Pub Date : 2024-03-01Epub Date: 2024-07-20DOI: 10.4103/apc.apc_30_24
Diego R Ruiz-Avila, Subhrajit Lahiri, Syed Javed Zaidi, Harma Khachig Turbendian
A 4.1 kg male neonate with a diagnosis of double-inlet left ventricle with dextro-transposition of the great arteries was intubated shortly after birth due to respiratory insufficiency. The initial management consisted of a successful Stage I hybrid procedure. Persistent respiratory insufficiency led to cross-sectional imaging and bronchoscopy that demonstrated severe airway compression from a dilated main pulmonary artery. A Norwood procedure with Blalock-Thomas-Taussig shunt was performed at 1 month of age to relieve the airway obstruction. The patient was discharged home on room air at 2 months of age. This case highlights a unique single-ventricle anatomic variant with airway compression, which was successfully managed with deferred Norwood palliation.
一名体重 4.1 千克的男性新生儿被诊断为左心室双入口、大动脉右侧横位,出生后不久就因呼吸功能不全而被插管。最初的治疗包括成功的 I 期混合手术。持续的呼吸功能不全导致横断面成像和支气管镜检查显示主肺动脉扩张导致气道严重受压。1 个月大时,为缓解气道阻塞,患者接受了带有布洛克-托马斯-陶西分流术的诺伍德手术。患者在 2 个月大时出院回家,呼吸室内空气。该病例突显了一种独特的单心室解剖变异并伴有气道受压,通过延期诺伍德姑息术成功地解决了这一问题。
{"title":"Deferred Norwood in the setting of airway compression in double-inlet left ventricle with dextro-transposition of the great arteries.","authors":"Diego R Ruiz-Avila, Subhrajit Lahiri, Syed Javed Zaidi, Harma Khachig Turbendian","doi":"10.4103/apc.apc_30_24","DOIUrl":"10.4103/apc.apc_30_24","url":null,"abstract":"<p><p>A 4.1 kg male neonate with a diagnosis of double-inlet left ventricle with dextro-transposition of the great arteries was intubated shortly after birth due to respiratory insufficiency. The initial management consisted of a successful Stage I hybrid procedure. Persistent respiratory insufficiency led to cross-sectional imaging and bronchoscopy that demonstrated severe airway compression from a dilated main pulmonary artery. A Norwood procedure with Blalock-Thomas-Taussig shunt was performed at 1 month of age to relieve the airway obstruction. The patient was discharged home on room air at 2 months of age. This case highlights a unique single-ventricle anatomic variant with airway compression, which was successfully managed with deferred Norwood palliation.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-07-20DOI: 10.4103/apc.apc_72_24
Supratim Sen, Sivasubramanian Ramakrishnan
{"title":"Artificial intelligence in pediatric cardiology: Where do we stand in 2024?","authors":"Supratim Sen, Sivasubramanian Ramakrishnan","doi":"10.4103/apc.apc_72_24","DOIUrl":"10.4103/apc.apc_72_24","url":null,"abstract":"","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-07-20DOI: 10.4103/apc.apc_37_24
Deepanjan Bhattacharya, Narayanan Namboodiri, Krishna Kumar Mohanan Nair, Baiju S Dharan, Deepa Sasikumar, Arun Gopalakrishnan, K M Krishnamoorthy, Sabarinath Menon, Sowmya Ramanan, Sudip Dutta Baruah
Introduction: Permanent pacemaker implantation (PPI) in neonates is challenging with respect to indications, device selection, implantation technique, and long-term outcomes. Complex anatomy, the need for long-term pacing with high rates, and a problematic postoperative period are the major problems.
Methods: We prospectively followed up 22 newborns who underwent PPI below 28 days of life at our institute.
