Pediatric pulmonary hypertension and pulmonary arterial hypertension secondary to congenital heart diseases

Olguntürk, Rana

doi:10.5152/akd.2010.119

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…Çocukluk çağında pulmoner arter hipertansiyonunun en sık nedeni doğuştan kalp hastalıkları olup olguların yaklaşık olarak %50'sinden sorumludur. [1,3] [4] 1995 yılında yayınladıkları ventriküler septal defekt onarımı yapılan 100 hastalık çalışmalarında pulmoner hipertansiyonu olan grupta ameliyat sonrası pulmoner hipertansif kriz insidansını %18 ve krizin mortalitesini ise %33 olarak bulmuşlardır. Günümüzde sildenafil, milrinon, prostaglandin E1 ve nitrik oksit gibi ilaçların kullanımı pulmoner hipertansiyon krizinin görülme sıklığını ve mortalitesini önemli ölçüde azaltmaktadır.…”

Section: Discussionunclassified

“…Pulmoner kateter olarak Seldinger yöntemi ile yerleştirilen bir adet mandrenli kılıf ve içinde kılavuz teli olan radyoopak özellikli 25 cm uzunluğunda bir kateter içeren seti (18G Cavafix ® MT B. Braun Melsungen AG Germany) kullanıldı (Şekil 1). Sağ ventrikül çıkım yoluna 5/0 polipropilen ile kese ağzı dikişi konulmasının ardından önce mandrenli kılıf daha sonra kılıf içinden kılavuz telli kateter geçirilmesinin ardından boyu pulmoner kapağın 1…”

Section: Cerrahi Teknikunclassified

“…Doğuştan kalp hastalıklarına bağlı pulmoner hipertansiyon çocukluk çağında görülen olguların yaklaşık yarısını oluşturur. [1] Bu hasta grubunda ameliyat öncesi ve sonrasında pulmoner arter basıncının doğru ve sık ölçümü tedavinin başarısı açısından önemlidir. Pulmoner arter basıncı izleminde yetişkin hastalarda perkütan teknikle transjuguler yerleştirilen pulmoner arter kateteri kullanılırken bu teknik hem tüm yaş ve ağırlıktaki çocuklara uygun kateter olmaması hem de doğuştan kalp hastalarının patolojik anatomik özellikleri nedeniyle tercih edilmemektedir.…”

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Safety of surgical pulmonary artery catheters in pediatric patients

Salihoğlu¹

2013

Turk Gogus Kalp Dama

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Bu çalışmada cerrahi pulmoner arter kateteri takılan pediatrik hastaların ameliyat sonrası sonuçları incelendi ve bu kateterlerin güvenilirliği irdelendi. Ça lış ma pla nı: Ocak 2010-Haziran 2012 tarihleri arasında 55 hastaya (26 erkek, 29 kız; ort. yaş 23.7±7.1 ay; dağılım 1-70 ay) cerrahi pulmoner arter kateteri yerleştirildi. Hastaların patoloji, yaş, vücut ağırlığı, pulmoner ve sistemik arter basıncı, ekstübasyon zamanı, kateter çekim zamanı, kanama miktarları, mortalite ve morbiditeleri gibi retrospektif incelemeleri yapıldı. Bul gu lar: Hastaların ortalama vücut ağırlığı 9.0±2.8 kg idi. Ameliyat öncesi olguların tamamında sistemik basınca eşit pulmoner hipertansiyon vardı. Otuz yedi hastaya pulmoner arter kateter yolu ile iloprost intravenöz infüzyonu uygulandı. Hastaların ortalama ekstübasyon zamanı 24.5±16.6 saat olup pulmoner arter kateteri çekim zamanı ortalaması ise 45.5±19.6 saat olarak gerçekleşti. Hastalarda kateter çekimi sonrası ortalama drenaj 23.7±14.4 mL idi. Hiçbir hastada kanama nedeniyle revizyon gerekmedi. Hastalarda pulmoner arter kateterine bağlı herhangi bir komplikasyon görülmedi. So nuç:Cerrahi pulmoner arter kateteri yerleştirilmesi hem sürekli basınç izlemi hem de ilaç infüzyonu için kullanılabilen kolay uygulanabilir bir yöntemdir. Bu yöntemin çocuk hastalarda ameliyat sonrası pulmoner hipertansiyon tedavisinin etkin uygulanmasında güvenli ve yardımcı bir yol olduğunu düşünüyoruz. Anah tar söz cük ler: Kalp cerrahisi; kateter; doğuştan kalp hastalığı. Background:This study aims to evaluate the postoperative outcomes of surgical pulmonary artery catheters in pediatric patients and to discuss the safety of these catheters. Methods: Between January 2010 and June 2012, surgical pulmonary artery catheters were implanted in 55 patients (26 boys, 29 girls; mean age 23.7±7.1 months; range 1 to 70 months). A retrospective analysis of the patients for pathology, age, body weight, pulmonary and systemic arterial pressure, extubation time, catheter removal time, the amount of bleeding, mortality and morbidity was performed. Results: The mean body weight of the patients was 9.0±2.8 kg. All patients had preoperative pulmonary hypertension which was equal to systemic pressure. Thirtyseven patients received iloprost intravenous infusion via a pulmonary artery catheter. The mean extubation time was 24.5±16.6 hours, while the mean time for pulmonary artery catheter removal was 45.5±19.6 hours. The mean drainage following catheter removal was 23.7±14.4 mL. None of the patients required any revision due to bleeding. No pulmonary artery catheter-related complication was observed in the patients. Conclusion:Surgical pulmonary artery catheterization is a simple technique which can be used for both continuous pressure monitorization and drug infusion. We conclude that this is a safe and contributing method for an effective management of postoperative pulmonary hypertension in pediatric patients.

