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Keywords = Pediatrics

  • Open Access Research Article
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    Trends Journal of Sciences Research 2019, 4(1), 9-13. http://doi.org/10.31586/CriticalCare.0401.02
    23 Views 77 Downloads PDF Full-text (654.248 KB) PDF Full-text (654.091 KB)  HTML Full-text
    Abstract
    Introduction: Acute hyperthermia is a common complication in the first 24 hours after open heart surgery with the incidence of 12% to 73%. The aim of this study was to evaluate the efficiency of postoperative peritoneal dialysis for controlling acute hyperthermia in pediatrics undergoing on-pump heart surgery. Methods:
    [...] Read more.
    Introduction: Acute hyperthermia is a common complication in the first 24 hours after open heart surgery with the incidence of 12% to 73%. The aim of this study was to evaluate the efficiency of postoperative peritoneal dialysis for controlling acute hyperthermia in pediatrics undergoing on-pump heart surgery. Methods: We reviewed clinical outcomes of 40 infants who underwent congenital surgery from August 2016 to August 2017. Patients were divided into two groups in terms of peritoneal dialysis requirement as group A and B. Demographic data, intraoperative and postoperative variables were compared between the patients. Results: Among the 40 high risk infants who underwent cardiac surgery, 20 patients were treated with peritoneal dialysis (group A). Mean rectal temperature and incidence of acute hyperthermia in 24h after surgery were higher in group A compared to group B (p ˂ 0.05). Infants in group A were younger, lighter and showed lower BSA compare to group B (p < 0.05). Also, higher concentration of serum potassium and lower urinary output were seen in group A compared to group B (p = 0.05). The incidence of neurological events was significantly higher in patients of group A (p < 0.05). Intubation time and intensive care unit stay was significantly more prolonged in the group A with peritoneal dialysis (p ˂ 0.05). Conclusion: Peritoneal dialysis performance was effective in treatment of induced hyperthermia in the first 24 h after operation. Indeed, younger age and lighter weight children are more prone to postoperative complication related to cardiopulmonary bypass surgery.  Full article
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    References
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    Baskin E, et al. Acute renal failure and mortality after open-heart surgery in infants. Ren Fail. 2005; 27(5):557-560.
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    Seghaye MC, Grabitz RG, Duchateau J, Busse S, Dabritz S, KochD, et al.Inflammatory reaction and capillary leak syndrome related to cardiopulmonary bypass inneonates undergoing cardiac operations. J Thorac Cardiovasc Surg. 1996;112(3):687-697.
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    Alkan T, et al. Postoperative prophylactic peritoneal dialysis in neonates and infants aftercomplex congenital cardiac surgery. ASAIO J. 2006; 52(6):693-697.
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    Stratman RC, Flynn JD, Hatton KW. Malignant hyperthermia: a pharmacogeneticDisorder. Orthopedics. 2009;32(11):
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    Metterlein T, Zink W, Kranke E, Haneya A, Graf B, Kranke P. Cardiopulmonarybypass in malignant hyperthermia susceptible patients: a systematic review of published cases. J Thorac Cardiovasc Surg. 2011;141(6):1488-1495.
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    Villasis-Keever MA, Zapata-Arenas DM, Penagos-Paniagua MJ.Frequency of postoperative fever in children with congenital heart disease undergoing cardiovascular surgery and associated risk factors. Rev Esp Cardiol. 2002;55(10):1063-1069.
    [8]
    Gupta AK, Singh VK, Varma A. Approach to postoperative fever in pediatric cardiac Patients. Ann Pediatr Cardiol. 2012;5(1):61-68.
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    Clark JA, Bar-Yosef S, Anderson A, Newman MF, Landolfo K, Grocott HP. Postoperative hyperthermia following off-pump versus on-pump coronary artery bypass Surgery. J Cardiothorac Vasc Anesth. 2005;19(4):426-429.
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    Thong WY, Strickler AG, Li S, Stewart EE, Collier CL, Vaughn WK, et al. Hyperthermia in the forty-eight hours after cardiopulmonary bypass. Anesth Analg. 2002;95(6):1489-1495.
    [11]
    Chan KL, et al. Peritoneal dialysis after surgery for congenital heart disease in infants and young children. Ann Thorac Surg. 2003; 76(5):1443-1449.
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    Bynum G, Patton J, Bowers W, Leav I, Hamlet M, Marsili M, et al. Peritoneal lavage cooling in an anesthetized dog heatstroke model. Aviat Space Environ Med. 1978;49(6):779-784.
    [13]
    Laffey JG, Boylan JF, Cheng DC. The systemic inflammatory response to cardiac surgery: implications for the anesthesiologist. Anesthesiology. 2002;97(1):215-252.
    [14]
    Boigner H, et al. Predictors of mortality at initiation of peritoneal dialysis in children after cardiac surgery. Ann Thorac Surg. 2004;77(1):61-65.
  • Open Access Research Article
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    Trends Journal of Sciences Research 2019, 4(4), 141-147. http://doi.org/10.31586/Urology.0404.02
    8 Views PDF Full-text (808.740 KB)  HTML Full-text
    Abstract
    Introduction: Hypospadias repair is a challenging technique in pediatric urology with a long learning curve. This study presents the results of urethroplasty performed by a single surgeon to repair hypospadias in children and compares the surgical outcomes at different periods. Materials and Methods: From January 2009 to February 2016, patients
    [...] Read more.
    Introduction: Hypospadias repair is a challenging technique in pediatric urology with a long learning curve. This study presents the results of urethroplasty performed by a single surgeon to repair hypospadias in children and compares the surgical outcomes at different periods. Materials and Methods: From January 2009 to February 2016, patients who were less than 18 years old and were operated for hypospadias were retrospectively reviewed and divided into two groups: group I (from January 2009 to February 2012) and group II (from March 2012 to February 2016). All operations were performed by the same pediatric surgeon, and surgical outcomes of the two periods were compared. Results: This study considered150 patients (69 in group I/81 in group II). The Mean operative age was 30.4±32.7 months in group I and 33.6±43.3 months in group II(p=0.309). The selected procedures mainly depended on the subjective anatomical analysis in the operating room and the surgeon’s preference. The mean follow-up duration was 21.7±28.31 months in group I and 13.6±16.6 months in group II (p=0.033).The overall complication rate was 44.9% in group I and 35.8% in group II (p=0.316). The incidence of glanular disruption significantly decreased from 21.7% to 6.2% (p=0.007) because of the wide dissection of the glanular wings and the deep incision of the urethral plate, which led to tension-free sutures for glanular reconstruction. Conclusions: One-stage repair of hypospadias may achieve satisfactory outcomes in cosmetic appearance and voiding function. Surgical outcomes could be improved by increasing practice.  Full article
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    References
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    Saafan HA. Two stage repair of proximal hypospadias: review of 33 cases. Ann Ped Surg 2010;6:89-92.
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    Sozubir S, Snodgrass W. A new algorithm for primary hypospadias repair based on tip urethroplasty. J Pediatr Surg 2003;38:1157-61.
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    Snodgrass W, Bush N. Tubularized incised plate proximal hypospadias repair: continued evolution and extended applications. J Pediatr Urol 2011;7: 2-9.
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    Snodgrass W, Macedo A, Hoebeke P, Mouriquand PDE. Hypospadias dilemmas: a round table. J Pediatr Urol 2011;7: 145-57.
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