Results: The median age at implantation was 2 days (interquartile range 1-9 days), and 9% were born preterm. The average heart rate before implantation was 46.4 ± 7.2 bpm. Maternal lupus antibodies were positive in 8 (36.4%) neonates, whereas 11 (50.0%) had associated congenital heart disease. Nineteen neonates underwent single chamber (VVI) and three underwent dual chamber (DDD) pacemaker implantation. Over a median follow-up of 46 months (range 2-123 months), the average ventricular pacing percentage was 87.5 ± 24.9%, with a stable pacing threshold. Seven children underwent pulse generator replacement due to battery depletion at a median age of 47 months. Pacing-induced ventricular dysfunction was seen in five children at a median age of 23.6 months, and two underwent upgradation to cardiac resynchronization therapy. Overall mortality was 13.6%, all due to tissue hypoperfusion and lactic acidosis in the postimplantation period.
Conclusions: PPI in neonates has a favorable outcome with excellent lead survival. Overall mortality is 13.6%, which is predominantly in the postimplantation period and related to myocardial dysfunction.
{"title":"Long-term outcome of permanent epicardial pacemaker implantation in neonates: Experience from an Indian center.","authors":"Deepanjan Bhattacharya, Narayanan Namboodiri, Krishna Kumar Mohanan Nair, Baiju S Dharan, Deepa Sasikumar, Arun Gopalakrishnan, K M Krishnamoorthy, Sabarinath Menon, Sowmya Ramanan, Sudip Dutta Baruah","doi":"10.4103/apc.apc_37_24","DOIUrl":"10.4103/apc.apc_37_24","url":null,"abstract":"<p><strong>Introduction: </strong>Permanent pacemaker implantation (PPI) in neonates is challenging with respect to indications, device selection, implantation technique, and long-term outcomes. Complex anatomy, the need for long-term pacing with high rates, and a problematic postoperative period are the major problems.</p><p><strong>Methods: </strong>We prospectively followed up 22 newborns who underwent PPI below 28 days of life at our institute.</p><p><strong>Results: </strong>The median age at implantation was 2 days (interquartile range 1-9 days), and 9% were born preterm. The average heart rate before implantation was 46.4 ± 7.2 bpm. Maternal lupus antibodies were positive in 8 (36.4%) neonates, whereas 11 (50.0%) had associated congenital heart disease. Nineteen neonates underwent single chamber (VVI) and three underwent dual chamber (DDD) pacemaker implantation. Over a median follow-up of 46 months (range 2-123 months), the average ventricular pacing percentage was 87.5 ± 24.9%, with a stable pacing threshold. Seven children underwent pulse generator replacement due to battery depletion at a median age of 47 months. Pacing-induced ventricular dysfunction was seen in five children at a median age of 23.6 months, and two underwent upgradation to cardiac resynchronization therapy. Overall mortality was 13.6%, all due to tissue hypoperfusion and lactic acidosis in the postimplantation period.</p><p><strong>Conclusions: </strong>PPI in neonates has a favorable outcome with excellent lead survival. Overall mortality is 13.6%, which is predominantly in the postimplantation period and related to myocardial dysfunction.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The study aims to assess the procedural outcomes and follow-up after transcatheter closure of ventricular septal defects (VSDs) in children utilizing the Konar-MF™ occluder (Lifetech Scientific, Shenzhen, PRC) device.
Materials and methods: Clinical features, demographic characteristics, and follow-up findings of children undergoing percutaneous VSD device closure were retrospectively analyzed from the medical records.
Results: Fifty-seven patients underwent VSD closure using the Konar-MF occluder between January 2019 and April 2023. Median age and body weight of patients were 36 (5-216) months and 12.5 (3.8-42) kg, respectively. The mean size of the defect on the left ventricular side was 6.5 ± 2.4 mm on echocardiography; the mean pulmonary artery pressure was 19.1 ± 9.7 mmHg. Three patients with severe pulmonary hypertension had successful device closure. The most used device size was 8 mm × 6 mm. The initially chosen device was upsized in 4 (7.01%) patients and downsized in 1 (1.7%) patient. Forty-five patients (78.9%) had device closure through the retrograde route. The procedure was successful in 53 (93.0%) patients. Immediate shunt occlusion was achieved in 86.8% of patients. Major complications, namely, embolization (1) and moderate aortic regurgitation (1) in two patients were successfully managed by surgery. One patient with severe tricuspid regurgitation has been on close follow-up. There was no mortality. Late complications such as valve regurgitation or rhythm disturbance were not identified on a median follow-up of 6 (1.5-47) months.
