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1.
Artigo em Inglês | MEDLINE | ID: mdl-34593311

RESUMO

OBJECTIVE: This study aimed to compare the effects of nasal high-frequency oscillatory ventilation (NHFOV) and noninvasive positive-pressure ventilation (NIPPV) as the initial postextubation therapies on preventing extubation failure (EF) in high-risk infants younger than three months after congenital heart surgery (CHS). DESIGN: This was a single-center, randomized, unblinded clinical trial. SETTING: The study was performed in a teaching hospital. PARTICIPANTS: Between January 2020 and January 2021, a total of 150 infants underwent CHS in the authors' hospital. INTERVENTIONS: Infants younger than three months with a high risk for extubation failure who were ready for extubation were randomized to either an NHFOV therapy group or an NIPPV therapy group, and received the corresponding noninvasive mechanical ventilation to prevent EF. MEASUREMENTS: Primary outcomes were reintubation, long-term noninvasive ventilation (NIV) support (more than 72 hours), and the time in NIV therapy. The secondary outcomes were adverse events, including mild-moderate hypercapnia, severe hypercapnia, severe hypoxemia, treatment intolerance, signs of discomfort, unbearable dyspnea, inability to clear secretions, emesis, and aspiration. MAIN RESULTS: Of 92 infants, 45 received NHFOV therapy, and 47 received NIPPV therapy after extubation. There were no significant differences between the NHFOV and the NIPPV therapy groups in the incidences of reintubation, long-term NIV support, and total time under NIV therapy. No significant difference was found of the severe hypercapnia between the two groups, but NHFOV treatment significantly decreased the rate of mild-moderate hypercapnia (p < 0.05). Other outcomes were similar in the two groups. CONCLUSIONS: Among infants younger than three months after CHS who had undergone extubation, NIPPV therapy and NHFOV therapy were the equivalent NIV strategies for preventing extubation failure, and NHFOV therapy was more effective in avoiding mild-moderate hypercapnia.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34583855

RESUMO

OBJECTIVE: The primary objective of this study was to assess the effect of selective lobar blockade on the risk of hypoxemia during one-lung ventilation in pediatric patients undergoing thoracoscopic surgery. DESIGN: This was a retrospective matched case-control cohort study. SETTING: The study was performed in a teaching hospital. PARTICIPANTS: A total of 60 pediatric patients who underwent thoracoscopic surgery in the authors' hospital from March 2020 to March 2021 were analyzed. INTERVENTIONS: The authors examined their electronic medical records and found 30 patients in whom selective lobar blockade was used. These patients then were matched to 30 other patients in whom routine main bronchial blockade was performed in the authors' center based on age, weight, sex, side of surgery, and type of surgery. MEASUREMENTS AND MAIN RESULTS: The inclusion criteria were four-fold: (1) pediatric patients with scheduled thoracoscopic resection of the middle and lower lobe lesions; (2) no obvious anesthesia or surgical contraindications; (3) American Society of Anesthesiologists class I to II; and (4) age younger than one year old. The exclusion criteria were as follows: (1) pediatric patients whose trachea was intubated with a size less than 3.0 mm; (2) a difficult airway; (3) changes in ventilation patterns during surgery; and (4) severe pneumonia and respiratory and circulatory system dysfunction. The following patient data were collected: (1) general clinical information; (2) mean arterial blood pressure, heart rate, central venous pressure, airway peak pressure (Ppeak), oxygenation index (PaO2/FIO2 ratio), and alveolar-arterial oxygen differential pressure (AaDO2) at different time points; that is, before one-lung ventilation (OLV) (T1), ten minutes after OLV (T2), and ten minutes after the end of OLV (T3); (3) degree of lung collapse ten minutes after OLV; (4) operative duration; and (5) the prevalence of hypoxemia, the number of adjustments required for intraoperative displacement of the bronchial blocker, and pulmonary atelectasis. A total of 135 patients were selected, and 60 pediatric patients (30 in group S and 30 in group R) were included in this study. There were no significant differences in age, sex, weight, general preoperative data, degree of lung collapse, or operative duration (p > 0.05). The perioperative hemodynamics between the two groups were not statistically significant (p > 0.05). The oxygenation index, AaDO2, and Ppeak were not significantly different between the two groups at the T1 time point (p > 0.05). However, the oxygenation index was higher, and AaDO2 and Ppeak were lower in group S than in group R at the T2 and T3 time points (p < 0.05). The incidence of atelectasis, the prevalence of hypoxemia, and the number of adjustments required for intraoperative displacement of the bronchial blocker in group S were lower than those in group R (p < 0.05). CONCLUSION: Selective lobar bronchial blockade, using a bronchial blocker in pediatric thoracoscopic surgery, may represent an alternative to excluding the main bronchial blockade for patients undergoing middle and lower lobe procedures, which may improve intraoperative oxygenation and reduce postoperative atelectasis.

