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5. An evaluation of the outcomes associated with peritoneal catheter use in neonates undergoing cardiac surgery: A multicenter study

Author

Zang, Huaiyu, Winlaw, David, Bailly, David, Goldstein, Stuart, Gist, Katja, Brandewie, Katie L., Bhat, Priya N., Diddle, John W., Ghbeis, Muhammad, Prodhan, Parthak, Garcia, Xiomara, Ramer, Shannon, Albertson, Mindy, Rodriquez, Zahidee, Lukacs, Mary, Gaies, Michael, Freytag, Joshua, Sammons, Amanda, Abraha, Hideat, Butcher, John, Zanaboni, Dominic, Sanchez de Toledo, Joan, Domnina, Yuliya A., Saenz, Lucas, Baust, Tracy, Kluck, Jane, Sasaki, Jun, Raees, Aanish, O'Neil, Erika R., Lasa, Javier J., Phillips, Patrick A., Hock, Kristal M., Valentine, Kevin, Tadphale, Sachin, Buckley, Jason R., Schroeder, Luke, Clarke, Shanelle, Zhang, Wenying, Smith, Andrew, Absi, Mohammed, Askenazi, David J., Duncan, Linda, Bertrandt, Rebecca A., Sosa, Lisa J., O’Neal, Erika R., Doman, Tammy, Viers, Suzanne, Smith, Andrew H., Bailly, David K., Kwiatkowski, David M., Alten, Jeffrey A., Mah, Kenneth E., Selewski, David T., Raymond, Tia T., Afonso, Natasha S., Blinder, Joshua J., Coghill, Matthew T., Cooper, David S., Koch, Joshua D., Krawczeski, Catherine D., Morales, David L.S., Neumayr, Tara M., Rahman, A.K.M. Fazlur, Reichle, Garrett, Tabbutt, Sarah, Webb, Tennille N., and Borasino, Santiago

Published
2024
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6. Risk Factors Associated With Bleeding in Children With Cardiac Disease Receiving Extracorporeal Membrane Oxygenation: A Multi-Center Data Linkage Analysis

Author

Ankola, Ashish A, Bailly, David K, Reeder, Ron W, Cashen, Katherine, Dalton, Heidi J, Dolgner, Stephen J, Federman, Myke, Ghassemzadeh, Rod, Himebauch, Adam S, Kamerkar, Asavari, Koch, Josh, Kohne, Joseph, Lewen, Margaret, Srivastava, Neeraj, Willett, Renee, and Alexander, Peta MA

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Clinical Sciences, Hematology, Lung, Clinical Research, Cardiovascular, Heart Disease, Pediatric, extracorporeal membrane oxygenation, bleeding, pediatric, cardiac, anticoagulation, Cardiovascular medicine and haematology
Abstract

Background: Bleeding is a common complication of extracorporeal membrane oxygenation (ECMO) for pediatric cardiac patients. We aimed to identify anticoagulation practices, cardiac diagnoses, and surgical variables associated with bleeding during pediatric cardiac ECMO by combining two established databases, the Collaborative Pediatric Critical Care Research Network (CPCCRN) Bleeding and Thrombosis in ECMO (BATE) and the Extracorporeal Life Support Organization (ELSO) Registry. Methods: All children (80 ml/kg on any ECMO day. Bleeding odds were assessed on ECMO Day 1 and from ECMO Day 2 onwards with multivariable logistic regression. Results: There were 187 children with 114 (61%) bleeding events in the study cohort. Biventricular congenital heart disease (94/187, 50%) and cardiac medical diagnoses (75/187, 40%) were most common, and 48 (26%) patients were cannulated directly from cardiopulmonary bypass (CPB). Bleeding events were not associated with achieving pre-specified therapeutic ranges of activated clotting time (ACT) or platelet levels. In multivariable analysis, elevated INR and fibrinogen were associated with bleeding events (OR 1.1, CI 1.0-1.3, p = 0.02; OR 0.77, CI 0.6-0.9, p = 0.004). Bleeding events were also associated with clinical site (OR 4.8, CI 2.0-11.1, p < 0.001) and central cannulation (OR 1.75, CI 1.0-3.1, p = 0.05) but not with cardiac diagnosis, surgical complexity, or cannulation from CPB. Bleeding odds on ECMO day 1 were increased in patients with central cannulation (OR 2.82, 95% CI 1.15-7.08, p = 0.023) and those cannulated directly from CPB (OR 3.32, 95% CI 1.02-11.61, p = 0.047). Conclusions: Bleeding events in children with cardiac diagnoses supported on ECMO were associated with central cannulation strategy and coagulopathy, but were not modulated by achieving pre-specified therapeutic ranges of monitoring assays.