Conclusion: Transcatheter VSD closure using a Konar-MF occluder device is safe and effective, even in smaller children. The ability to deliver both anterogradely and retrogradely is a unique advantage.
{"title":"Procedural outcomes of percutaneous closure of perimembranous and other ventricular septal defects using Konar-MF occluder and short-term follow-up.","authors":"Somrita Laha, Debasree Gangopadhyay, Mahua Roy, Anoop Singh, Debabrata Nandi, Joyeeta Dutta","doi":"10.4103/apc.apc_201_23","DOIUrl":"10.4103/apc.apc_201_23","url":null,"abstract":"<p><strong>Introduction: </strong>The study aims to assess the procedural outcomes and follow-up after transcatheter closure of ventricular septal defects (VSDs) in children utilizing the Konar-MF™ occluder (Lifetech Scientific, Shenzhen, PRC) device.</p><p><strong>Materials and methods: </strong>Clinical features, demographic characteristics, and follow-up findings of children undergoing percutaneous VSD device closure were retrospectively analyzed from the medical records.</p><p><strong>Results: </strong>Fifty-seven patients underwent VSD closure using the Konar-MF occluder between January 2019 and April 2023. Median age and body weight of patients were 36 (5-216) months and 12.5 (3.8-42) kg, respectively. The mean size of the defect on the left ventricular side was 6.5 ± 2.4 mm on echocardiography; the mean pulmonary artery pressure was 19.1 ± 9.7 mmHg. Three patients with severe pulmonary hypertension had successful device closure. The most used device size was 8 mm × 6 mm. The initially chosen device was upsized in 4 (7.01%) patients and downsized in 1 (1.7%) patient. Forty-five patients (78.9%) had device closure through the retrograde route. The procedure was successful in 53 (93.0%) patients. Immediate shunt occlusion was achieved in 86.8% of patients. Major complications, namely, embolization (1) and moderate aortic regurgitation (1) in two patients were successfully managed by surgery. One patient with severe tricuspid regurgitation has been on close follow-up. There was no mortality. Late complications such as valve regurgitation or rhythm disturbance were not identified on a median follow-up of 6 (1.5-47) months.</p><p><strong>Conclusion: </strong>Transcatheter VSD closure using a Konar-MF occluder device is safe and effective, even in smaller children. The ability to deliver both anterogradely and retrogradely is a unique advantage.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anatomical configurations where the viscero-atrial structures do not follow the usual arrangement or mirror-imaged arrangement is described conventionally as heterotaxy. Isomerism in the context of the congenitally malformed heart is a situation where some paired structures on opposite sides of the left-right axis of the body are, in morphologic terms, symmetrical mirror images of each other. It encompasses two separate entities, right and left isomerism, the former being usually associated with asplenia and the latter with polysplenia. We report herein a rare case of left isomerism that is associated with asplenia in a 4-year-old girl.
{"title":"Asplenia in left isomerism.","authors":"Usnish Adhikari, Venkatesh Gurajala, Palanisamy Dinesh Raja, Anoop Ayyappan, Deepti Narasimhaiah, Arun Gopalakrishnan","doi":"10.4103/apc.apc_4_24","DOIUrl":"10.4103/apc.apc_4_24","url":null,"abstract":"<p><p>Anatomical configurations where the viscero-atrial structures do not follow the usual arrangement or mirror-imaged arrangement is described conventionally as heterotaxy. Isomerism in the context of the congenitally malformed heart is a situation where some paired structures on opposite sides of the left-right axis of the body are, in morphologic terms, symmetrical mirror images of each other. It encompasses two separate entities, right and left isomerism, the former being usually associated with asplenia and the latter with polysplenia. We report herein a rare case of left isomerism that is associated with asplenia in a 4-year-old girl.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: This prospective, randomized, double-blind trial was done to compare intranasal dexmedetomidine and intranasal midazolam as premedication for sedation and ease of child-parent separation in pediatric patients of tetralogy of Fallot (TOF) undergoing corrective cardiac surgery.