3.
Int J Qual Health Care ; 33(3)2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34490460

RESUMO

OBJECTIVE: The purpose of this study was to investigate the effect of using telemedicine to improve the quality of life of parents of infants with congenital heart disease (CHD) surgery after discharge. METHODS: A prospective randomized controlled study was conducted in a provincial hospital in China from November 2020 to April 2021 to compare the quality of life of parents of infants with CHD surgery after discharge between the WeChat follow-up group and the outpatient follow-up group. A total of 84 patients (42 in each group) and 168 parents (84 in each group) participated in this study. RESULTS: One month after discharge, the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores of parents in the intervention group were significantly lower than those in the control group (P < 0.05). Compared with the SAS and SDS scores at discharge, the scores of parents in the intervention group were significantly lower at 1 month after discharge (P < 0.05), while the scores of parents in the control group were similar at 1 month after discharge (P > 0.05). At discharge, in both the intervention group and the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P < 0.05). One month after discharge, in the control group, the SAS and SDS scores of the mothers were higher than those of the fathers (P < 0.05). One month after discharge, in the intervention group, the SAS and SDS scores of the mothers were similar to those of the fathers (P > 0.05). The comparison of the SAS and SDS scores of parents with different education levels showed that in both the intervention group and control group, the lower the parents' educational levels, the higher their SAS and SDS scores (P < 0.05). One month after discharge, in the control group, the lower the parents' education levels, the higher their SAS and SDS scores (P < 0.05). One month after discharge, in the intervention group, the SAS and SDS scores were similar among parents with different educational levels. The results of the World Health Organization Quality of Life Brief scale showed that the scores of the physiological, psychological, social and environmental fields at 1 month after discharge in the intervention group were significantly higher than those in the control group (P < 0.05). CONCLUSION: Providing health education and medical support to the parents of infants with CHD surgery after discharge via telemedicine can effectively relieve parents' anxiety and depression and improve their quality of life.


Assuntos
Cardiopatias Congênitas , Telemedicina , Ansiedade , Humanos , Lactente , Pais , Alta do Paciente , Estudos Prospectivos , Qualidade de Vida
4.
J Cardiothorac Surg ; 16(1): 266, 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34544460

RESUMO

BACKGROUND: To compare the short-term safety and efficacy of right anterolateral minithoracotomy (ALMT) and median sternotomy (MS) for the surgical treatment of atrial septal defects (ASDs). METHODS: The PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched for comparative studies focusing on surgical repair of ASDs via ALMT or MS published up to the end of April 27, 2020. We used random-effect or fixed-effect models to obtain pooled estimates. RESULTS: A total of 7 publications, including 665 patients (ALMT 296 and MS 369), were included. Age (WMD: 1.80 years, 95% CI 0.31-3.29), weight (WMD: - 0.91 kg, 95% CI - 5.57 to 3.75), sex distribution (OR: 1.00, 95% CI 0.74-1.35) and surgical type (patch or direct closure) (OR: 1.00, 95% CI 0.67-1.49) were comparable in the ALMT group and MS group. No significant differences in the success rate (OR 0.23; 95% CI 0.05-1.07) or severe complication rate (OR 1.46; 95% CI 0.41-5.22) were found between the ALMT group and the MS group. In addition, the differences in the cardiopulmonary bypass (CPB) time (WMD 6.33; 95% CI - 1.92 to 14.58 min, p = 0.13) and the operation time (WMD 5.23; 95% CI - 12.49 to 22.96 min, p = 0.56) between the ALMT group and the MS group were not statistically significant. However, the ALMT group had a significantly longer aortic cross-clamp time (2.37 min more, 95% CI 1.07-3.67 min, p = 0.0003). The intubation time was 1.82 h shorter (95% CI - 3.10 to - 0.55 h; p = 0.005), the intensive care unit (ICU) stay was 0.24 days shorter (95% CI - 0.44 to - 0.04 days; p = 0.02), and the postoperative hospital stay was 2.45 days shorter (95% CI - 3.01 to - 1.88 days; p < 0.00001) in the ALMT group than in the MS group. Furthermore, the incision length was significantly shortened by 8.97 cm in the ALMT group compared with the MS group (95% CI - 9.36 to - 8.58 cm; p < 0.00001). CONCLUSIONS: In the surgical treatment of ASD, ALMT and MS are equally safe and effective in terms of success rates and severe complication rates. The surgical procedures are equally difficult, but ALMT is associated with a faster functional recovery and better cosmetic results. Compared to MS, ALMT is the better choice for select ASD patients.