Published
2022

7. Assessment of fluid balance after neonatal cardiac surgery: a description of intake/output vs. weight-based methods

Author

Neumayr, Tara M., Alten, Jeffrey A., Bailly, David K., Bhat, Priya N., Brandewie, Katie L., Diddle, J. Wesley, and Ghbeis, Muhammad

Subjects
Water-electrolyte balance (Physiology) -- Evaluation, Heart -- Surgery, Children -- Surgery, Osmoregulation -- Evaluation, Health
Abstract

Background Fluid overload associates with poor outcomes after neonatal cardiac surgery, but consensus does not exist for the most clinically relevant method of measuring fluid balance (FB). While weight change-based FB (FB-W) is standard in neonatal intensive care units, weighing infants after cardiac surgery may be challenging. We aimed to identify characteristics associated with obtaining weights and to understand how intake/output-based FB (FB-IO) and FB-W compare in the early postoperative period in this population. Methods Observational retrospective study of 2235 neonates undergoing cardiac surgery from 22 hospitals comprising the NEonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) database. Results Forty-five percent (n = 998) of patients were weighed on postoperative day (POD) 2, varying from 2 to 98% among centers. Odds of being weighed were lower for STAT categories 4 and 5 (OR 0.72; 95% CI 0.53-0.98), cardiopulmonary bypass (0.59; 0.42-0.83), delayed sternal closure (0.27; 0.19-0.38), prophylactic peritoneal dialysis use (0.58; 0.34-0.99), and mechanical ventilation on POD 2 (0.23; 0.16-0.33). Correlation between FB-IO and FB-W was weak for every POD 1-6 and within the entire cohort (correlation coefficient 0.15; 95% CI 0.12-0.17). FB-W measured higher than paired FB-IO (mean bias 12.5%; 95% CI 11.6-13.4%) with wide 95% limits of agreement (- 15.4-40.4%). Conclusions Weighing neonates early after cardiac surgery is uncommon, with significant practice variation among centers. Patients with increased severity of illness are less likely to be weighed. FB-W and FB-IO have weak correlation, and further study is needed to determine which cumulative FB metric most associates with adverse outcomes. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information., Author(s): Tara M. Neumayr [sup.1] , Jeffrey A. Alten [sup.2] , David K. Bailly [sup.3] , Priya N. Bhat [sup.4] , Katie L. Brandewie [sup.2] , J. Wesley Diddle [sup.5] [...]

Published
2023
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10. An evaluation of the outcomes associated with peritoneal catheter use in neonates undergoing cardiac surgery: A multicenter study

Author

Kwiatkowski, David M., primary, Alten, Jeffrey A., additional, Mah, Kenneth E., additional, Selewski, David T., additional, Raymond, Tia T., additional, Afonso, Natasha S., additional, Blinder, Joshua J., additional, Coghill, Matthew T., additional, Cooper, David S., additional, Koch, Joshua D., additional, Krawczeski, Catherine D., additional, Morales, David L.S., additional, Neumayr, Tara M., additional, Rahman, A.K.M. Fazlur, additional, Reichle, Garrett, additional, Tabbutt, Sarah, additional, Webb, Tennille N., additional, Borasino, Santiago, additional, Zang, Huaiyu, additional, Winlaw, David, additional, Bailly, David, additional, Goldstein, Stuart, additional, Gist, Katja, additional, Brandewie, Katie L., additional, Bhat, Priya N., additional, Diddle, John W., additional, Ghbeis, Muhammad, additional, Prodhan, Parthak, additional, Garcia, Xiomara, additional, Ramer, Shannon, additional, Albertson, Mindy, additional, Rodriquez, Zahidee, additional, Lukacs, Mary, additional, Gaies, Michael, additional, Freytag, Joshua, additional, Sammons, Amanda, additional, Abraha, Hideat, additional, Butcher, John, additional, Zanaboni, Dominic, additional, Sanchez de Toledo, Joan, additional, Domnina, Yuliya A., additional, Saenz, Lucas, additional, Baust, Tracy, additional, Kluck, Jane, additional, Sasaki, Jun, additional, Raees, Aanish, additional, O'Neil, Erika R., additional, Lasa, Javier J., additional, Phillips, Patrick A., additional, Hock, Kristal M., additional, Valentine, Kevin, additional, Tadphale, Sachin, additional, Buckley, Jason R., additional, Schroeder, Luke, additional, Clarke, Shanelle, additional, Zhang, Wenying, additional, Smith, Andrew, additional, Absi, Mohammed, additional, Askenazi, David J., additional, Duncan, Linda, additional, Bertrandt, Rebecca A., additional, Sosa, Lisa J., additional, O’Neal, Erika R., additional, Doman, Tammy, additional, Viers, Suzanne, additional, Smith, Andrew H., additional, and Bailly, David K., additional

