19 results on '"Chang, Anthony C"'
Search Results
2. How could ChatGPT impact my practice as an intensivist? An overview of potential applications, risks and limitations.
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Komorowski, Matthieu, del Pilar Arias López, Maria, and Chang, Anthony C.
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CHATGPT , *MACHINE learning , *NATURAL language processing , *LANGUAGE models , *COMMUNICATIVE disorders - Abstract
How could ChatGPT impact my practice as an intensivist? Chat Generative Pre-trained Transformer (ChatGPT) is a very large natural language processing model that uses deep learning algorithms trained on vast amounts of internet data to generate human-like responses to user prompts. Potential applications of ChatGPT in intensive care medicine ChatGPT and large language models (LLMs) could potentially impact the clinical practice of intensive care medicine in significant ways (Table 1). Handling of medical notes As an artificial intelligence (AI) specialised in language problems, ChatGPT could assist clinicians in a number of tasks related to handling medical data and clinical notes. [Extracted from the article]
- Published
- 2023
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3. Management of the postoperative pediatric cardiac surgical patient.
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Bronicki, Ronald A. and Chang, Anthony C.
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HEMODYNAMICS , *CARDIAC patients , *RESPIRATORY diseases , *CARDIOVASCULAR diseases , *POSTOPERATIVE care - Abstract
The article discusses the aspects and latest advances in the management of postoperative pediatric cardiac patients. It provides an assessment of hemodynamics and tissue oxygenation in postoperative cardiac patients. The issues encountered by patients such as respiratory dysfunction, cardiovascular dysfunction and systolic dysfunction are examined. The author concludes that efforts such as mechanical circulatory devices for pediatric patients impact postoperative management.
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- 2011
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4. Future Pharmacologic Agents for Treatment of Heart Failure in Children.
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Moffett, Brady S. and Chang, Anthony C.
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HEART failure in children , *HEART diseases , *HEART failure treatment , *PEDIATRICS , *PULMONARY hypertension , *VASOPRESSIN - Abstract
The addition of new agents to the armamentarium of treatment options for heart failure in pediatric patients is exciting and challenging. Administration of these therapies to pediatric patients will require careful scrutiny of the data and skilled application. Developmental changes in drug metabolism, excretion, and distribution are concerning in pediatric patients, and inappropriate evaluation of these parameters can have disastrous results. Manipulation of the neurohormonal pathways in heart failure has been the target of most recently developed pharmacologic agents. Angiotensin receptor blockers (ARBs), aldosterone antagonists, beta-blockers, and natriuretic peptides are seeing increased use in pediatrics. In particular, calcium sensitizing agents represent a new frontier in the treatment of acute decompensated heart failure and may replace traditional inotropic therapies. Endothelin receptor antagonists have shown benefit in the treatment of pulmonary hypertension, but their use in heart failure is still debatable. Vasopressin antagonists, tumor necrosis factor inhibitors, and neutral endopeptidase inhibitors are also targeting aspects of the neurohormonal cascade that are currently not completely understood. The future of pharmacologic therapies will include pharmacogenomic studies on new and preexisting therapies for pediatric heart failure. The education and skill of the practitioner when applying these agents in pediatric heart failure is of utmost importance. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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5. Starting a pediatric cardiac intensive care program: essential elements for sustained success
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Chang, Anthony C.
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PEDIATRIC cardiology , *HEART diseases , *CONGENITAL heart disease , *CRITICAL care medicine - Abstract
Pediatric cardiac intensive care has now emerged as a specialized clinical area focusing on the unique needs of critically-ill neonatal, pediatric and adult patients with congenital and acquired heart disease. The start-up project of a pediatric cardiac intensive care program is both exciting and challenging, and this endeavor demands a balanced clinical and administrative approach to ensure its success. Although an increasing number of pediatric cardiac programs have either started or are considering starting a dedicated cardiac intensive care unit and program, there are no published primers regarding logistical aspects of such a daunting endeavor. There are 25 essential elements in five broad categories that serve as underpinnings of a balanced strategy in starting a pediatric cardiac intensive care program, using a compendium of clinical experiences as well as administrative principles. In addition, a ‘scorecard’ approach incorporating these elements is introduced and can be utilized as a useful objective tool to serially measure the progress and success of such a program. As in any business organization, long-term greatness of a cardiac intensive care program can be attained by a relentless effort to improve; this effort, however, needs to be focused and its effects measurable. [Copyright &y& Elsevier]
- Published
- 2003
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6. Proceedings of 2015 Innovations in Pediatric Heart Failure Symposium.