5.
J Card Surg ; 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477246

RESUMO

OBJECTIVE: To investigate the effect of music therapy on infants who underwent mechanical ventilation after cardiac surgery. METHODS: A prospective randomized controlled study was conducted in a provincial hospital in southeast China. The subjects were randomly divided into the music therapy (MT) group and the control group. Both groups were given standardized sedation treatment and routine nursing. Infants in the MT group received 60 min of MT three times a day. The sedation medication, Richmond sedation agitation scale (RASS) score, incidence of delirium, mechanical ventilation duration, length of cardiac intensive care unit (CICU) stay, restraint belt use time, and successful ventilation withdrawal rate were collected. RESULTS: Infants in the control group had a higher total amount of on-demand midazolam (p = .039). Infants in the MT group had a significantly lower incidence of delirium, shorter mechanical ventilation duration, and restraint band use time (p = .047, p = .046, and p = .038, respectively). Although infants in the MT group had a higher success rate of ventilation withdrawal, lower RASS scores, and shorter ICU stay, the difference was not statistically significant (p = .427, p = .585, and p = .068, respectively). CONCLUSION: MT in the ICU can reduce the use of on-demand sedative drugs, shorten mechanical ventilation, and reduce the occurrence of delirium in infants who underwent mechanical ventilation after cardiac surgery. MT is a safe and reliable treatment and worthy of clinical application.

6.
J Card Surg ; 36(11): 4134-4138, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34423474

RESUMO

OBJECTIVE: The objective of the present study is to explore the effect of different feeding intervals on the feeding outcomes of infants who underwent ventricular septal defect (VSD) closure. METHODS: This study is a prospective, randomized controlled trial conducted by a provincial hospital in China. According to different feeding intervals, 78 eligible participants were randomly divided into Group A (2-h interval, n = 39) and Group B (3-h interval, n = 39). The basic clinical data, total feeding time, incidence of feeding intolerance, and nurse job satisfaction scores of the two groups were collected. RESULTS: The total feeding time in Group A was significantly longer than that in Group B (142.5 ± 15.4 vs. 132.0 ± 16.1 min/d, p = .020). The nurse job satisfaction scores in Group A were significantly lower than those in Group B (101.7 ± 9.8 vs. 108.8 ± 10.1, p = .005). There were no significant differences in the duration of mechanical ventilation (3.7 ± 1.1 vs. 3.9 ± 1.0 d, p = .272), length of ICU stay (4.5 ± 1.1 d vs. 4.7 ± 0.9 d, p = .451), or length of hospital stay (13.2 ± 1.4 vs. 13.3 ± 1.0 d, p = .642) between the two groups. Although the incidence of feeding intolerance in Group A was slightly lower than that in Group B, the difference was not statistically significant. CONCLUSION: Feeding at an interval of 2 or 3 h has no significant effect on the feeding outcomes of infants, and feeding at intervals of 3 h can reduce nurses' workload and improve nursing job satisfaction.


