placebo controlled study investigated the role of milrinone in 227 children early after biventricular repair for CHD. The study concluded that a low output state was present in just over one quarter of patients receiving placebo (despite catecholamines), and that prophylactic high dose milrinone, given in the intensive care unit after surgery, reduced the incidence of a low output state to 12%.
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7
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33645514693
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Population pharmacokinetics of milrinone in neonates with hypoplastic left heart syndrome undergoing stage I reconstruction
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Zuppa AF, Nicolson SC, Adamson PC, et al. Population pharmacokinetics of milrinone in neonates with hypoplastic left heart syndrome undergoing stage I reconstruction. Anesth Analg 2006;102:1062-9.
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Anesth Analg
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Zuppa, A.F.1
Nicolson, S.C.2
Adamson, P.C.3
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8
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0037422531
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Kivikko M, Lehtonen L, Colucci WS. Sustained hemodynamic effects of intravenous levosimendan. Circulation 2003;107:81-6. ▶ A unique feature of levosimendan, when compared to most intravenous vasoactive drugs, is that its effects are prolonged secondary to the continuing beneficial effects of its metabolites, primarily OR-1896, with an elimination halflife of 70-80 h. This prospective study in adults showed that while levosimendan concentrations fell rapidly in the first few hours after discontinuing the drug, metabolites continued to increase for a further 24-48 h, with haemodynamic effects lasting at least as long.
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Kivikko M, Lehtonen L, Colucci WS. Sustained hemodynamic effects of intravenous levosimendan. Circulation 2003;107:81-6. ▶ A unique feature of levosimendan, when compared to most intravenous vasoactive drugs, is that its effects are prolonged secondary to the continuing beneficial effects of its metabolites, primarily OR-1896, with an elimination halflife of 70-80 h. This prospective study in adults showed that while levosimendan concentrations fell rapidly in the first few hours after discontinuing the drug, metabolites continued to increase for a further 24-48 h, with haemodynamic effects lasting at least as long.
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9
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33748648616
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Namachivayam P, Crossland DS, Butt WW, et al. Early experience with levosimendan in children with ventricular dysfunction. Pediatr Crit Care Med 2006;7:445-8.
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Pediatr Crit Care Med
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Namachivayam, P.1
Crossland, D.S.2
Butt, W.W.3
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10
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Turanlahti M, Boldt T, Palkama T, et al. Pharmacokinetics of levosimendan in pediatric patients evaluated for cardiac surgery. Pediatr Crit Care Med 2004;5:457-62.
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Turanlahti, M.1
Boldt, T.2
Palkama, T.3
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11
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34547561245
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Phenoxybenzamine in the treatment of hypoplastic left heart syndrome: A core review
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Phenoxybenzamine has been associated with improved survival early after stage 1 palliation. This article provides an excellent overview of the pharmacology of phenoxybenzamine, and considers its administration in the postoperative setting, ▶
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Guzzetta NA. Phenoxybenzamine in the treatment of hypoplastic left heart syndrome: a core review. Anesth Analg 2007;105:312-5. ▶ Phenoxybenzamine has been associated with improved survival early after stage 1 palliation. This article provides an excellent overview of the pharmacology of phenoxybenzamine, and considers its administration in the postoperative setting.
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(2007)
Anesth Analg
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Guzzetta, N.A.1
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12
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41849111689
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Mossad E, Motta P, Sehmbey K, et al. The hemodynamic effects of phenoxybenzamine in neonates, infants, and children. J Clin Anesth 2008;20:94-8.
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Mossad, E.1
Motta, P.2
Sehmbey, K.3
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13
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Sackner-Bernstein JD, Kowalski M, Fox M, et al. Short-term risk of death after treatment with nesiritide for decompensated heart failure: a pooled analysis of randomized controlled trials. JAMA 2005;293:1900-5. ▶ There is growing interest in nesiritide in paediatrics. This analysis of three randomised controlled trials, involving 485 nesiritide and 377 control patients, demonstrated increased mortality with nesiritide (hazard ratio 1.80, 95% confidence interval 0.98 to 3.31; p=0.057). The authors emphasise that this pooled analysis should not be interpreted as an adequately powered prospective trial, but should be considered hypothesis generating rather than a conclusive negative study.
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Sackner-Bernstein JD, Kowalski M, Fox M, et al. Short-term risk of death after treatment with nesiritide for decompensated heart failure: a pooled analysis of randomized controlled trials. JAMA 2005;293:1900-5. ▶ There is growing interest in nesiritide in paediatrics. This analysis of three randomised controlled trials, involving 485 nesiritide and 377 control patients, demonstrated increased mortality with nesiritide (hazard ratio 1.80, 95% confidence interval 0.98 to 3.31; p=0.057). The authors emphasise that this pooled analysis should not be interpreted as an adequately powered prospective trial, but should be considered hypothesis generating rather than a conclusive negative study.
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14
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33644984584
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Simsic JM, Scheurer M, Tobias JD, et al. Perioperative effects and safety of nesiritide following cardiac surgery in children. J Intensive Care Med 2006;21:22-6.
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Simsic, J.M.1
Scheurer, M.2
Tobias, J.D.3
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15
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Stocker C, Penny DJ, Brizard CP, et al. Intravenous sildenafil and inhaled nitric oxide: a randomised trial in infants after cardiac surgery. Intensive Care Med 2003;29:1996-2003.