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Singh, Rakesh K., Chang, Anthony C., Towbin, Jeffrey A., and Lipshultz, Steven E.
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HEART failure , *HEART failure in children , *HEART failure treatment , *ECHOCARDIOGRAPHY , *CONFERENCES & conventions , *DIAGNOSIS - Published
- 2016
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7. Serial Plasma BNP Levels in Assessing Inadequate Left Ventricular Decompression on ECMO.
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Falkensammer, Christine B., Heinle, Jeffrey S., and Chang, Anthony C.
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HEART ventricle abnormalities , *SURGICAL arteriovenous shunts , *EXTRACORPOREAL membrane oxygenation , *INFANT girls , *CARDIAC arrest , *NEUROPEPTIDES , *PULMONARY artery - Abstract
We describe a female infant with complex single ventricle physiology who had undergone median sternotomy for placement of a right-sided systemic-to-pulmonary artery shunt, division of a patent ductus arteriosus, and left pulmonary artery augmentation. Her early postoperative course was complicated by cardiac arrest requiring institution of extracorporeal membrane oxygenation (ECMO) support. The brain natriuretic peptide (BNP) levels acutely improved after left ventricular decompression by insertion of a left atrial cannula. In this setting BNP levels may be an indicator of left ventricular stretch and are potentially a useful index to monitor left ventricular distension. [ABSTRACT FROM AUTHOR]
- Published
- 2008
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8. Association of Freestanding Children's Hospitals With Outcomes in Children With Critical Illness.
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Gupta, Punkaj, Rettiganti, Mallikarjuna, Fisher, Paige L., Chang, Anthony C., Rice, Tom B., and Wetzel, Randall C.
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CHILDREN'S hospitals , *PEDIATRIC clinics , *CATASTROPHIC illness , *PROPENSITY score matching , *COMORBIDITY , *HEART diseases , *SEVERITY of illness index - Abstract
Objectives: Little is known about the relationship between freestanding children's hospitals and outcomes in children with critical illness. The purpose of this study was to evaluate the association of freestanding children's hospitals with outcomes in children with critical illness.Design: Propensity score matching was performed to adjust for potential confounding variables between patients cared for in freestanding or nonfreestanding children's hospitals. We tested the sensitivity of our findings by repeating the primary analyses using inverse probability of treatment weighting method and regression adjustment using the propensity score.Setting: Retrospective study from an existing national database, Virtual PICU Systems (LLC) database.Patients: Patients less than 18 years old admitted to one of the participating PICUs in the Virtual PICU Systems, LLC database were included (2009-2014).Interventions: None.Measurements and Main Results: A total of 538,967 patients from 140 centers were included. Of these, 323,319 patients were treated in 60 freestanding hospitals. In contrast, 215,648 patients were cared for in 80 nonfreestanding hospitals. By propensity matching, 134,656 patients were matched 1:1 in the two groups (67,328 in each group). Prior to matching, patients in the freestanding hospitals were younger, had greater comorbidities, had higher severity of illness scores, had higher incidence of cardiac arrest, had higher resource utilization, and had higher proportion of patients undergoing complex procedures such as cardiac surgery. Before matching, the outcomes including mortality were worse among the patients cared for in the freestanding hospitals (freestanding vs nonfreestanding, 2.5% vs 2.3%; p < 0.001). After matching, the majority of the study outcomes were better in freestanding hospitals (freestanding vs nonfreestanding, mortality: 2.1% vs 2.8%, p < 0.001; standardized mortality ratio: 0.77 [0.73-0.82] vs 0.99 [0.87-0.96], p < 0.001; reintubation: 3.4% vs 3.8%, p < 0.001; good neurologic outcome: 97.7% vs 97.1%, p = 0.001).Conclusions: In this large observational study, we demonstrated that ICU care provided in freestanding children's hospitals is associated with improved risk-adjusted survival chances compared to nonfreestanding children's hospitals. However, the clinical significance of this change in mortality should be interpreted with caution. It is also possible that the hospital structure may be a surrogate of other factors that may bias the results. [ABSTRACT FROM AUTHOR]- Published
- 2016
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9. Report of the National Heart, Lung, and Blood Institute Working Group: An Integrated Network for Congenital Heart Disease Research.