Assuntos
Comunicação Interventricular , Comunicação Interventricular/cirurgia , Humanos , Lactente , Recém-Nascido , Tempo de Internação , Estudos Prospectivos , Respiração Artificial , Resultado do Tratamento
7.
J Cardiothorac Surg ; 16(1): 206, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34321062

RESUMO

BACKGROUND: To observe the effect of combining dexmedetomidine with sufentanil on postoperative analgesia in children who underwent transthoracic device closure of ventricular septal defects (VSDs) with ultrafast track anesthesia. METHODS: This was a retrospective study. Eighty-seven children who underwent transthoracic device closure of VSDs were retrospectively analyzed. Patients were divided into three groups based on the different drugs used for postoperative patient-controlled analgesia. RESULTS: No statistically significant differences in hemodynamic parameters were noted among the three groups after surgery (p > 0.05). The FLACC score in the SD2 group was significantly greater than those in the S groups and SD1 groups after surgery (p < 0.001). The Ramsay score in the S group was significantly lower than that of the SD1 and SD2 groups at 6 h (p < 0.001 and p = 0.003), 12 h (p = 0.002 and p = 0.012), and 24 h (p < 0.001 and p < 0.001) after surgery. The pressing frequency of the analgesic pump 48 h after the operation in the SD2 group was significantly greater than that in the other two groups (p < 0.05). The incidences of respiratory depression, nausea, and vomiting in the S group were significantly greater than those in the SD1 and SD2 groups (p < 0.05). CONCLUSION: The combination of 0.04 µg/kg/h dexmedetomidine and 0.04 µg/kg/h sufentanil intravenous analgesia was more effective than the other two analgesic strategies in children who underwent transthoracic device closure of ventricular septal defects (VSDs) with ultrafast track anesthesia.


Assuntos
Anestesia , Comunicação Interventricular , Analgesia Controlada pelo Paciente , Pré-Escolar , Dexmedetomidina , Feminino , Comunicação Interventricular/cirurgia , Humanos , Masculino , Dor Pós-Operatória/prevenção & controle , Estudos Retrospectivos , Sufentanil
8.
Cardiol Young ; : 1-4, 2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34325770

RESUMO

BACKGROUND: To explore the feasibility and superiority of applying the WeChat platform in a midterm follow-up of surgical repair for ventricular septal defects in infants. METHODS: Eighty-six infants with VSD who underwent surgical repair were divided into an outpatient follow-up group and a WeChat follow-up group. The clinical data, including complications, economic cost, time spent, loss to follow-up rate, and parents' satisfaction at the 3-month and 1-year follow-ups, were recorded and analysed. RESULTS: There was no significant difference in the incidence of post-operative complications between the two groups. Although the loss to follow-up rate in the WFU group was lower than that of the OFU group, the difference was not statistically significant. The economic cost and time spent in the 3 months and 1 year after discharge in the WFU group were significantly lower than those in the OFU group. One year after discharge, the PSQ-18 score of the WFU group was significantly higher than that of the OFU group. CONCLUSION: Compared with outpatient follow-up, the WeChat platform at the midterm follow-up after surgical repair of VSDs in infants has the advantages of saving time and economic costs and improves parents' satisfaction.

9.
Brain Res ; 1767: 147572, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34216581

RESUMO

Deep hypothermic circulatory arrest (DHCA) during heart surgery may induce neuroinflammation leading to neurocognitive dysfunction. Chlorogenic acid (CA) is a common phytochemical, which can attenuate neuroinflammation. Nevertheless, the underlying mechanism involved in the anti-inflammatory effect of CA after DHCA is unknown. The present study therefore characterized the anti-inflammatory functions of CA after DHCA using in vivo and in vitro DHCA models. The activation of microglia, inflammatory cytokine levels, and the NF-κB pathway were measured. The results showed that CA treatment ameliorated neurocognitive function and reduced the inflammatory cytokine levels in the brain and circulation. Furthermore, the microglial and NF-κB activations were suppressed after DHCA. CA exerted the same anti-inflammatory effect in hypothermia OGD microglial cells as the in vivo study. Additional studies indicated that the regulation of ubiquitin ligase activity of TRAF6 and RIP1 by CYLD was related to the mechanism involving inhibition of CA in the NF-κB pathway. Together, the results showed that CA may attenuate neuroinflammation after DHCA by modulating the signaling of CYLD/NF-κB.