Published
2024
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14. Pharmacokinetic Modeling Using Real‐World Data to Optimize Unfractionated Heparin Dosing in Pediatric Patients on Extracorporeal Membrane Oxygenation and Evaluate Target Achievement–Clinical Outcomes Relationship

Author

Salem, Ahmed M., primary, Smith, Trey, additional, Wilkes, Jacob, additional, Bailly, David K., additional, Heyrend, Caroline, additional, Profsky, Michael, additional, Yellepeddi, Venkata K., additional, and Gopalakrishnan, Mathangi, additional

Published
2023
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15. Optimal Fat-Modified Diet Duration for the Treatment of Postoperative Chylothorax in Children

Author

Winder, Melissa M., primary, Schwartz, Stephanie, additional, Buckley, Jason R., additional, Fogg, Kristi L., additional, Matiasek, Megan, additional, Lyman, Alissa, additional, Tortorich, Alisa, additional, Holmes, Kathy, additional, Frank, Deborah U., additional, Nasworthy, Mandy, additional, Vichayavilas, Piyagarnt E., additional, Bertrandt, Rebecca A., additional, Kasmai, Cam, additional, Kuester, Jill C., additional, Raymond, Tia T., additional, Greiten, Lawrence E., additional, Reeder, Ron W., additional, and Bailly, David K., additional

Published
2023
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17. Pharmacokinetic Modeling Using Real‐World Data to Optimize Unfractionated Heparin Dosing in Pediatric Patients on Extracorporeal Membrane Oxygenation and Evaluate Target Achievement–Clinical Outcomes Relationship.

Author

Salem, Ahmed M., Smith, Trey, Wilkes, Jacob, Bailly, David K., Heyrend, Caroline, Profsky, Michael, Yellepeddi, Venkata K., and Gopalakrishnan, Mathangi

Subjects
BIOLOGICAL models, EXTRACORPOREAL membrane oxygenation, PEDIATRICS, RETROSPECTIVE studies, TREATMENT duration, TREATMENT effectiveness, COMPARATIVE studies, HEPARIN
Abstract

Unfractionated heparin (UFH) is a commonly used anticoagulant for pediatric patients undergoing extracorporeal membrane oxygenation (ECMO), but evidence is lacking on the ideal dosing. We aimed to (1) develop a population pharmacokinetic (PK) model for UFH, measured through anti–factor Xa assay; (2) optimize UFH starting infusions and dose titrations through simulations; and (3) explore UFH exposure–clinical outcomes relationship. Data from 218 patients admitted to Utah's Primary Children's Hospital were retrospectively collected. A 1‐compartment PK model with time‐varying clearance (CL) adequately described UFH PK. Weight on CL and volume of distribution and ECMO circuit change on CL were significant covariates. The typical estimates for initial CL and first‐order rate constant to reach steady‐state CL were 0.57 L/(h·10 kg) and 0.02/h. Comparable to non‐ECMO patients, the typical steady‐state CL was 0.81 L/(h·10 kg). Simulations showed that a 75 IU/kg UFH bolus dose followed by starting infusions of 25 and 20 IU/h/kg for patients aged younger than 6 years and 6 years or older, respectively, achieved the therapeutic target in 56.6% of all patients, whereas only 3.1% exceeded the target. The proposed UFH titration schemes achieved the target in more than 90% of patients while less than 0.63% were above the target after 24 and 48 hours of treatment. The median intensive care unit survival time in patients within and below the target at 24 hours was 136 and 66 hours, respectively. In conclusion, PK model of UFH was developed for pediatric patients on ECMO. The proposed UFH dosing scheme attained the anti–factor Xa target rapidly and safely. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Development of the Pediatric Extracorporeal Membrane Oxygenation Prediction Model for Risk-Adjusting Mortality*

Author

Bailly, David K., Reeder, Ron W., Winder, Melissa, Barbaro, Ryan P., Pollack, Murray M., Moler, Frank W., Meert, Kathleen L., Berg, Robert A., Carcillo, Joseph, Zuppa, Athena F., Newth, Christopher, Berger, John, Bell, Michael J., Dean, Michael J., Nicholson, Carol, Garcia-Filion, Pamela, Wessel, David, Heidemann, Sabrina, Doctor, Allan, Harrison, Rick, Bratton, Susan L., and Dalton, Heidi

Published
2019
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23. Comparing outcomes of venovenous versus venoarterial extracorporeal membrane oxygenation in neonatal and pediatric respiratory failure: A retrospective review of Extracorporeal Life Support Organization registry.