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Namachivayam P, Theilen U, Butt WW, et al. Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children. Am J Respir Crit Care Med 2006;174:1042-7. ▶ Rebound pulmonary hypertension can complicate the weaning of inhaled nitric oxide. In this randomised, placebo controlled trial, a single dose of sildenafil (0.4 mg/ kg) given 1 h before discontinuing nitric oxide completely prevented rebound, and this was also associated with a significantly shorter duration of mechanical ventilation and intensive care unit stay.
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Namachivayam P, Theilen U, Butt WW, et al. Sildenafil prevents rebound pulmonary hypertension after withdrawal of nitric oxide in children. Am J Respir Crit Care Med 2006;174:1042-7. ▶ Rebound pulmonary hypertension can complicate the weaning of inhaled nitric oxide. In this randomised, placebo controlled trial, a single dose of sildenafil (0.4 mg/ kg) given 1 h before discontinuing nitric oxide completely prevented rebound, and this was also associated with a significantly shorter duration of mechanical ventilation and intensive care unit stay.
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17
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0028913294
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Characterization of right ventricular diastolic performance after complete repair of tetralogy of Fallot. Restrictive physiology predicts slow postoperative recovery
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Cullen S, Shore D, Redington A. Characterization of right ventricular diastolic performance after complete repair of tetralogy of Fallot. Restrictive physiology predicts slow postoperative recovery. Circulation 1995;91:1782-9.
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Cullen, S.1
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The effects of carbon dioxide on oxygenation and systemic, cerebral, and pulmonary vascular hemodynamics after the bidirectional superior cavopulmonary anastomosis
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Hoskote A, Li J, Hickey C, et al. The effects of carbon dioxide on oxygenation and systemic, cerebral, and pulmonary vascular hemodynamics after the bidirectional superior cavopulmonary anastomosis. J Am Coll Cardiol 2004;44:1501-9.
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Hoffman GM, Tweddell JS, Ghanayem NS, et al. Alteration of the critical arteriovenous oxygen saturation relationship by sustained afterload reduction after the Norwood procedure. J Thorac Cardiovasc Surg 2004;127:738-45.
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Bradley SM, Atz AM, Simsic JM. Redefining the impact of oxygen and hyperventilation after the Norwood procedure. J Thorac Cardiovasc Surg 2004;127:473-80. ▶ Postoperative management of infants after stage 1 palliation has shifted away from the maintenance of pulmonary vasoconstriction, towards the optimisation of systemic oxygen delivery and mixed venous oxygen saturation. This prospective study demonstrated that neither inspired oxygen nor hyperventilation were detrimental early after stage 1 palliation, and higher levels of inspired oxygen were associated with improved systemic oxygen delivery.
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Bradley SM, Atz AM, Simsic JM. Redefining the impact of oxygen and hyperventilation after the Norwood procedure. J Thorac Cardiovasc Surg 2004;127:473-80. ▶ Postoperative management of infants after stage 1 palliation has shifted away from the maintenance of pulmonary vasoconstriction, towards the optimisation of systemic oxygen delivery and mixed venous oxygen saturation. This prospective study demonstrated that neither inspired oxygen nor hyperventilation were detrimental early after stage 1 palliation, and higher levels of inspired oxygen were associated with improved systemic oxygen delivery.
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22
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Very-low-dose inhaled nitric oxide: A selective pulmonary vasodilator after operations for congenital heart disease
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Bizzarro M, Gross I. Inhaled nitric oxide for the postoperative management of pulmonary hypertension in infants and children with congenital heart disease. Cochrane Database Syst Rev 2005:CD005055. ▶ This important systematic review highlighted the paucity of well designed studies and longer term outcome data in the existing literature. The four studies that fitted the criteria for this analysis showed no short term benefit for children receiving inhaled nitric oxide compared to controls, in terms of the incidence of pulmonary hypertensive crises, haemodynamics, oxygenation, or mortality.
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Bizzarro M, Gross I. Inhaled nitric oxide for the postoperative management of pulmonary hypertension in infants and children with congenital heart disease. Cochrane Database Syst Rev 2005:CD005055. ▶ This important systematic review highlighted the paucity of well designed studies and longer term outcome data in the existing literature. The four studies that fitted the criteria for this analysis showed no short term benefit for children receiving inhaled nitric oxide compared to controls, in terms of the incidence of pulmonary hypertensive crises, haemodynamics, oxygenation, or mortality.
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24
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33646193532
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Extracorporeal life support after staged palliation of a functional single ventricle: Subsequent morbidity and survival
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Hoskote A, Bohn D, Gruenwald C, et al. Extracorporeal life support after staged palliation of a functional single ventricle: subsequent morbidity and survival. J Thorac Cardiovasc Surg 2006;131:1114-21.
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27
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Cardiac catheterization of patients supported by extracorporeal membrane oxygenation
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In this excellent retrospective review from a single institution, 60 cardiac catheterisations were carried out in children on ECMO. Catheterisation was performed safely, and resulted in 50 transcatheter, surgical, or combined interventions, ▶
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Booth KL, Roth SJ, Perry SB, et al. Cardiac catheterization of patients supported by extracorporeal membrane oxygenation. J Am Coll Cardiol 2002;40:1681-6. ▶ In this excellent retrospective review from a single institution, 60 cardiac catheterisations were carried out in children on ECMO. Catheterisation was performed safely, and resulted in 50 transcatheter, surgical, or combined interventions.
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J Am Coll Cardiol
, vol.40
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Booth, K.L.1
Roth, S.J.2
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