10.
J Card Surg ; 36(10): 3690-3697, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34318543

RESUMO

OBJECTIVE: To investigate the effect of WeChat follow-up management of infants who underwent ventricular septal defect (VSD) repair on parents' disease knowledge and quality of life. METHODS: Participants were randomly assigned to an intervention group (n = 40) or a control group (n = 40). The intervention group was followed up with WeChat, while the control group was followed up using a traditional method. The disease knowledge, mental state, and quality of life of the two groups of parents were analyzed and compared. RESULTS: During the 3-month follow-up period, the PedSQL (PedsQL family impact module) results showed that the overall score in the intervention group was significantly higher than that in the control group. The parents in the intervention group were better at managing "emotion control," "worry," and "family communication" than those in the control group. The results of the LKQCHD (Leuven congenital heart disease knowledge questionnaire) showed that the parents in the intervention group had a higher mastery of "basic knowledge and treatment of congenital heart disease," "related complications," and "postoperative rehabilitation" than those in the control group. CONCLUSION: Knowledge education and psychological counseling for parents of children who underwent VSD repair through WeChat follow-up management can effectively improve parents' knowledge, relieve their anxiety and sadness, and improve their quality of life.


Assuntos
Comunicação Interventricular , Qualidade de Vida , Criança , Seguimentos , Comunicação Interventricular/cirurgia , Humanos , Lactente , Pais , Estudos Prospectivos
11.
Artigo em Inglês | MEDLINE | ID: mdl-34305078

RESUMO

OBJECTIVE: To investigate the safety and effectiveness of extraluminal placement of a bronchial blocker compared with carbon dioxide (CO2) artificial pneumothorax in infants undergoing video-assisted thoracoscopic surgery (VATS). METHODS: The study involved 33 infants (group A) who underwent one-lung ventilation (OLV) with extraluminal placement of a bronchial blocker and 35 other infants (group B) who underwent CO2 artificial pneumothorax. Clinical characteristics, the degree of lung collapse, and complications were compared. RESULTS: The degree of lung collapse in group A was significantly higher than that in group B at T2 and T3. The mean arterial pressure (MAP) of group B was significantly lower than that of group A at 10 min and 30 min after OLV. The partial pressure of carbon dioxide (PaCO2) of group B was significantly higher than that of group A at 30 min after OLV. The incidence of hypotension in group B was higher than that in group A. CONCLUSION: Compared with CO2 artificial pneumothorax, extraluminal placement of a bronchial blocker is associated with a better degree of lung collapse, fewer episodes of hypotension, and lower PaCO2 accumulation during OLV in infants undergoing VATS.

12.
J Cardiothorac Surg ; 16(1): 118, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33933112

RESUMO

OBJECTIVE: To study the effect of an early childhood education machine on sedation and analgesia in children after cardiothoracic surgery. METHODS: A prospective randomized controlled study was conducted in a provincial hospital in China. Fifty-two patients (aged from 1 to 5 years) underwent cardiothoracic surgery (including: ventricular septal defect, patent ductus arteriosus, atrial septal defect, pulmonary stenosis, pulmonary sequestration and congenital cystic adenomatoid lung malformation) were divided into the study group (n = 26) and the control group (n = 26). The patients in the study group underwent intervention with an early childhood education machine (uniform type) in addition to routine standard treatment and nursing, while the patients in the control group only received routine standard treatment and nursing. Richmond agitation sedation score (RASS) and face, legs, activity, cry, consolability (FLACC) score of all of the patients were evaluated, and the negative emotions (self-rating anxiety scale (SAS) score and self-rating depression scale (SDS) score) of the parents of the two groups were compared. RESULTS: There was no significant difference in the general clinical data between the two groups. The RASS and FLACC scores in the study group were significantly lower than those in the control group, and the SAS and SDS scores of the parents in the study group were significantly lower than those in the control group. CONCLUSION: The application of an early childhood education machine for children after cardiothoracic surgery can effectively reduce postoperative agitation, improve sedation and analgesia of the patients, and ease the pessimistic mood of the patients' parents.


