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COVID-19 Related Myocarditis and Stroke in Children: Spared but not Safe

Sahulee, Raj
ORIGINAL:0014946
ISSN: 2674-2489
CID: 4819802

Arterial Ischemic Stroke as an Unusual First Manifestation of Parvovirus B19 Myocarditis in an Infant

Bhansali, Suneet A; Sahulee, Raj
ORIGINAL:0014796
ISSN: 2572-9292
CID: 4627632

Safety Checklist Implementation Did Not Reduce Central Venous Catheter Duration in Pediatric Cardiac ICU Patients

Sahulee, Raj; Ramirez, Michelle M; Al-Qaqaa, Yasir M; Chakravarti, Sujata B; McKinstry, Jaclyn
The Center for Disease Control recommends prompt removal of nonessential central venous catheters (CVCs) to reduce the risk for central line-associated bloodstream infections. Safety checklists have been trialed to reduce nonessential CVC days, but pediatric studies are lacking. Our specific aim was to detect >10% reduction in mean CVC duration after implementation of a safety checklist addressing CVCs in our unit.
PMCID:7056290
PMID: 32190798
ISSN: 2472-0054
CID: 4352882

The Prevalence of Congenital Anomalies of the Airway or Lung in Infants with Hypoplastic Left Heart Syndrome and Differences in Midterm Outcomes: A National Pediatric Cardiology Quality Improvement Collaborative Registry Analysis

Sahulee, Raj; Singh, Rakesh K; Pasternack, Daniel M
Infants with single ventricle physiology and congenital anomalies of the airway and/or lung are potentially poor candidates for staged palliation. The prevalence and midterm outcomes for patients with anomalies of the airway or lung with hypoplastic left heart syndrome are unknown. We performed an analysis of data in infants with hypoplastic left heart syndrome from the National Pediatric Cardiology Quality Improvement Collaborative registry. The prevalence of congenital anomalies of the airway or lung in the registry was determined. Clinical characteristics and midterm outcomes were compared between infants with hypoplastic left heart syndrome with and without anomalies of the airway or lung. Fifty-seven (2.3%) of 2467 infants with hypoplastic left heart syndrome enrolled in the registry had congenital airway or lung anomalies. Infants congenital anomalies of the airway or lung had significantly lower transplant-free survival at 1 year (49.5 vs 77.2%, p < 0.001). Infants with airway or lung anomalies had longer combined hospital length of stay for stage 1 and stage 2 palliation (102 vs 65.1 days, p < 0.001) and underwent more major procedures (2.04 vs 0.93 procedures, p < 0.001) than those without. There was no difference in the number of interstage readmissions (1.85 vs 1.89, p = 0.87) or need for non-oral feeding supplementation (71.4 vs 54.5%, p = 0.12) between groups. Infants enrolled in the National Pediatric Cardiology Quality Improvement Collaborative registry with hypoplastic left heart syndrome and anomalies of the airway or lung have increased morbidity and mortality at 1 year compared to those with hypoplastic left heart syndrome alone.
PMID: 35731252
ISSN: 1432-1971
CID: 5281982

Elevated Levels of Urinary Biomarkers TIMP-2 and IGFBP-7 Predict Acute Kidney Injury in Neonates after Congenital Heart Surgery

Ramírez, Michelle; Chakravarti, Sujata; Busovsky-McNeal, Melissa; McKinstry, Jaclyn; Al-Qaqaa, Yasir; Sahulee, Raj; Kumar, T K Susheel; Li, Xiaochun; Goldberg, Judith D; Gefen, Ashley M; Malaga-Dieguez, Laura
PMCID:9208843
PMID: 35734207
ISSN: 2146-4618
CID: 5282022

Surgical palliation for an infant with hypoplastic left heart syndrome and congenital lobar emphysema: a case report

Pham, ST; Sahulee, Raj
ORIGINAL:0014945
ISSN: 2692-9759
CID: 4819792

The Use of the Biomarker Procalcitonin in Pediatric Cardiovascular Disorders

Sahulee, Raj; McKinstry, Jaclyn; Chakravarti, Sujata B
ORIGINAL:0014244
ISSN: 2167-4841
CID: 4038862