Materials and methods: Forty children with TOF, between 1 and 10 years, undergoing corrective cardiac surgery were included in the study and, after randomization, were given intranasal midazolam (0.2 mg/kg) or intranasal dexmedetomidine (1 µg/kg), 30 min before shifting to the operation room (OR). Patients were assessed for sedation and child-parent separation, along with hemodynamic parameters, respiratory rate, and oxygen saturation (SpO2) 30 min after drug administration, at the time of shifting inside the OR, and at the time of induction of anesthesia.
Results: Both groups had comparable child-parent scores, hemodynamic parameters, SpO2, and respiratory rate. However, the dexmedetomidine group had significantly better sedation levels than the midazolam group patients at the time of shifting inside the OR (dexmedetomidine group: 3.55 ± 0.82 vs. midazolam group: 2.80 ± 0.83; P = 0.007) and at the time of induction of anesthesia (dexmedetomidine group: 3.40 ± 0.75 vs. midazolam group: 2.70 ± 0.86; P = 0.009).
Conclusion: Intranasal dexmedetomidine provides better sedation than midazolam, with similar child-parent separation scores and hemodynamic parameters, respiratory rate, and SpO2. No adverse events were observed in both groups. A study on a larger population will help in further establishing the safety and superiority of dexmedetomidine and will further its regular use as an intranasal premedication.
研究背景这项前瞻性、随机、双盲试验旨在比较鼻内注射右美托咪定和鼻内注射咪达唑仑作为接受心脏矫正手术的法洛氏四联症(TOF)小儿患者的镇静预处理药物,以及儿童与父母分离的便利性:研究纳入了40名接受心脏矫正手术的1至10岁法洛氏四联症患儿,随机分组后,在转入手术室(OR)前30分钟给予鼻内咪达唑仑(0.2毫克/千克)或鼻内右美托咪定(1微克/千克)。在用药后 30 分钟、转入手术室时和麻醉诱导时,对患者的镇静效果、子女与父母的分离情况以及血液动力学参数、呼吸频率和血氧饱和度(SpO2)进行评估:结果:两组患儿的家长评分、血液动力学参数、SpO2 和呼吸频率相当。右美托咪定组:3.55 ± 0.82 vs. 咪达唑仑组:2.80 ± 0.83;P = 0.007)和麻醉诱导时(右美托咪定组:3.40 ± 0.75 vs. 咪达唑仑组:2.80 ± 0.83;P = 0.007):结论:结论:与咪达唑仑相比,右美托咪定鞘内注射能提供更好的镇静效果,且儿童与家长的分离评分、血液动力学参数、呼吸频率和SpO2相似。两组患者均未出现不良反应。对更多人群进行研究将有助于进一步确定右美托咪定的安全性和优越性,并促进其作为鼻内预处理药物的常规使用。
{"title":"Effects of intranasal dexmedetomidine versus intranasal midazolam as premedication in children with tetralogy of Fallot undergoing corrective cardiac surgery: A randomized trial.","authors":"Sarvesh Srivastava, Sambhunath Das, Neeti Makhija, Sandeep Chauhan","doi":"10.4103/apc.apc_10_24","DOIUrl":"10.4103/apc.apc_10_24","url":null,"abstract":"<p><strong>Background: </strong>This prospective, randomized, double-blind trial was done to compare intranasal dexmedetomidine and intranasal midazolam as premedication for sedation and ease of child-parent separation in pediatric patients of tetralogy of Fallot (TOF) undergoing corrective cardiac surgery.</p><p><strong>Materials and methods: </strong>Forty children with TOF, between 1 and 10 years, undergoing corrective cardiac surgery were included in the study and, after randomization, were given intranasal midazolam (0.2 mg/kg) or intranasal dexmedetomidine (1 µg/kg), 30 min before shifting to the operation room (OR). Patients were assessed for sedation and child-parent separation, along with hemodynamic parameters, respiratory rate, and oxygen saturation (SpO2) 30 min after drug administration, at the time of shifting inside the OR, and at the time of induction of anesthesia.</p><p><strong>Results: </strong>Both groups had comparable child-parent scores, hemodynamic parameters, SpO2, and respiratory rate. However, the dexmedetomidine group had significantly better sedation levels than the midazolam group patients at the time of shifting inside the OR (dexmedetomidine group: 3.55 ± 0.82 vs. midazolam group: 2.80 ± 0.83; <i>P</i> = 0.007) and at the time of induction of anesthesia (dexmedetomidine group: 3.40 ± 0.75 vs. midazolam group: 2.70 ± 0.86; P = 0.009).