Assuntos
Analgesia/métodos , Sequestro Broncopulmonar/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Malformação Adenomatoide Cística Congênita do Pulmão/cirurgia , Permeabilidade do Canal Arterial/cirurgia , Comunicação Interatrial/cirurgia , Comunicação Interventricular/cirurgia , Estenose da Valva Pulmonar/cirurgia , Anestesia , Pré-Escolar , China , Feminino , Hemodinâmica , Humanos , Lactente , Masculino , Dor , Manejo da Dor , Período Pós-Operatório , Estudos Prospectivos , Índice de Gravidade de Doença
13.
Cardiol Young ; : 1-5, 2021 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-34024301

RESUMO

OBJECTIVES: To investigate the safety and feasibility of midazolam for conscious sedation in transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography. METHODS: A retrospective analysis was performed on 55 patients who underwent transcatheter device closure of atrial septal defects from October, 2019 to May, 2020. All patients received intravenous midazolam and local anesthesia with lidocaine to maintain sedation. A group of previous patients with unpublished data who underwent the same procedure with general anesthesia was set as the control group. The relevant clinical parameters, the Ramsay sedation scores, the numerical rating scale, and the post-operative satisfaction questionnaire were recorded and analyzed. RESULTS: In the midazolam group, the success rate of atrial septal defect closure was 98.2%. Hemodynamic stability was observed during the procedure. None of the patients needed additional endotracheal intubation for general anesthesia. Compared with the control group, the midazolam group had no statistically significant differences in the Ramsay sedation score and numerical rating scale scores. Patients in the midazolam group experienced more post-operative satisfaction than those in the control group. CONCLUSIONS: Conscious sedation using midazolam is a safe and effective anesthetic technique for transcatheter device closure of atrial septal defects guided solely by transthoracic echocardiography.

14.
Heart Surg Forum ; 24(2): E249-E255, 2021 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-33798054

RESUMO

OBJECTIVE: This study aimed to evaluate the application of synchronized nasal intermittent positive pressure ventilation (SNIPPV) in the respiratory weaning of infants after congenital heart surgery. METHODS: We retrospectively analyzed the clinical data of 63 infants who were extubated from mechanical ventilation after congenital heart surgery between January 2020 and September 2020. The data, including demographics, anatomic diagnosis, radiology and laboratory test results, and perioperative variables were recorded. RESULTS: The extubation failure rate within 48 h after extubation was significantly lower in the SNIPPV group than in the nasal continuous positive airway pressure (NCPAP) group. The PaO2 level and PaO2/FiO2 ratio within 48 h after extubation were higher in the SNIPPV group than in the NCPAP group (P < .05). Meanwhile, the PaCO2 level within 48 h was significantly lower in the SNIPPV group (P < .05). Compared with the NCPAP group, the median duration of postoperative noninvasive support and the duration from extubation to hospital discharge were shorter in the SNIPPV group; the total hospital cost was lower in the SNIPPV group. No significant differences were observed between the two groups concerning VAP, pneumothorax, feeding intolerance, sepsis, mortality, and other complications (P > .05). CONCLUSION: SNIPPV was shown to be superior to NCPAP in avoiding reintubation after congenital heart surgery in infants and significantly improved oxygenation and reduced PaCO2 retention after extubation. Further studies are needed to confirm the efficacy and safety of SNIPPV as a routine weaning strategy.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Pressão Positiva Contínua nas Vias Aéreas/métodos , Cardiopatias Congênitas/cirurgia , Ventilação com Pressão Positiva Intermitente/métodos , Desmame do Respirador/métodos , Extubação/métodos , Feminino , Seguimentos , Humanos , Lactente , Masculino , Estudos Retrospectivos
15.
Heart Surg Forum ; 24(2): E299-E304, 2021 03 26.
Artigo em Inglês | MEDLINE | ID: mdl-33798056

