Article
Medicine, General & Internal
Kevin D. Hill, Prince J. Kannankeril, Jeffrey P. Jacobs, H. Scott Baldwin, Marshall L. Jacobs, Sean M. O'Brien, David P. Bichel, Eric M. Graham, Brian Blasiole, Ashraf Resheidat, Adil S. Husain, S. Ram Kumar, Jerry L. Kirchner, Dianne S. Gallup, Joseph W. Turek, Mark Bleiweis, Bret Mettler, Alexis Benscoter, Eric Wald, Tara Karamlou, Andrew H. Van Bergen, David Overman, Pirooz Eghtesady, Ryan Butts, John S. Kim, John P. Scott, Brett R. Anderson, Michael F. Swartz, Patrick McConnell, David F. Vener, Jennifer S. Li
Summary: This multicenter trial found that prophylactic use of methylprednisolone did not significantly reduce the likelihood of a worse outcome in infants undergoing surgery with cardiopulmonary bypass, but was associated with a higher percentage of postoperative hyperglycemia requiring insulin in the methylprednisolone group compared to the placebo group.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Lance Hsieh, Lan N. Tu, Alison Paquette, Quanhu Sheng, Shilin Zhao, Douglas Bittel, James O'Brien, Kasey Vickers, Peter Pastuszko, Vishal Nigam
Summary: A study on neonatal patients undergoing cardiopulmonary bypass (CPB) revealed differential expression of multiple miRNAs in circulating leukocytes during and after bypass. These miRNAs are predicted to modulate pathways related to inflammation and signal transduction, contributing to the systemic inflammatory response post-CPB.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2022)
Article
Medicine, General & Internal
Sarah E. Drennan, Kathryn Y. Burge, Edgardo G. Szyld, Jeffrey V. Eckert, Arshid M. Mir, Andrew K. Gormley, Randall M. Schwartz, Suanne M. Daves, Jess L. Thompson, Harold M. Burkhart, Hala Chaaban
Summary: The study evaluated the utility of clinical and laboratory variables in predicting low cardiac output syndrome following cardiac surgery in infants. Patients on cardiopulmonary bypass had higher levels of specific cytokines upon ICU admission compared to non-bypass patients. Aortic cross-clamp duration was the most predictive surgical metric for low cardiac output syndrome in the patient population studied.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Medicine, General & Internal
Panagiotis Doukas, Gabriel Hellfritsch, Daniel Wendt, Mirko Magliani, Mohammad E. Barbati, Houman Jalaie, Michael J. Jacobs, Alexander Gombert
Summary: This pilot study investigated the efficacy of cytokine adsorption in controlling early inflammation cascade in patients undergoing open thoracoabdominal aortic repair. The results suggest that intraoperative hemoadsorption may be feasible and safe, but larger trials are needed to evaluate its clinical outcomes.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Health Care Sciences & Services
Luan Oliveira Ferreira, Victoria Winkler Vasconcelos, Janielle de Sousa Lima, Jaime Rodrigues Vieira Neto, Giovana Escribano da Costa, Jordana de Castro Esteves, Sallatiel Cabral de Sousa, Jonathan Almeida Moura, Felipe Ruda Silva Santos, Joao Monteiro Leitao Filho, Matheus Ramos Protasio, Pollyana Sousa Araujo, Claudio Jose da Silva Lemos, Karina Dias Resende, Dielly Catrina Favacho Lopes
Summary: Patients undergoing coronary revascularization with extracorporeal circulation or cardiopulmonary bypass may develop systemic inflammatory response due to biochemical changes in the microcirculation. Inflammatory signaling pathways can be activated by surgical incision, reperfusion injury, and blood contact with non-endothelial membranes, leading to the production and activation of inflammatory cells, cytokine production, and oxidative stress. Addressing new perspectives for intraoperative treatment and management may reduce this inflammatory storm, improve prognosis, and potentially lower mortality rates in these patients.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Review
Biochemistry & Molecular Biology
Giuseppe Filiberto Serraino, Federica Jiritano, Davide Costa, Nicola Ielapi, Domenica Battaglia, Umberto Marcello Bracale, Pasquale Mastroroberto, Michele Andreucci, Raffaele Serra
Summary: This systematic review aims to explore the role of matrix metalloproteinases (MMPs) in routine cardiac operations, especially cardiopulmonary bypass (CPB). The results show that MMP levels are significantly correlated with CPB and the gelatinases MMP-2 and MMP-9 are highly released during cardiac surgery with CPB. Increased MMP levels are associated with adverse post-operative outcomes. Future large-scale prospective multicenter randomized clinical trials are needed to investigate the impact of mechanical and pharmacological strategies on the inflammatory response and postoperative outcomes in cardiac surgery and CPB.