</p><p><strong>Conclusion: </strong>Intranasal dexmedetomidine provides better sedation than midazolam, with similar child-parent separation scores and hemodynamic parameters, respiratory rate, and SpO2. No adverse events were observed in both groups. A study on a larger population will help in further establishing the safety and superiority of dexmedetomidine and will further its regular use as an intranasal premedication.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transcatheter closure of sinus venosus defect (SVD) is an emerging intervention that utilizes a covered stent to redirect the right upper pulmonary vein to the left atrium. Preprocedural computed tomography analysis, as well as the interventional procedure, necessitates the use of radiographic contrast media. Contrast use is prohibited in patients with advanced kidney disease, who also carry high surgical risks of cardiopulmonary bypass. Transesophageal echocardiography-guided catheter intervention with zero contrast use is presented in this report, along with technical details about planning the procedure. Covered stent exclusion of SVD without contrast use has not been reported in the literature so far.
{"title":"Zero-contrast transcatheter closure of sinus venosus defect in advanced renal failure.","authors":"Puthiyedath Thejaswi, Pramod Sagar, Kothandam Sivakumar","doi":"10.4103/apc.apc_29_24","DOIUrl":"10.4103/apc.apc_29_24","url":null,"abstract":"<p><p>Transcatheter closure of sinus venosus defect (SVD) is an emerging intervention that utilizes a covered stent to redirect the right upper pulmonary vein to the left atrium. Preprocedural computed tomography analysis, as well as the interventional procedure, necessitates the use of radiographic contrast media. Contrast use is prohibited in patients with advanced kidney disease, who also carry high surgical risks of cardiopulmonary bypass. Transesophageal echocardiography-guided catheter intervention with zero contrast use is presented in this report, along with technical details about planning the procedure. Covered stent exclusion of SVD without contrast use has not been reported in the literature so far.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: An abnormal variation in blood electrolytes, such as potassium, contributes to mortality in children admitted to intensive care units. Continuous and real-time monitoring of potassium serum levels can prevent fatal arrhythmias, but this is not currently practical. The study aims to use machine learning to estimate blood potassium levels with accuracy in real time noninvasively.
Methods: Hospitalized patients in the Pediatric Department of the Rajaie Cardiology and Medical Research Center and Tehran Heart Center were recruited from December 2021 to June 2022. The electrocardiographic (ECG) features of patients were evaluated. We defined 16 features for each signal and extracted them automatically. The dimension reduction operation was performed with the assistance of the correlation matrix. Linear regression, polynomials, decision trees, random forests, and support vector machine algorithms have been used to find the relationship between characteristics and serum potassium levels. Finally, we used a scatter plot and mean square error (MSE) to display the results.
Results: Of 463 patients (mean age: 8 ± 1 year; 56% boys) hospitalized, 428 patients met the inclusion criteria, with 35 patients having a high noise of ECG were excluded. After the dimension reduction step, 11 features were selected from each cardiac signal. The random forest regression algorithm showed the best performance with an MSE of 0.3.
Conclusion: The accurate estimation of serum potassium levels based on ECG signals is possible using machine learning algorithms. This can be potentially useful in predicting serum potassium levels in specific clinical scenarios.
