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Intensive Care Medicine

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18.11.2016 | Editorial

Paediatric cardiopulmonary bypass surgery: the challenges of heterogeneity and identifying a meaningful endpoint for clinical trials

verfasst von: V. J. Pappachan, K. L. Brown, S. M. Tibby

Erschienen in: Intensive Care Medicine | Ausgabe 1/2017

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Excerpt

Survival following paediatric surgery for congenital heart disease (CHD) has improved dramatically over the past two decades; 30-day mortality estimates are now 2.5–4% [1]. However short- and long-term morbidity remain significant issues and hospital length of stay remains unchanged [1]. Both are costly and are linked to poorer long-term neurodevelopmental outcomes [2]. We are now operating on a greater proportion of younger, smaller patients; many with associated extra-cardiac anomalies and chromosomal disorders [3]. Ideally trials should report both immediate perioperative and post-discharge outcomes [4]. …

Jacobs JP, He X, Mayer JE et al (2016) Mortality trends in pediatric and congenital heart surgery: an analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database. Ann Thorac Surg 102:1345–1352. doi:10.1016/j.athoracsur.2016.01.071 CrossRefPubMed

Newburger JW, Sleeper LA, Bellinger DC et al (2012) Early developmental outcome in children with hypoplastic left heart syndrome and related anomalies: the single ventricle reconstruction trial. Circulation 125:2081–2091. doi:10.1161/CIRCULATIONAHA.111.064113 CrossRefPubMedPubMedCentral

Brown KL, Crowe S, Franklin R et al (2015) Trends in 30-day mortality rate and case mix for paediatric cardiac surgery in the UK between 2000 and 2010. Open Heart 2:e000157. doi:10.1136/openhrt-2014-000157 CrossRefPubMedPubMedCentral

Brown KL, Wray J, Knowles RL et al (2016) Infant deaths in the UK community following successful cardiac surgery: building the evidence base for optimal surveillance, a mixed-methods study. NIHR J Libr, Southampton (UK)

Guzik TJ, Korbut R, Adamek-Guzik T (2003) Nitric oxide and superoxide in inflammation and immune regulation. J Physiol Pharmacol 54:469–487PubMed

Liao JC, Hein TW, Vaughn MW et al (1999) Intravascular flow decreases erythrocyte consumption of nitric oxide. Proc Natl Acad Sci USA 96:8757–8761CrossRefPubMedPubMedCentral

Rassaf T, Kleinbongard P, Kelm M (2005) Circulating NO pool in humans. Kidney Blood Press Res 28:341–348. doi:10.1159/000090188 CrossRefPubMed

Mellgren K, Friberg LG, Mellgren G et al (1996) Nitric oxide in the oxygenator sweep gas reduces platelet activation during experimental perfusion. Ann Thorac Surg 61:1194–1198CrossRefPubMed

Gianetti J, Del Sarto P, Bevilacqua S et al (2004) Supplemental nitric oxide and its effect on myocardial injury and function in patients undergoing cardiac surgery with extracorporeal circulation. J Thorac Cardiovasc Surg 127:44–50. doi:10.1016/j.jtcvs.2002.08.001 CrossRefPubMed

10.

Checchia PA, Bronicki RA, Muenzer JT et al (2013) Nitric oxide delivery during cardiopulmonary bypass reduces postoperative morbidity in children–a randomized trial. J Thorac Cardiovasc Surg 146:530–536. doi:10.1016/j.jtcvs.2012.09.100 CrossRefPubMed

11.

James C, Millar J, Horton S et al (2016) Nitric oxide administration during paediatric cardiopulmonary bypass: a randomised controlled trial. Intensive Care Med 42:1744–1752. doi:10.1007/s00134-016-4420-6 CrossRefPubMed

12.

Fudulu D, Angelini G (2016) Oxidative stress after surgery on the immature heart. Oxid Med Cell Longev 2016:1971452. doi:10.1155/2016/1971452 CrossRefPubMedPubMedCentral

13.

Agarwal HS, Hardison DC, Saville BR et al (2014) Residual lesions in postoperative pediatric cardiac surgery patients receiving extracorporeal membrane oxygenation support. J Thorac Cardiovasc Surg 147:434–441. doi:10.1016/j.jtcvs.2013.03.021 CrossRefPubMed

14.

Berry SM, Connor JT, Lewis RJ (2015) The platform trial: an efficient strategy for evaluating multiple treatments. JAMA 313:1619–1620. doi:10.1001/jama.2015.2316 CrossRefPubMed

15.

Bartlett RH, Roloff DW, Cornell RG et al (1985) Extracorporeal circulation in neonatal respiratory failure: a prospective randomized study. Pediatrics 76:479–487PubMed

Titel: Paediatric cardiopulmonary bypass surgery: the challenges of heterogeneity and identifying a meaningful endpoint for clinical trials
verfasst von: V. J. Pappachan
K. L. Brown
S. M. Tibby
Publikationsdatum: 18.11.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Intensive Care Medicine / Ausgabe 1/2017
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-016-4622-y

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