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Section: Discussionunclassified

Section: Cerrahi Teknikunclassified

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Safety of surgical pulmonary artery catheters in pediatric patients

Salihoğlu¹

2013

Turk Gogus Kalp Dama

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“…newborn, for which the public health insurance was approved in Japan since 2010 8,9) . Furthermore, since the breath NO concentration increases significantly in inflammatory airway diseases, including allergic bronchial asthma, the exhaled NO concentration has attracted attention as an indicator of inflammatory airway diseases in recent years 10,11) .…”

Section: Introductionmentioning

confidence: 99%

Effect of Oral L-Arginine Administration on Exhaled Nitric Oxide (No) Concentration in Healthy Volunteers

Ogata

Yatabe

Misaka

et al. 2013

FJMS

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: We previously reported a case of pulmonary hypertension, where the symptoms were improved by oral L -arginine (arginine) administration. Arginine may increase nitric oxide (NO) production in the pulmonary artery. Exhaled NO may reflect pulmonary artery NO production. It has been demonstrated that exhaled NO concentration is higher in patients with allergic diseases, but whether oral arginine administration alters exhaled NO is unknown. Therefore, in this study, we investigated whether oral arginine administration increases exhaled NO among healthy volunteers with and without a history of allergy. Eleven subjects were given a single oral dose (200 mg/kg) of arginine, and their plasma arginine concentrations and exhaled NO were measured up to 150 minutes. Baseline values of exhaled NO concentration were significantly higher in those with a history of allergy (56.4±20.3 ppb, n=5, P<0.05) than those without (16.8±4.0 ppb, n=6). Oral arginine increased exhaled NO, which peaked at 60 minutes after the administration in those with a history of allergy (85.2±44.8 ppb, n=5). However, the increase in exhaled NO was not significant compared to the baseline values. In contrast, plasma arginine concentration was increased significantly by arginine administration (P<0.01), regardless of an allergy history. These results suggested that the difference in exhaled NO concentration was not due to a difference in arginine absorption. Serum IgE level was significantly higher in the group with a history of allergy. Eosinophils and white blood cells were within normal range in all subjects. We conclude that oral arginine administration does not significantly increase exhaled NO, regardless of allergy history. However, as arginine administration has been reported to be effective in patients with pulmonary hypertension, it will be necessary to test exhaled NO in subjects with pulmonary hypertension in the future.

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Sensitive Cardiac Troponins: Could They Be New Biomarkers in Pediatric Pulmonary Hypertension Due to Congenital Heart Disease?

Kayalı

Ertuğrul²,

Yoldaş

et al. 2018

Pediatr Cardiol

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To analyze the role of sensitive cardiac troponin I (scTnI) and high-sensitive troponin T (hscTnT) in the determination of myocardial injury caused by volume and pressure load due to pulmonary hypertension (PH) and to investigate if these markers may be useful in the management of PH in childhood. Twenty-eight patients with congenital heart disease (CHD) with left to right shunt and PH, 29 patients with CHD with left to right shunt but without PH, and 18 healthy children, in total 75 individuals, were included in the study. All cases were aged between 4 and 36 months. Echocardiographic evaluation was performed in all cases, and invasive hemodynamic investigation was performed in 33 cases. Blood samples were obtained from all cases, for the measurement of brain natriuretic peptide (BNP), pro-brain natriuretic peptide (pro-BNP), sensitive cardiac troponin I (scTnI), and high-sensitive troponin T (hscTnT) levels. The mean BNP, pro-BNP, scTnI, and hsTnT levels were statistically significantly higher in patients with PH than in the patients without PH (p < 0.001). A statistically significant positive correlation was determined between pulmonary artery systolic pressure and scTnI and hscTnT levels (r = 0.34 p = 0.01, r = 0.46 p < 0.001, respectively) levels. Pulmonary hypertension determined in congenital heart diseases triggers myocardial damage independently of increased volume or pressure load and resistance, occurring by disrupting the perfusion via increasing ventricular wall tension and the myocardial oxygen requirement. Serum scTnI and hscTnT levels may be helpful markers to determine the damage associated with PH in childhood.

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Pediatric pulmonary hypertension and pulmonary arterial hypertension secondary to congenital heart diseases

Cited by 5 publications

References 34 publications

Safety of surgical pulmonary artery catheters in pediatric patients

Safety of surgical pulmonary artery catheters in pediatric patients

Effect of Oral L-Arginine Administration on Exhaled Nitric Oxide (No) Concentration in Healthy Volunteers

Sensitive Cardiac Troponins: Could They Be New Biomarkers in Pediatric Pulmonary Hypertension Due to Congenital Heart Disease?

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