{"title":"Artificial intelligence-based model for automatic real-time and noninvasive estimation of blood potassium levels in pediatric patients.","authors":"Hamid Mokhtari Torshizi, Negar Omidi, Mohammad Rafie Khorgami, Razieh Jamali, Mohsen Ahmadi","doi":"10.4103/apc.apc_54_24","DOIUrl":"10.4103/apc.apc_54_24","url":null,"abstract":"<p><strong>Background: </strong>An abnormal variation in blood electrolytes, such as potassium, contributes to mortality in children admitted to intensive care units. Continuous and real-time monitoring of potassium serum levels can prevent fatal arrhythmias, but this is not currently practical. The study aims to use machine learning to estimate blood potassium levels with accuracy in real time noninvasively.</p><p><strong>Methods: </strong>Hospitalized patients in the Pediatric Department of the Rajaie Cardiology and Medical Research Center and Tehran Heart Center were recruited from December 2021 to June 2022. The electrocardiographic (ECG) features of patients were evaluated. We defined 16 features for each signal and extracted them automatically. The dimension reduction operation was performed with the assistance of the correlation matrix. Linear regression, polynomials, decision trees, random forests, and support vector machine algorithms have been used to find the relationship between characteristics and serum potassium levels. Finally, we used a scatter plot and mean square error (MSE) to display the results.</p><p><strong>Results: </strong>Of 463 patients (mean age: 8 ± 1 year; 56% boys) hospitalized, 428 patients met the inclusion criteria, with 35 patients having a high noise of ECG were excluded. After the dimension reduction step, 11 features were selected from each cardiac signal. The random forest regression algorithm showed the best performance with an MSE of 0.3.</p><p><strong>Conclusion: </strong>The accurate estimation of serum potassium levels based on ECG signals is possible using machine learning algorithms. This can be potentially useful in predicting serum potassium levels in specific clinical scenarios.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-07-20DOI: 10.4103/apc.apc_16_24
Paul Padovani, Mohamedou Ly, Alban-Elouen Baruteau
Data on the safety and efficiency of perventricular device closure of complex ventricular septal defects (VSDs) are scarce. We report successful one-stage combined hybrid perventricular and percutaneous closure of the muscular VSDs in a critically ill 4-kg infant, using the new multifunctional occluder.
{"title":"Rescue one-stage hybrid perventricular and percutaneous device closure of multiple muscular ventricular septal defects using the new multifunctional occluder.","authors":"Paul Padovani, Mohamedou Ly, Alban-Elouen Baruteau","doi":"10.4103/apc.apc_16_24","DOIUrl":"10.4103/apc.apc_16_24","url":null,"abstract":"<p><p>Data on the safety and efficiency of perventricular device closure of complex ventricular septal defects (VSDs) are scarce. We report successful one-stage combined hybrid perventricular and percutaneous closure of the muscular VSDs in a critically ill 4-kg infant, using the new multifunctional occluder.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-07-20DOI: 10.4103/apc.apc_8_24
Yeka W Nmadu, Robert F English
Dual drainage of a pulmonary vein is an unusual anomaly of pulmonary venous drainage. While being evaluated for hypertension, a child was found with dual drainage of the upper left lobe through a vertical vein that connects to the normal pulmonary vein as well as the innominate vein with no symptoms from his effective left-to-right shunt.
{"title":"Dual-drainage pulmonary venous return of the left upper lobe.","authors":"Yeka W Nmadu, Robert F English","doi":"10.4103/apc.apc_8_24","DOIUrl":"10.4103/apc.apc_8_24","url":null,"abstract":"<p><p>Dual drainage of a pulmonary vein is an unusual anomaly of pulmonary venous drainage. While being evaluated for hypertension, a child was found with dual drainage of the upper left lobe through a vertical vein that connects to the normal pulmonary vein as well as the innominate vein with no symptoms from his effective left-to-right shunt.</p>","PeriodicalId":8026,"journal":{"name":"Annals of Pediatric Cardiology","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}