Document Detail


Short-term outcome of infants presenting to pediatric intensive care unit with new cardiac diagnoses.
MedLine Citation:
PMID:  21087430     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To outline the etiology, clinical course, short-term survival to discharge and neurological outcome of infants (<1 yr) with new cardiac diagnoses presenting to a pediatric intensive care (PICU) unit with acute cardiac compromise.
METHODS: Retrospective search of a computerized database and medical case notes for all acute cardiac admissions to PICU from June 2001 to 2006. Pre-existing hospital-based patients with new cardiac diagnoses were excluded.
RESULTS: Seventy patients were identified, 38 (54%) of whom were male. There were six main subgroups: obstructive left heart lesions (n= 20), transposition of the great arteries (TGA) (n= 9), total anomalous pulmonary venous drainage (TAPVD) (n= 7), dilated cardiomyopathy (n= 11), arrhythmia (n= 12), and others (n= 11). Fifty-nine patients (84%) were external referrals to our center. The median age at presentation was 13.5 days (0-272) with median duration of symptoms of 1 day (0-21). The median base deficit at presentation was -7.6 mEq/L (-43 to +4.2). Fifty-three patients (76%) required respiratory support with a median duration of ventilation of 4 days (1-49). Fifty-six patients (80%) required inotropic support. The median PICU stay was 7 days (1-64) with a median total hospital stay of 16 days (1-71). Six patients (9%) died prior to discharge. Of the survivors 7 (11%) had seizure activity or evolving clinical neurological abnormalities.
CONCLUSIONS: Cardiovascular compromise due to previously unrecognized congenital or acquired heart disease is associated with clinically significant morbidity and mortality. Longer term follow-up is required to evaluate the initial effect of poor cardiac output and hypoxia on long-term neurodevelopmental outcome.
Authors:
Giridhar Dhandayuthapani; Shanta Chakrabarti; Aruna Ranasinghe; Linda Hunt; David Grant; Robin P Martin; Damien Kenny
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Congenital heart disease     Volume:  5     ISSN:  1747-0803     ISO Abbreviation:  Congenit Heart Dis     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-11-22     Completed Date:  2011-03-04     Revised Date:  2011-05-05    
Medline Journal Info:
Nlm Unique ID:  101256510     Medline TA:  Congenit Heart Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  444-9     Citation Subset:  IM    
Affiliation:
Bristol Royal Hospital for Children-Bristol Congenital Heart Centre, Bristol, UK. damienkenny@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Cardiotonic Agents / therapeutic use
Child Development
Delayed Diagnosis
England
Female
Heart Diseases / complications,  diagnosis*,  mortality,  physiopathology,  therapy*
Hospital Mortality
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric* / statistics & numerical data
Length of Stay
Male
Nervous System / growth & development
Outcome and Process Assessment (Health Care)* / statistics & numerical data
Patient Discharge
Respiration, Artificial
Retrospective Studies
Risk Assessment
Risk Factors
Seizures / etiology,  physiopathology
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiotonic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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