The authors report a case of Large Anterior mediastinal mass in which Transoesophageal Echocardiography (TEE) revealed a large mass that was compressing the right atrium, SVC, henceforth, TEE helped in guid</span&g...The authors report a case of Large Anterior mediastinal mass in which Transoesophageal Echocardiography (TEE) revealed a large mass that was compressing the right atrium, SVC, henceforth, TEE helped in guid</span><span style="font-size:10.0pt;font-family:"">ing</span><span style="font-size:10.0pt;font-family:""> aspiration and surgical resection of the cystic mass. Therefore, through this case report, <span>authors emphasize the importance of performing intraoperative real-time</span> TEE in the mediastinal mass. This imaging technique helps in visualizing the external compression of cardio-vascular structure and aid in their management, obviating the possibility of large vascular structures from being injured by the surgeon during intraoperative manipulation.展开更多
Background: A Randomized Controlled Trial (RCT) has been elaborated where goal directed fluid and hemodynamic therapy (GDFHT) will be realized with trans-thoracic echocardiographic aortic blood flow peak velocity vari...Background: A Randomized Controlled Trial (RCT) has been elaborated where goal directed fluid and hemodynamic therapy (GDFHT) will be realized with trans-thoracic echocardiographic aortic blood flow peak velocity variation (ΔVpeak) and distance minute (DM) to guide fluid therapy and hemodynamics in high risk pediatric surgical patients. This RCT will clarify the impact of GDFHT with ΔVpeak and DM on postoperative outcome in terms of morbidity, length of stay in the intensive care unit (LOSICU), length of mechanical ventilation (LMV) and length of hospital stay (LOS) in children. To determine values of ΔVpeak, DM and VTI predictive of these postoperative outcomes, an observational pilot study will be realized. This pilot study is described here. The primary objective of this study is to determine values of ΔVpeak, DM and ITV predictive of postoperative outcome in children in terms of morbidity. The secondary objectives are to determine values of ΔVpeak, DM and ITV predictive of LOSICU, LMV, LOS, intraoperative, postoperative fluid administration and vasoactive-inotropic therapy. Methods: 500 - 1000 children aged less than 18 years will be included prospectively. Statistic analysis will be realized with XLSTAT 2019.4.2 software or plus. Results and Conclusions: This trial protocol will determine values of ΔVpeak, DM and ITV with echocardiography predictive of postoperative outcome in children.展开更多
<u>Background:</u><span style="font-family:Verdana;"> Extracorporeal</span><span style="font-family:;" "=""> </span><span style="font-fami...<u>Background:</u><span style="font-family:Verdana;"> Extracorporeal</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">membrane oxygenation is a rescue life support technique used in life threatening</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">conditions of refractory respiratory and/or cardiac distress. Indication for extracorporeal life support in children</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">depends on age and varies from pulmonary to cardiac pathologies. In some cases</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> it may be used as a bridge to a</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">therapeutic procedure.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">We described here the management of respiratory failure due to hemoptysis in a child with a Fontan circulation</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">and veno-venous extracorporeal membrane oxygenation which served as a bridge to angio-embolization. Hemoptysis can be a life threatening condition which can lead to hypovolemic shock and impaired alveolar gas</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">exchange. The latter can result in respiratory failure and consequent asphyxia.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">When hemoptysis occurs in a patient with a univentricular</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">heart and a Fontan circulation, management of this</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">clinical situation can be challenging due to the particular physiology of the latter. Total cavopulmonary connection is a palliative surgical repair which constitutes Fontan circulation as a definitiv展开更多
文摘The authors report a case of Large Anterior mediastinal mass in which Transoesophageal Echocardiography (TEE) revealed a large mass that was compressing the right atrium, SVC, henceforth, TEE helped in guid</span><span style="font-size:10.0pt;font-family:"">ing</span><span style="font-size:10.0pt;font-family:""> aspiration and surgical resection of the cystic mass. Therefore, through this case report, <span>authors emphasize the importance of performing intraoperative real-time</span> TEE in the mediastinal mass. This imaging technique helps in visualizing the external compression of cardio-vascular structure and aid in their management, obviating the possibility of large vascular structures from being injured by the surgeon during intraoperative manipulation.
文摘Background: A Randomized Controlled Trial (RCT) has been elaborated where goal directed fluid and hemodynamic therapy (GDFHT) will be realized with trans-thoracic echocardiographic aortic blood flow peak velocity variation (ΔVpeak) and distance minute (DM) to guide fluid therapy and hemodynamics in high risk pediatric surgical patients. This RCT will clarify the impact of GDFHT with ΔVpeak and DM on postoperative outcome in terms of morbidity, length of stay in the intensive care unit (LOSICU), length of mechanical ventilation (LMV) and length of hospital stay (LOS) in children. To determine values of ΔVpeak, DM and VTI predictive of these postoperative outcomes, an observational pilot study will be realized. This pilot study is described here. The primary objective of this study is to determine values of ΔVpeak, DM and ITV predictive of postoperative outcome in children in terms of morbidity. The secondary objectives are to determine values of ΔVpeak, DM and ITV predictive of LOSICU, LMV, LOS, intraoperative, postoperative fluid administration and vasoactive-inotropic therapy. Methods: 500 - 1000 children aged less than 18 years will be included prospectively. Statistic analysis will be realized with XLSTAT 2019.4.2 software or plus. Results and Conclusions: This trial protocol will determine values of ΔVpeak, DM and ITV with echocardiography predictive of postoperative outcome in children.
文摘<u>Background:</u><span style="font-family:Verdana;"> Extracorporeal</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">membrane oxygenation is a rescue life support technique used in life threatening</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">conditions of refractory respiratory and/or cardiac distress. Indication for extracorporeal life support in children</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">depends on age and varies from pulmonary to cardiac pathologies. In some cases</span><span style="font-family:Verdana;">,</span><span style="font-family:Verdana;"> it may be used as a bridge to a</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">therapeutic procedure.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">We described here the management of respiratory failure due to hemoptysis in a child with a Fontan circulation</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">and veno-venous extracorporeal membrane oxygenation which served as a bridge to angio-embolization. Hemoptysis can be a life threatening condition which can lead to hypovolemic shock and impaired alveolar gas</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">exchange. The latter can result in respiratory failure and consequent asphyxia.</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">When hemoptysis occurs in a patient with a univentricular</span><span style="font-family:;" "=""> </span><span style="font-family:Verdana;">heart and a Fontan circulation, management of this</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">clinical situation can be challenging due to the particular physiology of the latter. Total cavopulmonary connection is a palliative surgical repair which constitutes Fontan circulation as a definitiv