Author

Furlong-Dillard, Jamie M., Feygin, Yana B., Reeder, Ron W., Wilson, Johnna S., Blauvelt, David G., Todd-Tzanetos, Deanna R., Carter, Stewart R., Alexander, Peta M. A., and Bailly, David K.

Subjects
RESPIRATORY insufficiency, CONFIDENCE intervals, EXTRACORPOREAL membrane oxygenation, RETROSPECTIVE studies, TREATMENT effectiveness, COMPARATIVE studies, ARTIFICIAL respiration, RESEARCH funding, LOGISTIC regression analysis, ODDS ratio, OVERALL survival, CHILDREN
Abstract

Background: The ideal extracorporeal membrane oxygenation (ECMO) modality choice (venoarterial [VA] versus venovenous [VV]) for a primary respiratory reason is complex and multifactorial. There is an increasing need to identify the ideal (VV vs. VA) support modality in this population. The objective of this study was to compare survival outcomes of subjects with respiratory failure who could have received VV or VA ECMO. Subjects and Methods: Children ≤20 kg requiring ECMO for respiratory indications from January 2015 to December 2019 were identified retrospectively from the Extracorporeal Life Support Organization registry. To identify a cohort eligible for VV, we excluded subjects receiving cardiac support therapies and included only those receiving mechanical ventilation with a positive end expiratory pressure ≥10 or high frequency oscillatory ventilation or had a PaO2/FiO2 ratio ≤200 or an oxygenation index ≥16. Subjects were grouped by initial cannulation strategy. Statistical approach utilized doubly robust propensity weighted logistic regression and primary outcome was survival to hospital discharge. Results: Of 1686 VV candidates, 871 underwent VV and 815 VA ECMO for a respiratory indication. VV ECMO was associated with higher survival (odds ratio: 1.57; confidence interval: 1.22-2.03, P < 0.001). Conclusions: VV ECMO selection for subjects with respiratory failure was associated with lower mortality in small pediatric and neonatal patients. [ABSTRACT FROM AUTHOR]

Published
2023
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26. Fluid Accumulation After Neonatal Congenital Cardiac Operation: Clinical Implications and Outcomes

Author

Bailly, David K., primary, Alten, Jeffrey A., additional, Gist, Katja M., additional, Mah, Kenneth E., additional, Kwiatkowski, David M., additional, Valentine, Kevin M., additional, Diddle, J.Wesley, additional, Tadphale, Sachin, additional, Clarke, Shanelle, additional, Selewski, David T., additional, Banerjee, Mousumi, additional, Reichle, Garrett, additional, Lin, Paul, additional, Gaies, Michael, additional, Blinder, Joshua J., additional, Prodhan, Parthak, additional, Garcia, Xiomara, additional, Ramer, Shannon, additional, Albertson, Mindy, additional, Ghbeis, Muhammad B., additional, Cooper, David S., additional, Rodriquez, Zahidee, additional, Lukacs, Mary, additional, Zanaboni, Dominic, additional, Sanchez de Toledo, Joan, additional, Domnina, Yuliya A., additional, Saenz, Lucas, additional, Baust, Tracy, additional, Kluck, Jane, additional, Duncan, Linda, additional, Koch, Joshua D., additional, Freytag, Joshua, additional, Sammons, Amanda, additional, Abraha, Hideat, additional, Butcher, John, additional, Sasaki, Jun, additional, Krawczeski, Catherine D., additional, Bertrandt, Rebecca A., additional, Raymond, Tia T., additional, Buckley, Jason R., additional, Schroeder, Luke, additional, Raees, Aanish, additional, Sosa, Lisa J., additional, Bhat, Priya N., additional, Neumayr, Tara M., additional, Afonso, Natasha S., additional, O’Neal, Erika R., additional, Lasa, Javier J., additional, Phillips, Patrick A., additional, Ardisana, Amy, additional, Gonzalez, Kim, additional, Doman, Tammy, additional, Viers, Suzanne, additional, Zhang, Wenying, additional, Hock, Kristal M., additional, and Borasino, Santiago, additional

Published
2022
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29. Epidemiology of Neonatal Acute Kidney Injury After Cardiac Surgery Without Cardiopulmonary Bypass

