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1,990 results on '"Gauvreau, Kimberlee"'

11. Changes in Practice/Outcomes of Pediatric/Congenital Catheterization in Response to the First Wave of COVID.

Author

Quinn, Brian, Barry, Oliver, Batlivala, Sarosh, Boe, Brian, Glatz, Andrew, Gauvreau, Kimberlee, Goldstein, Bryan, Gudausky, Todd, Hainstock, Michael, Holzer, Ralf, Nicholson, George, Trucco, Sara, Whiteside, Wendy, Yeh, Mary, Bergersen, Lisa, and OByrne, Michael

Subjects
AE, adverse events, C3PO, Cardiac Catheterization Project on Outcomes Registry, FTR, failure to rescue, HSAE, high-severity adverse events, PCCL, pediatric/congenital catheterization laboratory, catheterization, health services research, outcomes research, pediatric cardiology
Abstract

BACKGROUND: The COVID-19 pandemic has posed tremendous stress on the health care system. Its effects on pediatric/congenital catheterization program practice and performance have not been described. OBJECTIVES: The purpose of this study was to evaluate how case volumes, risk-profile, and outcomes of pediatric/congenital catheterization procedures changed in response to the first wave of COVID-19 and after that wave. METHODS: A multicenter retrospective observational study was performed using Congenital Cardiac Catheterization Project on Outcomes Registry (C3PO) data to study changes in volume, case mix, and outcomes (high-severity adverse events [HSAEs]) during the first wave of COVID (March 1, 2020, to May 31, 2020) in comparison to the period prior to (January 1, 2019, to February 28, 2020) and after (June 1, 2020, to December 31, 2020) the first wave. Multivariable analyses adjusting for case type, hemodynamic vulnerability, and age group were performed. Hospital responses to the first wave were captured with an electronic study instrument. RESULTS: During the study period, 12,557 cases were performed at 14 C3PO hospitals (with 8% performed during the first wave of COVID and 32% in the postperiod). Center case volumes decreased from a median 32.1 cases/month (IQR: 20.7-49.0 cases/month) before COVID to 22 cases/month (IQR: 13-31 cases/month) during the first wave (P = 0.001). The proportion of cases with risk factors for HSAE increased during the first wave, specifically proportions of infants and neonates (P

Published
2022

15. Impact of pre-bypass ultrafiltration on prime values and clinical outcomes in neonatal and infant cardiopulmonary bypass

Author

Kohlsaat Katherine, Gauvreau Kimberlee, Fynn-Thompson Francis, Boyle Sharon, Connor Kevin, Regan William, Matte Gregory, and Nathan Meena

Subjects
pre-bypass ultrafiltration, congenital, pbuf, electrolytes, outcomes, bypass prime, blood prime, prime, Medicine
Abstract

Background: A standard blood prime for cardiopulmonary bypass (CPB) in congenital cardiac surgery may possess non-physiologic values for electrolytes, glucose, and lactate. Pre-bypass Ultrafiltration (PBUF) can make these values more physiologic and standardized prior to bypass initiation. We aimed to determine if using PBUF on blood primes including packed red blood cells and thawed plasma would make prime values more predictable and physiologic. Additionally, we aimed to evaluate whether the addition of PBUF had an impact on outcome measures. Methods: Retrospective review of consecutive patients ≤ 1 year of age undergoing an index cardiac operation on CPB between 8/2017 and 9/2021. As PBUF was performed at the perfusionists’ discretion, a natural grouping of patients that received PBUF vs. those that did not occur. Differences in electrolytes, glucose, and lactate were compared at specific time points using Fisher’s exact test for categorical variables and the Wilcoxon rank sum test for continuous variables. Clinical outcomes were also assessed. Results: In both cohorts, the median age at surgery was 3 months and 47% of patients were female; 308/704 (44%) of the PBUF group and 163/414 (39%) of the standard prime group had at least one preoperative risk factor. The proportion of PBUF circuits which demonstrated more physiologic values for glucose (318 [45%]), sodium (434, [62%]), potassium (688 [98%]), lactate (612 [87%]) and osmolality (595 [92%]) was significantly higher when compared to standard prime circuit levels for glucose (8 [2%]), sodium (13 [3%], potassium (150 [36%]), lactate (56 [13%]) and osmolality (23 [6%]) prior to CPB initiation. There were no differences in clinical outcomes or rates of major adverse events between the two cohorts. Conclusions: PBUF creates standardized and more physiologic values for electrolytes, glucose, and lactate before the initiation of bypass without significant impacts on in-hospital outcomes.

