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To evaluate the relationship between postoperative serum lactate levels and outcome in children undergoing open heart surgery. Prospective, noninterventional study. Pediatric intensive care unit (PICU) of a university hospital. 41 nonconsecutive children who had had cardiopulmonary bypass for repair of congenital heart disease. None. Serum lactate levels(More)
Hypoxic states are associated with abnormal proliferation and constriction of the smooth muscle cells surrounding the distal vessels of the lung. In hypoxic as well as in normal states, the endothelial cell layer may play a key role in controlling smooth muscle tone by secreting a number of vasoactive agents. Platelet-derived growth factor (PDGF), produced(More)
BACKGROUND We sought to determine if postoperative serial lactate determinations follow predictable patterns that could be useful in directing management, especially the initiation of postoperative mechanical cardiopulmonary support (CPS). METHODS Eight patients undergoing CPS in a 2-year period and 147 patients not requiring postoperative CPS in 6 months(More)
AIM To determine the efficacy and safety of a continuous subcutaneous local anesthetic (LA) infusion in pediatric patients following open heart surgery. BACKGROUND The use of a continuous LA infusion has been shown to be beneficial following adult cardiac surgery. To date there are no studies in the pediatric population. METHODS/MATERIALS Using a(More)
A 3-year-old 18 kg male child of the Jehovah's Witness faith presented with severe aortic regurgitation. A successful Ross procedure was performed using a pulmonary autograft, without the use of blood or blood product transfusion. Blood conservation strategy included: (1) preoperative treatment with recombinant human erythropoietin; (2) intraoperative(More)
A goal-directed therapy algorithm based on serial lactate values obtained from a point-of-care testing device was utilized in an attempt to reduce the mortality of patients after congenital heart surgery. Prospective study of patients undergoing surgery utilizing a goal-directed therapy algorithm in the postoperative period. The results of this group are(More)
OBJECTIVES The purpose of this study was to examine the safety and efficacy of interventional catheterization performed early after congenital heart surgery. BACKGROUND Transcatheter interventions performed in the early postoperative period are viewed as high risk. To date, there have been limited published data regarding these procedures. METHODS All(More)
BACKGROUND The efficacy of antegrade cerebral perfusion (ACP) during complex neonatal single ventricle palliation requiring arch reconstruction is uncertain. We adapted the use of ACP in early 2001 in a programmatic effort to minimize the use of deep hypothermic circulatory arrest (DHCA). METHODS We retrospectively analyzed data of 126 consecutive(More)