Author

Sasaki, Jun, primary, Rodriguez, Zahidee, additional, Alten, Jeffrey A., additional, Rahman, AKM Fazlur, additional, Reichle, Garrett, additional, Lin, Paul, additional, Banerjee, Mousumi, additional, Selewski, David, additional, Gaies, Michael, additional, Hock, Kristal M., additional, Borasino, Santiago, additional, Gist, Katja M., additional, Prodhan, Parthak, additional, Garcia, Xiomara, additional, Ramer, Shannon, additional, Sherman, Mindy, additional, Ghbeis, Muhammad B., additional, Clarke, Shanelle A., additional, Lukacs, Mary, additional, Zanaboni, Dominic, additional, Sanchez de Toledo, Joan, additional, Domnina, Yuliya A., additional, Saenz, Lucas, additional, Baust, Tracy, additional, Kluck, Jane, additional, Duncan, Linda, additional, Koch, Joshua D., additional, Diddle, J. Wesley, additional, Freytag, Joshua, additional, Harris, Amanda, additional, Abraha, Hideat, additional, Butcher, John, additional, Tadphale, Sachin D., additional, Krawczeski, Catherine D., additional, Kwiatkowski, David M., additional, Raymond, Tia T., additional, Burton, Grant L., additional, Das, Ashima, additional, Shan, Tajas, additional, Buckley, Jason R., additional, Schroeder, Luke, additional, Raees, Aanish, additional, Guidry, Bradley, additional, Sosa, Lisa J., additional, Bailly, David K., additional, Valentine, Kevin M., additional, Bhat, Priya N., additional, Neumayr, Tara M., additional, Afonso, Natasha S., additional, O’Neal, Erika R., additional, Lasa, Javier J., additional, Huskey, Jordan L., additional, Phillips, Patrick A., additional, Ardisana, Amy, additional, Gonzalez, Kim, additional, Columb, Eric, additional, Domar, Tammy, additional, and Viers, Suzanne, additional

Published
2022
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33. The final hospital need in children discharged from a cardiology acute care unit: a single-centre survey study

Author

Ware, Adam L., Reiter, Lauren, Winder, Melissa, Kelly, Dallin, Marietta, Jennifer, Ohsiek, Sonja, Ou, Zhining, Presson, Angela, and Bailly, David K.

Abstract

AbstractObjective:Children with heart disease may require inpatient care for many reasons, but ultimately have a final reason for hospitalisation prior to discharge. Factors influencing length of stay in paediatric cardiac acute care units have been described but the last reason for hospitalisation has not been studied. Our aim was to describe Final Hospital Need as a novel measure, determine Final Hospital Need in our patients, and describe factors associated with this Need.Methods:Single-centre survey design. Discharging providers selected a Final Hospital Need from the following categories: cardiovascular, respiratory, feeding/fluid, haematology/ID, pain/sedation, systems issues, and other/wound issues. Univariable and multivariable analyses were performed separately for outcomes “cardiovascular” and “feeding/fluid.”Measurements and Results:Survey response rate was 99% (624 encounters). The most frequent Final Hospital Needs were cardiovascular (36%), feeding/fluid (24%) and systems issues (13%). Probability of Final Hospital Need “cardiovascular” decreased as length of stay increased. Multivariate analysis showed Final Hospital Need “cardiovascular” was negatively associated with aortic arch repair, Norwood procedure, and Final ICU Need “respiratory” and “other.” Final Hospital Need "feeding/fluid” was negatively associated with left-sided valve procedure, but positively associated with final ICU need “respiratory,” and tube feeding at discharge.Conclusions:Final Hospital Need is a novel measure that can be predicted by clinical factors including age, Final ICU Need, and type of surgery. Final Hospital Need may be utilised to track changes in clinical care over time and as a target for improvement work.

Published
2023
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34. Development of consensus recommendations for the management of post-operative chylothorax in paediatric CHD

Author

Lion, Richard P., primary, Winder, Melissa M., additional, Amirnovin, Rambod, additional, Fogg, Kristi, additional, Bertrandt, Rebecca, additional, Bhaskar, Priya, additional, Kasmai, Cameron, additional, Holmes, Kathryn W, additional, Moza, Rohin, additional, Vichayavilas, Piyagarnt, additional, Gordon, Erin E., additional, Trauth, Amiee, additional, Horsley, Megan, additional, Frank, Deborah U., additional, Stock, Arabela, additional, Adamson, Greg, additional, Lyman, Alissa, additional, Raymond, Tia, additional, Diaz, Isaura, additional, DeMarco, Alicia, additional, Prodhan, Parthak, additional, Fundora, Michael, additional, Aljiffry, Alaa, additional, Dewitt, Aaron G, additional, Kozyak, Benjamin W., additional, Greiten, Lawrence, additional, Scahill, Carly, additional, Buckley, Jason, additional, and Bailly, David K., additional

Published
2022
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37. Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis.