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Pasquali, Sara K., Jacobs, Jeffrey P., Farber, Gregory K., Bertoch, David, Blume, Elizabeth D., Burns, Kristin M., Campbell, Robert, Chang, Anthony C., Chung, Wendy K., Riehle-Colarusso, Tiffany, Curtis, Lesley H., Forrest, Christopher B., Gaynor, William J., Gaies, Michael G., Go, Alan S., Henchey, Paul, Martin, Gerard R., Pearson, Gail, Pemberton, Victoria L., and Schwartz, Steven M.
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CONGENITAL heart disease diagnosis , *HEART abnormality diagnosis , *HEART abnormalities , *CARDIOVASCULAR system abnormalities , *DIAGNOSIS , *CLINICAL trials , *CONGENITAL heart disease , *DATABASES , *MEDICAL databases , *INFORMATION storage & retrieval systems , *MEDICAL informatics , *MEDICAL record linkage , *MEDICAL research , *DATA mining , *ACQUISITION of data , *ELECTRONIC health records , *DATA curation , *ECONOMICS ,CARDIOVASCULAR system pathophysiology - Abstract
The National Heart, Lung, and Blood Institute convened a working group in January 2015 to explore issues related to an integrated data network for congenital heart disease research. The overall goal was to develop a common vision for how the rapidly increasing volumes of data captured across numerous sources can be managed, integrated, and analyzed to improve care and outcomes. This report summarizes the current landscape of congenital heart disease data, data integration methodologies used across other fields, key considerations for data integration models in congenital heart disease, and the short- and long-term vision and recommendations made by the working group. [ABSTRACT FROM AUTHOR]
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- 2016
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10. Carotid intima-media thickness is increased in patients with mucopolysaccharidoses
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Wang, Raymond Y., Covault, Kelly K., Halcrow, Eileen M., Gardner, Audrey J., Cao, Xiaoling, Newcomb, Robert L., Dauben, Richard D., and Chang, Anthony C.
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MUCOPOLYSACCHARIDOSIS , *CAROTID artery , *THICKNESS measurement , *CARDIOVASCULAR diseases , *BIOMARKERS , *ECHOCARDIOGRAPHY , *GLYCOSAMINOGLYCANS - Abstract
Abstract: Background: The feasibility of carotid artery intima-media thickness (C-IMT), an established cardiovascular disease marker, as a cardiac risk marker in mucopolysaccharidosis (MPS) patients was explored. Objectives: To determine if C-IMT is abnormal in MPS versus unaffected controls, and if C-IMT correlates with coronary artery diameter in MPS. Material and methods: Measurements of C-IMT via neck ultrasound and echocardiographic parameters, including coronary artery diameters, were obtained from MPS and control patients, and compared. Results: Sixteen MPS subjects (6 MPS I, 6 MPS II, 2 MPS III, 1 MPS VI, 1 MPS VII) and sixteen age, ethnicity, and gender-matched controls were enrolled. Median MPS and control subject ages were 8.3±4.5 and 8.6±4.3years, respectively (p=0.73). Mean MPS and control C-IMTs were 0.54±0.070 and 0.48±0.034mm (p=0.0029). No differences in left main, left anterior descending, or right coronary artery diameters were seen between MPS and controls. A significant proportion of MPS subjects had mitral insufficiency (14/16; p=0.0002), aortic insufficiency (10/16; p=0.0021), and left ventricular dilatation (7/16, p=0.037) versus controls. C-IMT did not correlate significantly with age, height, weight, coronary measurements, or duration of treatment. Conclusion: C-IMT in MPS patients is increased compared to matched controls, likely reflective of arterial intima-medial glycosaminoglycan accumulation. MPS subjects demonstrated a high percentage of left-sided valvular insufficiency and ventricular dilatation. Additional studies should be performed in MPS patients to determine if C-IMT correlates with arterial elasticity, biomarkers of vascular dysfunction, and higher risk of cardiovascular events. [Copyright &y& Elsevier]
- Published
- 2011
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11. Chlamydophila pneumoniae Myopericarditis in a Child.