Article
Health Care Sciences & Services
Po-Shun Hsu, Jia-Lin Chen, Shih-Ying Sung, Yi-Ting Tsai, Chih-Yuan Lin, Yi-Fan Wu, Chien-Sung Tsai
Summary: This study compares the hemorheological and inflammatory changes before and after coronary artery bypass graft (CABG) surgery and finds that hyperviscosity persists for almost one week after the surgery. Inflammatory markers are also correlated with hemorheological changes. Understanding the interplay between inflammation and hemorheological properties is crucial for patient care.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Marie Vandestienne, Rayan Braik, Jean-Remi Lavillegrand, Geoffroy Hariri, Zoe Demailly, Nadine Ben Hamouda, Fabienne Tamion, Thomas Clavier, Hafid Ait-Oufella
Summary: This study investigated the role of TREM-1 in systemic inflammation during cardiac surgery with cardiopulmonary bypass (CPB). They found that TREM-1 expression on neutrophils decreased, while soluble TREM-1 levels increased after CPB. The study also showed that baseline sTREM-1 levels and early kinetics after cardiac surgery were associated with post-operative complications and prolonged length of stay.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Critical Care Medicine
Asaad G. Beshish, Ozzie Jahadi, Ashley Mello, Vamsi V. Yarlagadda, Andrew Y. Shin, David M. Kwiatkowski
Summary: This retrospective study examined the association between hyperoxia during cardiopulmonary bypass and outcomes in infants undergoing cardiac surgery. The results showed that hyperoxia was associated with increased mortality risk, acute kidney injury, and prolonged postoperative length of stay. Further research is needed to validate these findings and understand the mechanisms behind this association.
PEDIATRIC CRITICAL CARE MEDICINE
(2021)
Article
Critical Care Medicine
Rebecca J. Levy, Elizabeth W. Mayne, Amanda G. Sandoval Karamian, Mehreen Iqbal, Natasha Purington, Kathleen R. Ryan, Courtney J. Wusthoff
Summary: Seizure incidence in infants following CPB, even without deep hypothermic cardiac arrest, was found to be similar to recent estimates. The study identified novel risk factors for postoperative seizures through random forest analysis, creating a robust model with excellent sensitivity and specificity. Further validation of the model in an external population is needed.
NEUROCRITICAL CARE
(2022)
Article
Multidisciplinary Sciences
Parag N. Jain, Matthew Robertson, Javier J. Lasa, Lara Shekerdemian, Danielle Guffey, Yuhao Zhang, Krithika Lingappan, Paul Checchia, Cristian Coarfa
Summary: The study explored differential gene expression profiles in neonates with HLHS who develop LCOS after CPB, revealing significant changes in inflammatory and metabolic pathways. This opens up new possibilities for identifying potential therapeutic targets in this high-risk population.
SCIENTIFIC REPORTS
(2021)
Article
Cardiac & Cardiovascular Systems
Peng Gao, Yu Jin, Peiyao Zhang, Wenting Wang, Jinxiao Hu, Jinping Liu
Summary: This study investigated the association between nadir DO(2)i during cardiopulmonary bypass (CPB) and postoperative acute kidney injury (AKI) in low-weight infants undergoing cardiac surgery. The results suggested that in low-weight infants undergoing mild hypothermia during CPB, the critical DO(2)i for preventing AKI was 258 mL/min/m(2) in the hypothermia phase and 281 mL/min/m(2) for rewarming. It was also recommended to use an individualized critical DO(2)i threshold during CPB.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Yun-Wen Peng, Terry Major, Kristopher B. Deatrick, Azmath Mohammed, Mark Jeakle, John R. Charpie
Summary: Nicorandil demonstrates myocardial protection by attenuating IR-induced LV dysfunction associated with oxidative stress, inflammation, apoptosis, and organ injury. It should be further explored as a potential therapeutic strategy for limiting global IR injury during open-heart surgery in humans.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2022)
Article
Anesthesiology
Kristina Siemens, Beverley J. Hunt, Kiran Parmar, Dan Taylor, Caner Salih, Shane M. Tibby
Summary: This study evaluated the contribution of acquired factor XIII (FXIII) deficiency to clot strength in infants undergoing cardiac surgery and investigated the effect of fibrinogen concentrate supplementation on FXIII activity. The results showed that FXIII activity had a significant impact on clot strength, and fibrinogen concentrate supplementation increased FXIII activity and clot strength.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Medicine, General & Internal
Miroslaw Wilczynski, Michal Krejca, Piotr Stepinski, Marcin Rozalski, Jacek Golanski
Summary: In this study, the researchers aimed to investigate the relationship between platelet reactivity/activation and inflammatory markers in patients who underwent cardiopulmonary bypass surgery. They found that inflammatory markers CRP and TNF-alpha were strongly associated with platelet reactivity, and that high platelet reactivity correlated with a higher risk of post-operative rhythm disturbances and myocardial infarction.