Author

Bailly, David K, Reeder, Ron W, Muszynski, Jennifer A, Meert, Kathleen L, Ankola, Ashish A, Alexander, Peta MA, Pollack, Murray M, Moler, Frank W, Berg, Robert A, Carcillo, Joseph, Newth, Christopher, Berger, John, Bell, Michael J, Dean, J M, Nicholson, Carol, Garcia-Filion, Pamela, Wessel, David, Heidemann, Sabrina, Doctor, Allan, and Harrison, Rick

Subjects
*THROMBOLYTIC therapy, *RESEARCH, *CEREBRAL embolism & thrombosis, *ISCHEMIA, *PULMONARY embolism, *CONFIDENCE intervals, *BLOOD transfusion, *ANTICOAGULANTS, *EXTRACORPOREAL membrane oxygenation, *TREATMENT effectiveness, *RESEARCH funding, *DESCRIPTIVE statistics, *LOGISTIC regression analysis, *ODDS ratio, *HEMORRHAGE, *SECONDARY analysis, *LONGITUDINAL method, *CHILDREN
Abstract

To determine associations between anticoagulation practices and bleeding and thrombosis during pediatric extracorporeal membrane oxygenation (ECMO), we performed a secondary analysis of prospectively collected data which included 481 children (<19 years), between January 2012 and September 2014. The primary outcome was bleeding or thrombotic events. Bleeding events included a blood product transfusion >80 ml/kg on any day, pulmonary hemorrhage, or intracranial bleeding, Thrombotic events included pulmonary emboli, intracranial clot, limb ischemia, cardiac clot, and arterial cannula or entire circuit change. Bleeding occurred in 42% of patients. Five percent of subjects thrombosed, of which 89% also bled. Daily bleeding odds were independently associated with day prior activated clotting time (ACT) (OR 1.03, 95% CI= 1.00, 1.05, p =0.047) and fibrinogen levels (OR 0.90, 95% CI 0.84, 0.96, p <0.001). Thrombosis odds decreased with increased day prior heparin dose (OR 0.88, 95% CI 0.81, 0.97, p =0.006). Lower ACT values and increased fibrinogen levels may be considered to decrease the odds of bleeding. Use of this single measure, however, may not be sufficient alone to guide optimal anticoagulation practice during ECMO. [ABSTRACT FROM AUTHOR]

Published
2023
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39. Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis

Author

Bailly, David K, primary, Reeder, Ron W, additional, Muszynski, Jennifer A, additional, Meert, Kathleen L, additional, Ankola, Ashish A, additional, Alexander, Peta MA, additional, Pollack, Murray M, additional, Moler, Frank W, additional, Berg, Robert A, additional, Carcillo, Joseph, additional, Newth, Christopher, additional, Berger, John, additional, Bell, Michael J, additional, Dean, J M, additional, Nicholson, Carol, additional, Garcia-Filion, Pamela, additional, Wessel, David, additional, Heidemann, Sabrina, additional, Doctor, Allan, additional, Harrison, Rick, additional, Dalton, Heidi, additional, and Zuppa, Athena F, additional

Published
2022
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40. sj-pdf-2-prf-10.1177_02676591211056562 ��� Supplemental Material for Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis

Author

Bailly, David K, Reeder, Ron W, Muszynski, Jennifer A, Meert, Kathleen L, Ankola, Ashish A, Alexander, Peta MA, Pollack, Murray M, Moler, Frank W, Berg, Robert A, Carcillo, Joseph, Newth, Christopher, Berger, John, Bell, Michael J, Dean, J M, Nicholson, Carol, Garcia-Filion, Pamela, Wessel, David, Heidemann, Sabrina, Doctor, Allan, Harrison, Rick, Dalton, Heidi, and Zuppa, Athena F

Subjects
FOS: Clinical medicine, Cardiology, 110323 Surgery
Abstract

Supplemental Material, sj-pdf-2-prf-10.1177_02676591211056562 for Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis by David K Bailly, Ron W Reeder, Jennifer A Muszynski, Kathleen L Meert, Ashish A Ankola, Peta MA Alexander, Murray M Pollack, Frank W Moler, Robert A Berg, Joseph Carcillo, Christopher Newth, John Berger, Michael J Bell, J M Dean, Carol Nicholson, Pamela Garcia-Filion, David Wessel, Sabrina Heidemann, Allan Doctor, Doctor Harrison, Heidi Dalton and Athena F Zuppa in Perfusion

Published
2022
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41. sj-pdf-3-prf-10.1177_02676591211056562 ��� Supplemental Material for Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis