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Suesaowalak, Monnipa, Cheung, Michele, Tucker, Dawn, Chang, Anthony C., Chu, James, and Arrieta, Antonio
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CASE studies , *CHLAMYDOPHILA infections , *HEMODYNAMICS , *AZITHROMYCIN , *MYOCARDITIS , *ECHOCARDIOGRAPHY , *MEDICAL literature - Abstract
An 11-year-old boy with serologically confirmed Chlamydophila pneumoniae infection presented with clinical, laboratory, and echocardiographic changes consistent with myopericarditis. No reports on C. pneumoniae myopericarditis in children are found in the medical literature. The boy, previously healthy, presented with fever, rash, constitutional symptoms, elevated acute phase reactants, elevated cardiac enzymes, and high brain natriuretic peptide levels. Hemodynamic instabilities, including hypotension and mild hypoxia, were noted. Two-dimensional echocardiographic findings showed mildly depressed left ventricular systolic function and small pericardial effusion. Requiring inotropic support, the boy was treated with azithromycin 10 mg/kg once daily for 7 days and a single dose of intravenous immunoglobulin 2 g/kg. He recovered fully with improved left ventricular systolic function before hospital discharge. An early definitive diagnosis is essential to knowing the etiology of pediatric myocarditis. Specific therapy may play role in the management and prognosis of this disorder. [ABSTRACT FROM AUTHOR]
- Published
- 2009
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12. The Efficacy of Mitral Valve Surgery in Children with Dilated Cardiomyopathy and Severe Mitral Regurgitation.
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Breinholt, John P., Fraser, Charles D., Dreyer, William J., Chang, Anthony C., Smith, E. O'Brian, Heinle, Jeffrey S., Dean McKenzie, E., Clunie, Sarah K., Towbin, Jeffrey A., and Denfield, Susan W.
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MITRAL valve insufficiency , *MITRAL valve diseases , *CARDIOMYOPATHIES , *PEDIATRIC cardiology , *HEART transplantation ,CARDIAC surgery patients - Abstract
Severe mitral regurgitation predicts poor outcomes in adults with left ventricular dysfunction. Frequently, adult patients now undergo initial mitral valve surgery instead of heart transplant. Pediatric data are limited. This study evaluates the efficacy of mitral valve surgery for severe mitral regurgitation in children with dilated cardiomyopathy. This is a single-institution experience in seven children (range, 0.5–10.9 years) with severe mitral regurgitation and dilated cardiomyopathy who underwent mitral valve surgery between January 1988 and February 2005, with follow-up to January 2006. Children with dilated cardiomyopathy had a depressed fractional shortening preoperatively (24.4% ± 6.1%) that remained depressed (22.9% ± 7.6%) 1.3 ± 1.2 years after surgery ( p = 0.50). Left ventricular end-diastolic (6.5 ± 1.5 to 4.8 ± 1.8 z-scores, p < 0.01) and end-systolic (6.8 ± 1.5 to 5.5 ± 2.1 z-scores, p < 0.05) dimensions improved. Hospitalization frequency had a median decrease of 6.0 hospitalizations per year ( p < 0.02). Three patients were transplanted 0.2, 2.4, and 3.5 years after surgery. There was no perioperative mortality. Mitral valve surgery in children with dilated cardiomyopathy was performed safely and improved symptoms, stabilizing ventricular dysfunction in most patients. Mitral valve surgery should be considered prior to heart transplant in children with dilated cardiomyopathy and severe mitral regurgitation. [ABSTRACT FROM AUTHOR]
- Published
- 2008
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13. An Alternative Treatment Strategy for Pump Thrombus in the DeBakey VAD Child: Use of Clopidogrel as a Thrombolytic Agent
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Studer, Matthew A., Kennedy, Curtis E., Dreyer, William J., Price, Jack F., Moffett, Brady S., Teitel, Edward R., Carberry, Kathleen E., Morales, David L.S., McKenzie, E. Dean, and Chang, Anthony C.
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HEART transplantation , *PLASMINOGEN activators , *PEDIATRICS , *THERAPEUTICS , *FIBRINOLYTIC agents - Abstract
Our institution has used the DeBakey VAD Child as a bridge to heart transplantation in select pediatric patients. Pump thrombus is a potentially serious complication with few available treatment options. Only surgical device exchange or the use of tissue plasminogen activator are reported in the literature. We report the use of clopidogrel as an alternative thrombolytic agent in the presence of pump thrombus in an adolescent patient with a DeBakey VAD Child heart pump. [Copyright &y& Elsevier]
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- 2006
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14. Complex Pulmonary Atresia in a Neonate.
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Eble, Brian K., Fraser Jr., Charles D., Nihill, Michael R., Grifka, Ronald G., and Chang, Anthony C.