ARCHIVES OF MEDICAL SCIENCE
(2023)
Article
Cardiac & Cardiovascular Systems
Marie Emeline Pierre Louis, Adnan Bhutta, Adrian Holloway, Peter Gaskin
Summary: This study aims to investigate the evolution of pulmonary artery hypertension after repair of complete atrioventricular canal defect and its association with Trisomy 21. The results show that the right ventricular pressure remains elevated after surgery and does not normalize within one year, suggesting sustained elevation in pulmonary vascular resistance.
CARDIOLOGY IN THE YOUNG
(2022)
Article
Pharmacology & Pharmacy
Praneeth Jarugula, Sarah Scott, Vijay Ivaturi, Andreas Noack, Brady S. Moffett, Adnan Bhutta, Jogarao V. S. Gobburu
Summary: Pharmacometrics plays a key role in individualizing pediatric pharmacotherapy, and the development of clinical decision support systems with easy-to-use interfaces is on the rise. Rigorous testing for predictive performance is crucial for these tools to successfully integrate into clinical practice. The article walks through the components of a decision support tool and the testing process using an example of a vancomycin dosing tool for pediatrics.
JOURNAL OF CLINICAL PHARMACOLOGY
(2021)
Article
Critical Care Medicine
Dayanand Bagdure, Cortney B. Foster, Nan Garber, Adrian Holloway, Jenni Day, Jessica Lee, Gerardo Soto-Campos, Nancy Brundage, Adnan Bhutta, Ana Lia Graciano
Summary: A retrospective study analyzed outcomes of children admitted to PICUs in the US with firearm injuries from 2009 to 2017. The study found that firearm injuries are a major cause of morbidity and mortality in children aged 1-18 years, with a high mortality rate observed among those attempting suicide with a firearm. Further research is needed to better understand the epidemiology of firearm injuries in children and develop interventions to prevent unnecessary deaths.
PEDIATRIC CRITICAL CARE MEDICINE
(2021)
Article
Multidisciplinary Sciences
Shazia S. Mohsin, Qalab Abbas, Devyani Chowdhary, Farah Khalid, Abdul Sattar Sheikh, Zuviya Ghazala Ali Khan, Nadeem Aslam, Omaima Anis Bhatti, Maha Inam, Ali Faisal Saleem, Adnan T. Bhutta
Summary: Analysis of MIS-C patients revealed a younger age group with higher mortality rate. MIS-C demonstrated distinct clinical features and outcomes compared to historical cohorts of KD and VM.
Review
Anesthesiology
Cheng Wang, Shuliang Liu, Fang Liu, Adnan Bhutta, Tucker A. Patterson, William Slikker
Summary: Nonhuman primate (NHP) models play a crucial role in studying developmental neurotoxicity induced by general anesthetics, contributing to a better understanding of potential neurotoxicity associated with pediatric general anesthetics despite being less commonly used compared to other animal models.
ANESTHESIA AND ANALGESIA
(2022)
Article
Pediatrics
Qalab Abbas, Adrian Holloway, Paula Caporal, Eliana Lopez-Baron, Asya Agulnik, Kenneth E. Remy, John A. Appiah, Jonah Attebery, Ericka L. Fink, Jan Hau Lee, Shubhada Hooli, Niranjan Kissoon, Erika Miller, Srinivas Murthy, Fiona Muttalib, Katie Nielsen, Maria Puerto-Torres, Karla Rodrigues, Firas Sakaan, Adriana Teixeira Rodrigues, Erica A. Tabor, Amelie von Saint Andre-von Arnim, Matthew O. Wiens, William Blackwelder, David He, Teresa B. Kortz, Adnan T. Bhutta
Summary: This study aims to bridge the gap in our understanding of the burden, etiology, resource utilization, and outcomes associated with pediatric acute and critical illness in resource-limited settings. It will provide crucial data to inform future research and clinical management decisions in order to improve global pediatric hospital outcomes.
FRONTIERS IN PEDIATRICS
(2022)
Article
Medicine, Research & Experimental
Muhammad M. Mohiuddin, Corbin E. Goerlich, Avneesh K. Singh, Tianshu Zhang, Ivan Tatarov, Billeta Lewis, Faith Sentz, Alena Hershfeld, Gheorghe Braileanu, Patrick Odonkor, Erik Strauss, Brittney Williams, Allen Burke, Jamie Hittman, Adnan Bhutta, Ali Tabatabai, Anuj Gupta, Todd Vaught, Lori Sorrells, Kasinath Kuravi, Amy Dandro, Will Eyestone, David J. Kaczorowski, David Ayares, Bartley P. Griffith
Summary: This study reports the survival of genetically engineered porcine cardiac xenografts in baboon recipients for almost 9 months. The selective multi-gene modifications significantly improve the survival of cardiac xenografts, offering hope for transplantation in humans.