Author

Bailly, David K, Reeder, Ron W, Muszynski, Jennifer A, Meert, Kathleen L, Ankola, Ashish A, Alexander, Peta MA, Pollack, Murray M, Moler, Frank W, Berg, Robert A, Carcillo, Joseph, Newth, Christopher, Berger, John, Bell, Michael J, Dean, J M, Nicholson, Carol, Garcia-Filion, Pamela, Wessel, David, Heidemann, Sabrina, Doctor, Allan, Harrison, Rick, Dalton, Heidi, and Zuppa, Athena F

Subjects
FOS: Clinical medicine, Cardiology, 110323 Surgery
Abstract

Supplemental Material, sj-pdf-3-prf-10.1177_02676591211056562 for Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis by David K Bailly, Ron W Reeder, Jennifer A Muszynski, Kathleen L Meert, Ashish A Ankola, Peta MA Alexander, Murray M Pollack, Frank W Moler, Robert A Berg, Joseph Carcillo, Christopher Newth, John Berger, Michael J Bell, J M Dean, Carol Nicholson, Pamela Garcia-Filion, David Wessel, Sabrina Heidemann, Allan Doctor, Doctor Harrison, Heidi Dalton and Athena F Zuppa in Perfusion

Published
2022
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42. sj-pdf-1-prf-10.1177_02676591211056562 ��� Supplemental Material for Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis

Author

Bailly, David K, Reeder, Ron W, Muszynski, Jennifer A, Meert, Kathleen L, Ankola, Ashish A, Alexander, Peta MA, Pollack, Murray M, Moler, Frank W, Berg, Robert A, Carcillo, Joseph, Newth, Christopher, Berger, John, Bell, Michael J, Dean, J M, Nicholson, Carol, Garcia-Filion, Pamela, Wessel, David, Heidemann, Sabrina, Doctor, Allan, Harrison, Rick, Dalton, Heidi, and Zuppa, Athena F

Subjects
FOS: Clinical medicine, Cardiology, 110323 Surgery
Abstract

Supplemental Material, sj-pdf-1-prf-10.1177_02676591211056562 for Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis by David K Bailly, Ron W Reeder, Jennifer A Muszynski, Kathleen L Meert, Ashish A Ankola, Peta MA Alexander, Murray M Pollack, Frank W Moler, Robert A Berg, Joseph Carcillo, Christopher Newth, John Berger, Michael J Bell, J M Dean, Carol Nicholson, Pamela Garcia-Filion, David Wessel, Sabrina Heidemann, Allan Doctor, Doctor Harrison, Heidi Dalton and Athena F Zuppa in Perfusion

Published
2022
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43. sj-pdf-4-prf-10.1177_02676591211056562 ��� Supplemental Material for Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis

Author

Bailly, David K, Reeder, Ron W, Muszynski, Jennifer A, Meert, Kathleen L, Ankola, Ashish A, Alexander, Peta MA, Pollack, Murray M, Moler, Frank W, Berg, Robert A, Carcillo, Joseph, Newth, Christopher, Berger, John, Bell, Michael J, Dean, J M, Nicholson, Carol, Garcia-Filion, Pamela, Wessel, David, Heidemann, Sabrina, Doctor, Allan, Harrison, Rick, Dalton, Heidi, and Zuppa, Athena F

Subjects
FOS: Clinical medicine, Cardiology, 110323 Surgery
Abstract

Supplemental Material, sj-pdf-4-prf-10.1177_02676591211056562 for Anticoagulation practices associated with bleeding and thrombosis in pediatric extracorporeal membrane oxygenation; a multi-center secondary analysis by David K Bailly, Ron W Reeder, Jennifer A Muszynski, Kathleen L Meert, Ashish A Ankola, Peta MA Alexander, Murray M Pollack, Frank W Moler, Robert A Berg, Joseph Carcillo, Christopher Newth, John Berger, Michael J Bell, J M Dean, Carol Nicholson, Pamela Garcia-Filion, David Wessel, Sabrina Heidemann, Allan Doctor, Doctor Harrison, Heidi Dalton and Athena F Zuppa in Perfusion

Published
2022
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44. Risk Factors Associated With Bleeding in Children With Cardiac Disease Receiving Extracorporeal Membrane Oxygenation: A Multi-Center Data Linkage Analysis

Author

Ankola, Ashish A., primary, Bailly, David K., additional, Reeder, Ron W., additional, Cashen, Katherine, additional, Dalton, Heidi J., additional, Dolgner, Stephen J., additional, Federman, Myke, additional, Ghassemzadeh, Rod, additional, Himebauch, Adam S., additional, Kamerkar, Asavari, additional, Koch, Josh, additional, Kohne, Joseph, additional, Lewen, Margaret, additional, Srivastava, Neeraj, additional, Willett, Renee, additional, and Alexander, Peta M. A., additional

Published
2022
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46. Preventing Cardiac Arrest in the Pediatric Cardiac Intensive Care Unit Through Multicenter Collaboration.

