PurposeThere is a close relationship between the intestinal microbiota and heart failure, but no study has assessed this relationship in infants with congenital heart disease. This study aimed to explore the relationship between heart failure and intestinal microbiota in infants with congenital heart disease.MethodsTwenty-eight infants with congenital heart disease with heart failure admitted to a provincial children’s hospital from September 2021 to December 2021 were enrolled in this study. A total of 22 infants without heart disease and matched for age, sex, and weight were selected as controls. Faecal samples were collected from every participant and subjected to 16S rDNA gene sequencing.ResultsThe composition of the intestinal microbiota was significantly disordered in infants with heart failure caused by congenital heart disease compared with that in infants without heart disease. At the phylum level, the most abundant bacteria in the heart failure group were Firmicutes, Actinobacteria, Proteobacteria, and Bacteroidetes, and the most abundant bacteria in the control group were Firmicutes, Proteobacteria, Actinobacteria, and Bacteroidetes. At the genus level, the most abundant bacteria in the heart failure group were Enterococcus, Bifidobacterium, Subdoligranulum, Shigella, and Streptococcus, and the most abundant bacteria in the control group were Bifidobacterium, Blautia, Bacteroides, Streptococcus, and Ruminococcus. The alpha and beta diversities of the gut bacterial community in the heart failure group were significantly lower than those in the control group (p<0.05). Compared with the control group, retinol metabolism was significantly downregulated in the heart failure group.ConclusionHeart failure in infants with congenital heart disease caused intestinal microbiota disorder, which was characterised by an increase in pathogenic bacteria, a decrease in beneficial bacteria, and decreases in diversity and richness. The significant downregulation of retinol metabolism in the intestinal microbiota of infants with heart failure may be related to the progression of heart failure, and further study of the underlying mechanism is needed.

Objective: To explore the changes in the absolute value and decline rate of early serum cTnT and NT-proBNP in neonates who underwent V-A ECMO support therapy within one week of birth. Methods: Clinical data and laboratory test results of 17 neonates who underwent V-A ECMO support therapy within one week of birth from January 2020 to January 2023 were retrospectively collected from the electronic medical record system. The patients were divided into the survival group and the death group. The absolute values and decline rate of cTnT and NT-proBNP were compared between the two groups on the day, 24, 48, and 72 hours after ECMO treatment. Result: Of the 17 neonates, 10 survived, and 7 died, with a survival rate of 58.8%. The absolute values of cTnT and NT-proBNP in the survival group were significantly lower than those in the death group, and the decline rate was significantly higher than in the death group. In this study, neonates with no early decline in cTnT and NT-proBNP were all in the death group. Conclusion: The changes in the absolute value and decline rate of early serum cTnT and NT-proBNP in neonates who underwent V-A ECMO may predict their prognosis.

Objective Extracorporeal membrane oxygenation (ECMO) has been increasingly used for severe neonatal respiratory failure refractory to conventional treatments. This paper summarized our operation experience of neonatal ECMO via cannulation of the internal jugular vein and carotid artery. Methods The clinical data of 12 neonates with severe respiratory failure who underwent ECMO via internal jugular vein and carotid artery in our hospital from January 2021 to October 2022 were collected. Results All the neonates were successfully operation. The size of arterial intubation was 8 F, the size of venous intubation was 10 F. The operation time was 29 (22–40) minutes. ECMO was successfully removed in 8 neonates. They were successfully reconstructed the internal jugular vein and carotid artery. Arterial blood flow was unobstructed in 5 patients, mild stenosis in 2 patient, moderate stenosis in 1 patient. Venous blood flow was unobstructed in 6 patients, mild stenosis in 1 patient, and moderate stenosis in 1 patient. The complications were as follows: 1 case had poor neck incision healing after ECMO removing. No complications such as incisional bleeding, incisional infection, catheter-related blood infection, cannulation accidentally pulling away, vascular laceration, thrombosis, cerebral hemorrhage, cerebral infarction, and hemolysis occurred in all the patients. Conclusion Cannulation of the internal jugular vein and carotid artery can quickly establish an effective ECMO access for neonates with severe respiratory failure. Careful, skilled and delicate operation was essential. In addition, during the cannulation process, we should pay special attention to the position of cannulation, firm fixation and strict aseptic operation.