XENOTRANSPLANTATION
(2022)
Review
Pediatrics
Teresa B. Kortz, Katie R. Nielsen, Rishi P. Mediratta, Hailey Reeves, Nicole F. O'Brien, Jan Hau Lee, Jonah E. Attebery, Emaan G. Bhutta, Carter Biewen, Alvaro Coronado Munoz, Mary L. DeAlmeida, Yudy Fonseca, Shubhada Hooli, Hunter Johnson, Niranjan Kissoon, Mara L. Leimanis-Laurens, Amanda M. McCarthy, Carol Pineda, Kenneth E. Remy, Sara C. Sanders, Yemisi Takwoingi, Matthew O. Wiens, Adnan T. Bhutta
Summary: The study aims to determine the burden of hospitalization and mortality associated with acute pediatric critical illness in low- and middle-income countries (LMICs) through a systematic review and meta-analysis of the literature. The findings will help inform resource allocation decisions and improve the management and outcomes of children with these conditions in LMICs.
FRONTIERS IN PEDIATRICS
(2022)
Article
Public, Environmental & Occupational Health
Yudy Fonseca, Evangelina Urbina, Adnan Bhutta
Summary: COVID-19 has become a pandemic that overwhelms even advanced health care systems. Implementing guidelines is challenging due to the variability in health care systems between countries and regions.
JOURNAL OF PUBLIC HEALTH IN AFRICA
(2022)
Article
Public, Environmental & Occupational Health
Madiha Q. Raees, Yamikani Chimalizeni, Alice W. Muiruri Liomba, Paul Pensulo, Montfort Benard Gushu, Andrew Tebulo, Albert Malenga, Michael J. Sikorski, Adrian J. Holloway, Adnan T. Bhutta, Allan Doctor, Kenneth E. Remy, Nicole F. O'Brien, Douglas G. Postels, Terrie E. Taylor
Summary: Pediatric critical care medicine (PCCM) in high-income countries focuses on specialized care for vulnerable pediatric patients, but global best practices are lacking. PCCM research and education can bridge this gap by developing evidence-based guidelines to reduce child mortality worldwide.
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
(2023)
Article
Medicine, Research & Experimental
Cheng Wang, Adnan Bhutta, Xuan Zhang, Fang Liu, Shuliang Liu, Leah E. Latham, John C. Talpos, Tucker A. Patterson, William Slikker
Summary: A study on neonatal nonhuman primates undergoing surgery found that ketamine administration increased cytokine levels and resulted in neuronal degeneration. This is significant for understanding the effects of ketamine on the developing brain.
EXPERIMENTAL BIOLOGY AND MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Tamara Kliot, Adrian Holloway, Katherine Spillman, Julianne Moss, Natalie Louise Davis, Abebech Ayalew, Adnan Bhutta, Yayehyirad Mekonnen Ejigu
Summary: This study shows that a remote didactic education curriculum can effectively increase nursing knowledge in cardiac critical care, with significant improvement and retention over a 12-month period. Virtual curriculum delivered via remote education is an affordable and effective method to enhance nursing knowledge, encouraging bidirectional learning and sharing of expertise for those limited by travel or financial constraints.
WORLD JOURNAL FOR PEDIATRIC AND CONGENITAL HEART SURGERY
(2023)
Meeting Abstract
Pediatrics
Amal Malik, Adnan Bhutta, Zunaira Zulfiqar, Farah Shahid, Muhammad I. Habib, Sanam Khan, Arsalan Rehman
Article
Pediatrics
Dayanand N. Bagdure, Jason W. Custer, Cortney B. Foster, William C. Blackwelder, Vladimir Mishcherkin, Allison Portenoy, Adnan Bhutta
Summary: In this study analyzing care of children undergoing cardiac surgery, it was found that there was a direct relationship between STS-EACTS risk category and death rate in both dedicated cardiac intensive care units and mixed intensive care units. Additionally, there was no significant difference in mortality rates between the two types of units within the same STS-EACTS risk categories. Ultimately, the type of unit (dedicated CICU or mixed unit) did not impact outcomes for children undergoing cardiac surgery.
JOURNAL OF PEDIATRIC INTENSIVE CARE
(2021)
Article
Pediatrics
Jason W. Custer, Shari Simone, Adnan T. Bhutta
Summary: The study found that videoconferencing is a feasible solution to safely conduct multidisciplinary rounds while maintaining social distancing, and participants found it effective without interfering with normal workflow. Staff members believed that using videoconferencing can improve rounding efficiency and team productivity, but it may also decrease resident and team education.
JOURNAL OF PEDIATRIC INTENSIVE CARE
(2021)