1
|
Schullerer D, Schurter D, Meinhold A, Paal S, Staubli S, Bichsel I, Dave H, Cesnjevar R, Schweiger M. Safety issues with an inter-hospital transport of a patient with a Berlin Heart Excor biventircular assist device. Artif Organs 2023; 47:582-588. [PMID: 36356800 DOI: 10.1111/aor.14455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/26/2022] [Accepted: 11/02/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Interhospital transfers of pediatric patients on the Berlin Heart Excor have been published on an occasional basis. METHODS Nowadays medicine evolves away from just feasibility towards quality and safety issues. Management tools like risk analysis have found their way into clinical practice. RESULTS Exemplary, we present a case of a 20 months old boy on a Berlin Heart BiVAD Excor who underwent a 224 km ground transport. After a systematic review of the published literature, we describe our safety management with the aim was to provide highest quality of care for the transport. CONCLUSION Besides a risk analysis, we also describe our training and simulation protocol.
Collapse
Affiliation(s)
| | - David Schurter
- Schutz & Rettung Zurich, Ambulance Service, Zurich, Switzerland
| | - Anke Meinhold
- Paediatric Cardiac Intensive Care, University Children's Hospital, Zurich, Switzerland
| | - Sebastian Paal
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
| | - Susanne Staubli
- Visualisation, University Children's Hospital, Zurich, Switzerland
| | - Isabelle Bichsel
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
| | - Hitendu Dave
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
| | - Robert Cesnjevar
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
| | - Martin Schweiger
- Children's Heart Centre, University Children's Hospital, Zurich, Switzerland
| |
Collapse
|
2
|
Quandt D, Callegari A, Niesse O, Meinhold A, Dave H, Knirsch W, Kretschmar O. Balloon angioplasty and stent implantation within 30 days postcongenital heart surgery (CHS) in children. J Card Surg 2022; 37:4606-4611. [PMID: 36273426 DOI: 10.1111/jocs.17057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/17/2022] [Accepted: 10/02/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES This study aims to assess balloon angioplasty (BAP) and stent implantation (SI) procedures early after congenital heart surgery (CHS) in children. BACKGROUND These interventions are considered potential high-risk procedures and often avoided or postponed. METHODS This is a retrospective, single centre study of all BAP and SI procedures within 30 days after CHS (01/2001 until 01/2021). RESULTS A total of 127 (96 SI, 31 BAP) procedures were performed in 104 patients at median 6.5 days (interquartile range: 1-15) after CHS. Balloon-to-stenosis ratio and balloon-to-reference vessel ratio were significantly smaller compared to stent-to-stenosis ratio and stent-to-reference vessel ratio (p < .001 and p = .005). There was a greater rise in absolute vessel diameter, greater rise in vessel diameter in relation to the stenosis and vessel diameter in relation to the reference vessel with SI (p < .001, p = .01, and p < .001). Up to 94% SIs fulfilled both success criteria (increase of vessel diameter ≥50% of minimal vessel diameter or achievement ≥75% of the reference vessel diameter). Major adverse events were more frequent in the BAP group (p = .05). Intraprocedural complications were 5/31 (16%) in the BAP group and 13/96 (13%) in the SI group (p = .77). CONCLUSION BAP and SI procedures within 30 days post-CHS can be performed safely, with a greater stent-to-stenosis ratio and a greater rise in vessel diameter with stent implantation.
Collapse
Affiliation(s)
- Daniel Quandt
- Division of Pediatric Cardiology, Pediatric Heart Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Alessia Callegari
- Division of Pediatric Cardiology, Pediatric Heart Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Oliver Niesse
- Division of Pediatric Cardiology, Pediatric Heart Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Anke Meinhold
- Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Zurich, Zurich, Switzerland
| | - Hitendu Dave
- Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Department of Congenital Cardiothoracic Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | - Walter Knirsch
- Division of Pediatric Cardiology, Pediatric Heart Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Oliver Kretschmar
- Division of Pediatric Cardiology, Pediatric Heart Centre, University Children's Hospital Zurich, Zurich, Switzerland.,Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| |
Collapse
|
3
|
Quandt D, Callegari A, Niesse O, Christmann M, Meinhold A, Dave H, Knirsch W, Kretschmar O. Early Cardiac Catheterizations within 30 Days Post Congenital Heart Surgery in Children. CONGENIT HEART DIS 2022. [DOI: 10.32604/chd.2022.022401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
4
|
Thomas J, Corson NI, Meinhold A, Both CP. Neurological excitation in a 6-week-old male infant after morphine overdose. Paediatr Anaesth 2019; 29:1060-1061. [PMID: 31433900 DOI: 10.1111/pan.13723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/16/2019] [Accepted: 08/19/2019] [Indexed: 11/30/2022]
Abstract
While respiratory depression is a known complication of morphine overdose, the neuro-excitatory side effect of the morphine metabolite morphine-3-glucuronide is less widely known. Here, we report the case of an infant with neurological excitation after morphine overdose. The neuro-excitation in this infant was probably induced by an elevated morphine-3-glucuronide concentration.
Collapse
Affiliation(s)
- Jörg Thomas
- Department of Anesthesia, University Children´s Hospital, Zurich, Switzerland
| | - Nils I Corson
- Department of Anesthesia, University Insel Hospital, Bern, Switzerland
| | - Anke Meinhold
- Intensive Care Unit, University Children´s Hospital, Zurich, Switzerland
| | - Christian P Both
- Department of Anesthesia, University Children´s Hospital, Zurich, Switzerland
| |
Collapse
|