Published
2023
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23. Procedural Risk in Congenital Cardiac Catheterization (PREDIC3T).

Author

Quinn, Brian, Yeh, Mary, Gauvreau, Kimberlee, Ali, Fatima, Balzer, David, Barry, Oliver, Batlivala, Sarosh, Berman, Darren, Foerster, Susan, Goldstein, Bryan, Hainstock, Michael, Holzer, Ralf, Janssen, Dana, OByrne, Michael, Shirley, Lauren, Trucco, Sara, Whiteside, Wendy, and Bergersen, Lisa

Subjects
comparative effectiveness/patient‐centered outcomes research, congenital heart disease, pediatric intervention, pediatrics, Cardiac Catheterization, Heart Defects, Congenital, Hemodynamics, Humans, Infant, Odds Ratio, Registries, Risk Assessment, Risk Factors
Abstract

Background Advancements in the field, including novel procedures and multiple interventions, require an updated approach to accurately assess patient risk. This study aims to modernize patient hemodynamic and procedural risk classification through the creation of risk assessment tools to be used in congenital cardiac catheterization. Methods and Results Data were collected for all cases performed at sites participating in the C3PO (Congenital Cardiac Catheterization Project on Outcomes) multicenter registry. Between January 2014 and December 2017, 23 119 cases were recorded in 13 participating institutions, of which 88% of patients were

Published
2022

25. Higher Survival With the Use of Extracorporeal Cardiopulmonary Resuscitation Compared With Conventional Cardiopulmonary Resuscitation in Children Following Cardiac Surgery: Results of an Analysis of the Get With The Guidelines-Resuscitation Registry*

Author

Kobayashi, Ryan L., Gauvreau, Kimberlee, Alexander, Peta M. A., Teele, Sarah A., Fynn-Thompson, Francis, Lasa, Javier J., Bembea, Melania, Thiagarajan, Ravi R., Guerguerian, Anne-Marie, Fink, Ericka L., Lasa, Javier J., Roberts, Joan S., Su, Lillian, Brown, Linda L., Dewan, Maya, Bembea, Melania M., Kleinman, Monica, Gupta, Punkaj, Sutton, Robert M., Reeder, Ron, and Sweberg, Todd

Published
2024
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26. Catheterization for Congenital Heart Disease Adjustment for Risk Method II

Author

Quinn, Brian P., Gunnelson, Lauren C., Kotin, Sarah G., Gauvreau, Kimberlee, Yeh, Mary J., Hasan, Babar, Lozier, John, Barry, Oliver M., Shahanavaz, Shabana, Batlivala, Sarosh P., Salavitabar, Arash, Foerster, Susan, Goldstein, Bryan, Divekar, Abhay, Holzer, Ralf, Nicholson, George T., O’Byrne, Michael L., Whiteside, Wendy, and Bergersen, Lisa

Published
2024
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27. Higher Survival With the Use of Extracorporeal Cardiopulmonary Resuscitation Compared With Conventional Cardiopulmonary Resuscitation in Children Following Cardiac Surgery: Results of an Analysis of the Get With The Guidelines-Resuscitation Registry

Author

Kobayashi, Ryan L., Gauvreau, Kimberlee, Alexander, Peta M. A., Teele, Sarah A., Fynn-Thompson, Francis, Lasa, Javier J., Bembea, Melania, Thiagarajan, Ravi R., Guerguerian, Anne-Marie, Fink, Ericka L., Roberts, Joan S., Su, Lillian, Brown, Linda L., Dewan, Maya, Kleinman, Monica, Gupta, Punkaj, Sutton, Robert M., Reeder, Ron, and Sweberg, Todd

Published
2023
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