RESUMO

OBJECTIVE: To explore the effects of music video therapy on pain among preschool children after cardiothoracic surgery. METHODS: Patients in the music video therapy (MVT) group received a 30-min music video intervention, while patients in the music therapy (MT) group received a 30-min musical intervention. Both groups were given their respective therapy three times a day for three days. Patients in the control group did not receive MVT or MV. Measures, including pain scores, vital signs (heart rate, mean arterial pressure, respiratory rate, and oxygen saturation), and other postoperative indicators were recorded and analyzed. RESULTS: The MVT group showed a statistically significant decrease in heart rate, mean arterial pressure, and respiratory rate at the first day after surgery and pain scores at the first and second day after surgery compared to the MT group, but no significant difference was identified in oxygen saturation. The postoperative indicators including cumulative capacity of sufentanil use, the length of intensive care unit (ICU) stay, and the length of hospital stay in the MVT group were significantly lower than those in the control group. CONCLUSION: The findings provide further evidence to support the practice of music video therapy as a non-pharmaceutical intervention to reduce postoperative pain, reduce  the dosage of analgesics, shorten the length of ICU and hospital stay in preschool children after the cardiothoracic surgery.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Musicoterapia/métodos , Medição da Dor/métodos , Dor Pós-Operatória/reabilitação , Pressão Sanguínea/fisiologia , Pré-Escolar , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Período Pós-Operatório
16.
Heart Surg Forum ; 24(2): E233-E238, 2021 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-33798062

RESUMO

BACKGROUND: To investigate the safety and efficacy of remifentanil combined with dexmedetomidine in fast-track cardiac anesthesia (FTCA) for transthoracic device closure of atrial septal defect (ASD) in pediatric patients. METHODS: A retrospective analysis was performed on 61 cases of children undergoing ASD closure through a small thoracic incision from January 2018 to January 2020. According to whether FTCA was administered, they were divided into group F (fast-track anesthesia, n = 31) and group R (routine anesthesia, n = 30). RESULTS: There was no significant difference in general preoperative data, perioperative hemodynamics, or postoperative pain scores between the 2 groups (P > .05). The postoperative sedation score of group F was higher than that of group R 1 and 4 hours after extubation. Meanwhile, duration of mechanical ventilation and length of postoperative intensive care unit (ICU) stay of group F were significantly shorter than those of group R (P < .05). No serious anesthesia-related complications occurred. CONCLUSION: Remifentanil combined with dexmedetomidine in FTCA for transthoracic device closure of ASD in pediatric patients is safe and effective, is worthy of clinical promotion, and can benefit more children.


Assuntos
Anestesia/métodos , Procedimentos Cirúrgicos Cardíacos/métodos , Dexmedetomidina/farmacologia , Comunicação Interatrial/cirurgia , Remifentanil/farmacologia , Dispositivo para Oclusão Septal , Analgésicos não Narcóticos/farmacologia , Analgésicos Opioides/farmacologia , Pré-Escolar , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos
17.
Cardiol Young ; : 1-4, 2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33883048

RESUMO

OBJECTIVE: This study explored the clinical effect of employing breast milk oral care for infants who underwent surgical correction of ventricular septal defect. METHODS: A prospective randomised controlled study was conducted in a provincial hospital between January, 2020 and July, 2020 in China. Patients were randomly divided into an intervention group (breast milk oral care, n = 28) and a control group (physiological saline oral care, n = 28). The intervention group was given oral nursing using breast milk for infants in the early post-operative period, and the control group was given oral nursing using physiological saline. Related clinical data were recorded and analysed. RESULTS: There were no significant differences in age, gender, weight, operation time, cardiopulmonary bypass time, or aortic cross-clamping time between the two groups. Compared with the physiological saline oral care group, the mechanical ventilation duration, the length of ICU stay in the breast milk oral care group were significantly shorter. The time of start feeding and total enteral nutrition were significantly earlier in the intervention group than those in the control group. The incidence of post-operative pneumonia in the breast milk oral care group was 3.6%, which was significantly lower than that of the physiological saline oral care group. CONCLUSION: The use of breast milk for oral care in infants who underwent surgical correction of VSD can reduce the incidence of post-operative pneumonia and promote the recovery of gastrointestinal function.

18.
J Card Surg ; 36(7): 2263-2268, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33811664

RESUMO

BACKGROUND: To evaluate the safety and effectiveness of remifentanil-based fast-track cardiac anesthesia (FTCA) combined with the postoperative serratus anterior plane block (SAPB) for transthoracic device closure of atrial septal defect (ASD) in pediatric patients. METHODS: A total of 70 children who underwent transthoracic device closure of ASDs from January 2018 to June 2020 were divided into two groups according to different anesthesia strategies administered, namely group F (fast-track anesthesia, n = 38) and group R (routine anesthesia, n = 32), and relevant clinical data were collected and analyzed. RESULTS: There was no statistically significant difference between the two groups in general preoperative data, intraoperative hemodynamics, and FLACC score 1 h after extubation (p > .05). FLACC score of Group F was significantly lower than that of group R at 4, 8, 12, and 24 h after extubation (p < .05). The number of postoperative PCA press and the dose of PCA infusion in group F were lower than those in group R (p < .05). The mechanical ventilation duration, the length of intensive care unit stay in group F were statistically significantly lower than those in group R (p < .05). CONCLUSION: Remifentanil-based FTCA combined with the postoperative SAPB for transthoracic device closure of ASD in pediatric patients could effectively reduce postoperative pain of the children.