Author

Alten, Jeffrey, Cooper, David S., Klugman, Darren, Raymond, Tia Tortoriello, Wooton, Sharyl, Garza, Janie, Clarke-Myers, Katherine, Anderson, Jeffrey, Pasquali, Sara K., Absi, Mohammed, Affolter, Jeremy T., Bailly, David K., Bertrandt, Rebecca A., Borasino, Santiago, Dewan, Maya, Domnina, Yuliya, Lane, John, McCammond, Amy N., Mueller, Dana M., and Olive, Mary K.

Published
2022
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47. Risk Factors Associated With Bleeding in Children With Cardiac Disease Receiving Extracorporeal Membrane Oxygenation: A Multi-Center Data Linkage Analysis.

Author

Ankola, Ashish A, Ankola, Ashish A, Bailly, David K, Reeder, Ron W, Cashen, Katherine, Dalton, Heidi J, Dolgner, Stephen J, Federman, Myke, Ghassemzadeh, Rod, Himebauch, Adam S, Kamerkar, Asavari, Koch, Josh, Kohne, Joseph, Lewen, Margaret, Srivastava, Neeraj, Willett, Renee, Alexander, Peta MA, Ankola, Ashish A, Ankola, Ashish A, Bailly, David K, Reeder, Ron W, Cashen, Katherine, Dalton, Heidi J, Dolgner, Stephen J, Federman, Myke, Ghassemzadeh, Rod, Himebauch, Adam S, Kamerkar, Asavari, Koch, Josh, Kohne, Joseph, Lewen, Margaret, Srivastava, Neeraj, Willett, Renee, and Alexander, Peta MA

Abstract

Background: Bleeding is a common complication of extracorporeal membrane oxygenation (ECMO) for pediatric cardiac patients. We aimed to identify anticoagulation practices, cardiac diagnoses, and surgical variables associated with bleeding during pediatric cardiac ECMO by combining two established databases, the Collaborative Pediatric Critical Care Research Network (CPCCRN) Bleeding and Thrombosis in ECMO (BATE) and the Extracorporeal Life Support Organization (ELSO) Registry. Methods: All children (<19 years) with a primary cardiac diagnosis managed on ECMO included in BATE from six centers were analyzed. ELSO Registry criteria for bleeding events included pulmonary or intracranial bleeding, or red blood cell transfusion >80 ml/kg on any ECMO day. Bleeding odds were assessed on ECMO Day 1 and from ECMO Day 2 onwards with multivariable logistic regression. Results: There were 187 children with 114 (61%) bleeding events in the study cohort. Biventricular congenital heart disease (94/187, 50%) and cardiac medical diagnoses (75/187, 40%) were most common, and 48 (26%) patients were cannulated directly from cardiopulmonary bypass (CPB). Bleeding events were not associated with achieving pre-specified therapeutic ranges of activated clotting time (ACT) or platelet levels. In multivariable analysis, elevated INR and fibrinogen were associated with bleeding events (OR 1.1, CI 1.0-1.3, p = 0.02; OR 0.77, CI 0.6-0.9, p = 0.004). Bleeding events were also associated with clinical site (OR 4.8, CI 2.0-11.1, p < 0.001) and central cannulation (OR 1.75, CI 1.0-3.1, p = 0.05) but not with cardiac diagnosis, surgical complexity, or cannulation from CPB. Bleeding odds on ECMO day 1 were increased in patients with central cannulation (OR 2.82, 95% CI 1.15-7.08, p = 0.023) and those cannulated directly from CPB (OR 3.32, 95% CI 1.02-11.61, p = 0.047). Conclusions: Bleeding events in children with cardiac diagnoses supported on ECMO were associated with central cannulation st

Published
2021

48. Supplemental_material – Supplemental material for External validation of the Pediatric Extracorporeal Membrane Oxygenation Prediction model for risk adjusting mortality

Author

Bailly, David K, Furlong-Dillard, Jamie M, Winder, Melissa, Lavering, Mark, Barbaro, Ryan P, Meert, Kathleen L, Bratton, Susan L, Dalton, Heidi, and Reeder, Ron W

Subjects
FOS: Clinical medicine, Cardiology, 110323 Surgery
Abstract

Supplemental material, Supplemental_material for External validation of the Pediatric Extracorporeal Membrane Oxygenation Prediction model for risk adjusting mortality by David K Bailly, Jamie M Furlong-Dillard, Melissa Winder, Mark Lavering, Ryan P Barbaro, Kathleen L Meert, Susan L Bratton, Heidi Dalton and Ron W Reeder in Perfusion

Published
2020
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