Histidine-tryptophan-ketoglutarate solution decreases mortality and morbidity in high-risk patients with severe pulmonary arterial hypertension associated with complex congenital heart disease: an 11-year experience from a single institution

Li, X.W.; Lin, Yanjie; Lin, Haifeng; Huang, Jingyue; Tang, Xian‐Ming; Long, Xiao; Lu, Wei-jun; Wen, Zhaoke; Liang, Jian; Li, D.Y.; Zhao, Xiaofang

doi:10.1590/1414-431x20165208

Cited by 5 publications

(1 citation statement)

References 19 publications

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“…Considering more severe patients and prolonged aortic clamping periods, a non-randomized Chinese study, published in 2016, compared HTK and St. Thomas’ solutions in a group of patients undergoing dextro-transposition of the great arteries (d-TGA) correction with VSD and major pulmonary hypertension. In this experiment, the HTK solution promoted better results than the St. Thomas’ solution, which was translated into lower mortality and multiple organ failure [21] . Bojan et al [22] published in 2013 a French study comparing HTK solution and intermittent tepid blood solution in children undergoing Jatene surgery.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Myocardial Protection with HTK Solution and Hypothermic Hyperkalemic Blood Solution in the Correction of Acyanogenic Congenital Cardiopathies – A Randomized Study

Valente

Lustosa

Mota

et al. 2019

Braz J Cardiovasc Surg

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Objective The goal of the present study was to compare the myocardial protection obtained with histidine-tryptophan-ketoglutarate (HTK) cardioplegic solution (Custodiol ® ) and with intermittent hypothermic blood solution. Methods Two homogenous groups of 25 children with acyanotic congenital heart disease who underwent total correction with mean aortic clamping time of 60 minutes were evaluated in this randomized study. Troponin and creatine kinase-MB curves, vasoactive-inotropic score, and left ventricular function were obtained by echocardiogram in each group. The values were correlated and presented through graphs and tables after adequate statistical treatment. Results It was observed that values of all the studied variables varied over time, but there was no difference between the groups. Conclusion We conclude that in patients with acyanotic congenital cardiopathies submitted to total surgical correction, mean aortic clamping time around one hour, and cardiopulmonary bypass with moderate hypothermia, the HTK crystalloid cardioplegic solution offers the same myocardial protection as the cold-blood hyperkalemic cardioplegic solution analyzed, according to the variables considered in our study model.

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Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Myocardial Protection with HTK Solution and Hypothermic Hyperkalemic Blood Solution in the Correction of Acyanogenic Congenital Cardiopathies – A Randomized Study

Valente

Lustosa

Mota

et al. 2019

Braz J Cardiovasc Surg

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Pediatric Myocardial Protection

Talwar

Choudhary

2023

Pediatric Cardiac Surgery

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Real-World Evidence to Assess Medication Safety or Effectiveness in Children: Systematic Review

Lasky

Carleton

Horton

et al. 2020

Drugs - Real World Outcomes

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Background The promise of real-world evidence (RWE) is especially relevant to pediatrics, where medicines prescribed for children are often used without evidence derived from randomized clinical trials. Objectives The aim of this systematic review was to describe the state of RWE in pediatrics by identifying observational studies published during 2016 that used RWE to assess medication safety or effectiveness in children. Methods An electronic search of PubMed was combined with an extended search of references within systematic reviews and expert suggestions. Studies were included if they reported on an infant or child under 18 years with exposure to medications; assessed safety or effectiveness; specified a comparison or control group, and were published in English in 2016. Data extraction was conducted by one team member using a standardized form and reviewed by a second team member. Study quality was assessed using the GRACE checklist for rating the quality of observational studies. Results After removing duplicates, 915 citations were screened and 29 studies met the eligibility criteria. Most of the eligible studies relied on primary data collection or chart review at a single institution and did not use the growing number of administrative or electronic health record databases available. One-quarter of the studies did not use well-established statistical methods to control for confounders. No single disease group or medication predominated, and age groups ranged from infants to adolescents. Conclusions A small body of observational studies published in 2016 were categorized by the study team as using real-world data to assess medication safety or effectiveness in children. Studies varied in age groups, diseases or conditions, and methods, and may not have fully met the FDA definition of RWE. Our review indicates that the use of RWE is not fully developed in pediatrics, and suggests an opportunity to further develop capabilities and more fully leverage administrative and electronic health record databases to study medication safety and effectiveness in children. Our systematic review appears generalizable to pediatrics broadly, and documents that the high level of activity in RWE in general has had less of an impact on pediatrics.

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Histidine-tryptophan-ketoglutarate solution decreases mortality and morbidity in high-risk patients with severe pulmonary arterial hypertension associated with complex congenital heart disease: an 11-year experience from a single institution

Cited by 5 publications

References 19 publications

Comparative Analysis of Myocardial Protection with HTK Solution and Hypothermic Hyperkalemic Blood Solution in the Correction of Acyanogenic Congenital Cardiopathies – A Randomized Study

Comparative Analysis of Myocardial Protection with HTK Solution and Hypothermic Hyperkalemic Blood Solution in the Correction of Acyanogenic Congenital Cardiopathies – A Randomized Study

Pediatric Myocardial Protection

Real-World Evidence to Assess Medication Safety or Effectiveness in Children: Systematic Review

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