Atrioventricular block after congenital heart surgery: Analysis from the Pediatric Cardiac Critical Care Consortium

Romer, Amy J; Tabbutt, Sarah; Etheridge, Susan P; Fischbach, Peter; Ghanayem, Nancy S; Reddy, Vadiyala Mohan; Sahulee, Raj; Tanel, Ronn E; Tweddell, James S; Gaies, Michael; Banerjee, Mousumi; Retzloff, Lauren; Zhang, Wenying; Patel, Akash R
OBJECTIVES/OBJECTIVE:Our primary aims were to describe the contemporary epidemiology of postoperative high-grade atrioventricular block (AVB), the timing of recovery and permanent pacemaker (PPM) placement, and to determine predictors for development of and recovery from AVB. METHODS:Patients who underwent congenital heart surgery from August 2014 to June 2017 were analyzed for AVB using the Pediatric Cardiac Critical Care Consortium registry. Predictors of AVB with or without PPM were identified using multinomial logistic regression. We used these predictors to model the probability of PPM for the subgroup of patients with intraoperative complete AVB. RESULTS:We analyzed 15,901 surgical hospitalizations; 422 (2.7%) were complicated by AVB and 162 (1.0%) patients underwent PPM placement. In patients with transient AVB, 50% resolved by 2 days, and 94% resolved by 10 days. In patients who received a PPM, 50% were placed by 8 days and 62% were placed by 10 days. Independent risk factors associated with PPM compared with resolution of AVB were longer duration of cardiopulmonary bypass (relative risk ratio, 1.04; P = .023) and a high-risk operation (relative risk ratio, 2.59; P < .001). Among patients with complete AVB originating in the operating room, those with the highest predicted probability of PPM had a PPM placed only 77% of the time. CONCLUSIONS:In this cohort, postoperative AVB complicated almost 3% of congenital heart surgery cases and 1% of patients underwent PPM placement. Because almost all patients (94%) with transient AVB had resolution by 10 days, our results suggest there is limited benefit to delaying PPM placement beyond that time frame.
PMID: 30917883
ISSN: 1097-685x
CID: 3764242

[S.l.] : American Association for Thoracic Surgery, 2018

Post-operative heart block following congenital heart surgery: analysis from the Pediatric Cardiac Critical Care Consortium

Romer, Amy; Tabbutt, Sarah; Etheridge, Susan; Fischbach, Peter; Ghanayem, Nancy; Reddy, V Mohan; Sahulee, Raj; Tanel, Ronn; Twedell, James; Gaies, Michael; Retzloff, Lauren; Zhang, Wenying; Patel, Akash
(Website)
CID: 3132022

Donor predictors of allograft utilization for pediatric heart transplantation

Khan, Asma M; Green, Robert S; Lytrivi, Irene D; Sahulee, Raj
Pediatric heart transplantations are limited by the supply of donor allografts. We sought to determine the cardiac allograft utilization rate for pediatric donors and identify donor factors that predict graft use for transplantation. The United Network for Organ Sharing deceased donor database was queried from April 30, 2006, to March 31, 2014. Donor risk factors that might affect graft use for cardiac transplantation were evaluated. The pediatric cardiac graft utilization rate was calculated, and logistic regression modeling was performed to determine the relationship of risk factors with graft use for transplantation. During the study period, 6682 eligible cardiac donors <18 years of age were identified, and 3758 (56.2%) grafts were utilized for transplantation. Grafts from male donors (OR 1.181) were significantly associated with graft utilization. Graft donor age >1 year (OR 0.363), non-O blood type (OR 0.586), CDC 'high-risk' donor status (OR 0.676), use of inotropes (OR 0.718), use of >2 inotropes (OR 0.328), and donor left ventricular ejection fraction <50% (OR 0.045) were significantly associated with graft nonutilization. The pediatric cardiac allograft utilization rate and risk factors for graft use for transplantation have been identified. Additional studies will be needed to assess the donor-recipient relationship on pediatric transplant outcomes.
PMID: 27542078
ISSN: 1432-2277
CID: 2782472