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INFANT diseases , *ANGIOGRAPHY , *CORONARY arteries , *OPERATIVE surgery ,PULMONARY atresia - Abstract
We describe the case of a 3-week-old infant who was diagnosed with pulmonary atresia, a ventricular septal defect, and discontinuous pulmonary arteries. The pulmonary artery anatomy was delineated by angiography: the right pulmonary artery arose from the proximal right coronary artery, and the left pulmonary artery arose from a left ductus arteriosus. This case illustrates the importance of careful delineation of the anatomy in complex pulmonary atresia before surgical intervention. [ABSTRACT FROM AUTHOR]
- Published
- 2006
15. Preterm Infants With Congenital Heart Disease and Bronchopulmonary Dysplasia: Postoperative Course and Outcome After Cardiac Surgery.
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McMahon, Colin J., Penny, Daniel J., Nelson, David P., Ades, Anne M., Maskary, Salim Al, Speer, Michael, Katkin, Julie, McKenzie, E. Dean, Fraser, Charles D., and Chang, Anthony C.
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PREMATURE infant diseases , *BRONCHOPULMONARY dysplasia , *PALLIATIVE treatment , *CONGENITAL heart disease in children , *HYALINE membrane disease - Abstract
Objective. Success in treatment of premature infants has resulted in increased numbers of neonates who have bronchopulmonary dysplasia (BPD) and require surgical palliation or repair of congenital heart disease (CHD). We sought to investigate the impact of BPD on children with CHD after heart surgery. Methods. This was a retrospective, multicenter study of patients who had BPD, defined as being oxygen dependent at 28 days of age with radiographic changes, and CHD and had cardiac surgery (excluding arterial duct ligation) between January 1991 and January 2002. Forty-three infants underwent a total of 52 cardiac operations. The median gestational age at birth was 28 weeks (range: 23-35 weeks), birth weight was 1460 g (range: 431-2500 g), and age at surgery was 2.7 months (range: 1.0 -11.6 months). Diagnoses included left-to-right shunts (n = 15), conotruncal abnormalities (n = 13), arch obstruction (n = 6), univentricular hearts (n = 4), semilunar valve obstruction (n = 3), Shone syndrome (n = 1), and cortriatriatum (n = 1). Results. Thirty-day survival was 84% with 6 early and 6 late postoperative deaths. Survival to hospital discharge was 68%. There was 50% mortality for patients with univentricular hearts and severe BPD. The median duration of preoperative ventilation was 76 days (range: 2-244 days) and of postoperative ventilation was 15 days (range: 1-141 days). The median duration of cardiac ICU stay was 7.5 days (range: 1-30 days) and of hospital stay was 115 days (range: 35-475 days). Current pulmonary status includes on room air (n = 14), O2 at home (n = 4), and ventilated at home (n = 4) or in hospital (n = 4), and 5 patients were lost to follow-up. Conclusions. BPD has significant implications for children who have CHD and undergo cardiac surgery, leading to prolonged ICU and hospital stays, although most survivors are not O2 dependent. Postoperative mortality was highest among patients with univentricular hearts and severe BPD. Optimal timing of surgery and strategies to improve outcome remains to be delineated. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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16. A noninvasive estimation of mixed venous oxygen saturation using near-infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patients.
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Tortoriello, Tia A., Stayer, Stephen A., Mott, Antonio R., McKenzie, E. Dean, Fraser, Charles D., Andropoulos, Dean B., and Chang, Anthony C.