Assuntos
Anestesia em Procedimentos Cardíacos , Comunicação Interatrial , Bloqueio Nervoso , Criança , Comunicação Interatrial/cirurgia , Humanos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Remifentanil , Resultado do Tratamento
19.
J Card Surg ; 36(7): 2308-2313, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33811684

RESUMO

OBJECTIVES: To observe the effect of music video (MV) therapy on early postoperative pain in preschool children after cardiothoracic surgery. METHODS: 116 preschool children undergoing cardiothoracic surgery were randomly divided into the MV and control groups from June 2019 to March 2020. The related vital signs parameters, the Wong-Baker FACES pain rating scale, the FLACC scale, the number of postoperative PCA press and the cumulants of sufentanil use were recorded and analyzed. RESULTS: There were no statistically significant differences in general characteristics and preintervention data between the two groups. However, there were significantly lower in the heart rate, mean arterial pressure, respiratory rate, the number of postoperative PCA press, and the dosage of sufentanil in the MV group than those in the control group after the intervention. The Wong-Baker FACES and FLACC scales in the MV group were significantly lower than those in the control group at the time point of immediately after the first intervention, 1 day, and 2 days after the intervention. The two pain scores showed a downward trend over time, and the corresponding scores in the MV group were better than those in the control group. CONCLUSION: MV therapy can be an effective nonpharmaceutical intervention in the clinical to relieve children's postoperative pain after cardiothoracic surgery.


Assuntos
Analgesia , Musicoterapia , Música , Pré-Escolar , Humanos , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle
20.
Int J Qual Health Care ; 33(2)2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33835158

RESUMO

OBJECTIVE: During the COVID-19 pandemic, parents of infants having medical problem face challenges of insufficient medical resources at home. The purpose of this study was to investigate the effect of WeChat-based telehealth services on the preoperative follow-up of infants with congenital heart disease (CHD) during the COVID-19 pandemic. METHODS: This study retrospectively analyzed the medical records of 190 infants with CHD who underwent remote follow-up via WeChat from December 2019 to May 2020 in Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University. In addition, the psychological benefits of WeChat on the parents of these infants were analyzed. RESULTS: In total, 190 infants were involved in this study, including 72 cases of ventricular septal defects, 42 cases of patent ductus arteriosus, 55 cases of atrial septal defects, 3 cases of tetralogy of Fallot, 2 cases of endocardial cushion defects, 12 cases of pulmonary stenosis, 2 cases of total anomalous pulmonary venous connection and 2 cases of aortic arch constriction. During the follow-up period, 48 infants who received surgical indications were hospitalized in time for surgical treatment. It was recommended that 10 infants with respiratory tract infections be treated in local hospitals through the WeChat platform. We provided feeding guidance to 28 infants with dysplasia through the WeChat platform. The psychological evaluation results of parents showed that the median score and range of Self-Rating Depression Scale scores were 42 and 32-58, respectively. Nine parents (4.7%) were clinically depressed, while the majority had mild depression. The median score and range of Self-Rating Anxiety Scale scores were 44 and 31-59, respectively. Twenty parents (10.5%) had clinical anxiety, while the rest had mild anxiety. CONCLUSION: During the COVID-19 pandemic, follow-up management and health services for infants with CHD prior to surgery through the WeChat platform were useful in identifying the state of an infant's condition as well as in identifying and relieving care pressure, anxiety and depression in the parents.


Assuntos
Cardiopatias Congênitas/cirurgia , Pais/educação , Pais/psicologia , Telemedicina/métodos , Adulto , COVID-19/prevenção & controle , China/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Consulta Remota , Estudos Retrospectivos , SARS-CoV-2 , Mídias Sociais
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