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CARDIAC surgery , *CHILDREN , *OXYGEN , *SPECTRUM analysis , *BLOOD , *INDUCED cardiac arrest - Abstract
: Near-infrared spectroscopy (NIRS) is a noninvasive optical monitor of regional cerebral oxygen saturation (rSO2). The aim of this study was to validate the use of NIRS by cerebral oximetry in estimating invasively measured mixed venous oxygen saturation (SvO2) in pediatric postoperative cardiac surgery patients.: Twenty patients were enrolled following cardiac surgery with intraoperative placement of a pulmonary artery (PA) or superior vena cava (SVC) catheter. Five patients underwent complete biventricular repair– complete atrioventricular canal (n = 3) and other (n = 2). Fifteen patients with functional single ventricle underwent palliative procedures– bidirectional Glenn (n = 11) and Fontan (n = 4). Cerebral rSO2 was monitored via NIRS (INVOS 5100) during cardiac surgery and 6 h postoperatively. SvO2 was measured from blood samples obtained via an indwelling PA or SVC catheter and simultaneously correlated with rSO2 by NIRS at five time periods: in the operating room after weaning from cardiopulmonary bypass, after sternal closure, and in the CICU at 2, 4, and 6 h after admission.: Each patient had five measurements (total = 100 comparisons). SvO2 obtained via an indwelling PA or SVC catheter for all patients correlated with rSO2 obtained via NIRS: Pearson's correlation coefficient of 0.67 (P < 0.0001) and linear regression ofr2 = 0.45 (P < 0.0001). Separate linear regression of the complete biventricular repairs demonstrated anr = 0.71,r2 = 0.50 (P < 0.0001). Bland–Altman analysis showed a bias of +3.3% with a precision of 16.6% for rSO2 as a predictor of SvO2 for all patients. Cerebral rSO2 was a more accurate predictor of SvO2 in the biventricular repair patients (bias−0.3, precision 11.8%), compared with the bidirectional Glenn and Fontan patients.: Regional cerebral oximetry via NIRS correlates with SvO2 obtained via invasive monitoring. However, the wide limits of agreement suggest that it may not be possible to predict absolute values of SvO2 for any given patient based solely on the noninvasive measurement of rSO2. Near-infrared spectroscopy, using the INVOS 5100 cerebral oximeter, could potentially be used to indicate trends in SVO2, but more studies needs to be performed under varying clinical conditions. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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17. Lessons learned from the first application of the DeBakey VAD Child: An intracorporeal ventricular assist device for children
- Author
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Morales, David L.S., DiBardino, Daniel J., McKenzie, E. Dean, Heinle, Jeff S., Chang, Anthony C., Loebe, Matthias, Noon, George P., DeBakey, Michael E., and Fraser, Charles D.
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ARTIFICIAL implants , *BIOMEDICAL materials , *SURGERY , *PROSTHETICS , *MEDICAL equipment , *SURGICAL instruments - Abstract
We report and describe the design and the first clinical implantation of the DeBakey ventricular assist device (VAD) Child, a pediatric intracorporeal left ventricular assist device, in a 6-year-old girl. The risk-benefit of novel technologies in advanced heart failure and the lessons learned by our experience are important to consider in hopes that other centers (where this device is now available) may benefit. [Copyright &y& Elsevier]
- Published
- 2005
- Full Text
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18. Publishing Artificial Intelligence Research Papers: A Tale of Three Journals.
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Shortliffe, Edward H., Peleg, Mor, Combi, Carlo, Chang, Anthony C., and Vinci, Justyna
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ARTIFICIAL intelligence , *MEDICAL care , *NATURAL language processing , *KNOWLEDGE representation (Information theory) , *COMPUTER vision , *ELECTRONIC journals , *PUBLISHING , *NEWSLETTERS - Abstract
We trust it is clear that JBI addresses a broader range of methods than AI, whereas the other two journals are singularly focused on AI and data science. With the growth in Artificial Intelligence in Medicine (AIM) research and the plethora of informatics journals, there is some confusion where to direct an AIM-related manuscript for peer review and possible publication. [Extracted from the article]
- Published
- 2021
- Full Text
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19. Mesenteric Oxygen Desaturation.
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Stapleton, Gary E., Eble, Brian K., Dickerson, Heather A., Andropoulos, Dean B., and Chang, Anthony C.
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NEONATAL necrotizing enterocolitis , *HEART abnormalities , *INFANT diseases , *OXIMETRY , *SPECTRUM analysis - Abstract
Congenital heart disease is a risk factor for the development of necrotizing enterocolitis, although the exact mechanism of development remains unclear. Herein, we report the case of an infant with pulmonary atresia, an intact ventricular septum, and multiple aortopulmonary collateral vessels. At 4 weeks of age, the infant developed necrotizing enterocolitis in association with significant mesenteric oxygen desaturation, as measured by means of near-infrared spectroscopy. With bowel rest and antibiotic therapy, the patient's mesenteric oxygen saturation and clinical status improved. This case highlights the importance of impaired mesenteric oxygen delivery consequential to congenital heart disease as a possible risk factor for necrotizing enterocolitis, and the use of near-infrared spectroscopy to measure tissue perfusion noninvasively in high-risk patients. To our knowledge, this is the 1st report of mesenteric oxyhemoglobin desaturation in association with necrotizing enterocolitis in a patient who also had congenital heart disease. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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