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193 results on '"Simsic, Janet M."'

5. Abstract 13298: Racial and Ethnic Variation in ECMO Use, Failure to Rescue, & Mortality in Pediatric Cardiac ICU Patients: A Multicenter Cohort Study From the Pediatric Cardiac Critical Care Consortium Registry

Author

Brunetti, Marissa A, Griffis, Heather M, Obyrne, Michael L, Glatz, Andrew C, HUANG, JING, Chan, Titus, Schumacher, Kurt, Bailly, David, Domnina, Yuliya, Lasa, Javier J, Moga, Michael-Alice, Zaccagni, Hayden, Simsic, Janet M, and Gaynor, James W

Published
2022
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7. A stepwise model for delivering medical humanitarian aid requiring complex interventions

Author

Young, J Nilas, Everett, Josie, Simsic, Janet M, Taggart, Nathaniel W, Litwin, Sonny Bert, Lusin, Natalia, Hasse, Lizbeth, Krivoshchekov, Evgeny V, Marcin, James P, Raff, Gary W, and Cetta, Frank

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Heart Disease, Cardiovascular, Good Health and Well Being, Altruism, Cardiology, Cooperative Behavior, Delivery of Health Care, Education, Medical, Heart Defects, Congenital, Humans, International Cooperation, Leadership, Medical Missions, Models, Organizational, Program Development, Program Evaluation, Quality of Health Care, Russia, Thoracic Surgery, Time Factors, Treatment Outcome, United States, Volunteers, Cardiorespiratory Medicine and Haematology, Respiratory System, Cardiovascular medicine and haematology, Clinical sciences
Abstract

ObjectivesCardiothoracic surgeons and practitioners of cardiovascular medicine have a long history of humanitarian aid. Although this is worthwhile at multiple levels and occasionally described in some detail, few efforts have a proven algorithm with demonstrable outcomes that suggest effective educational methodology or clinical results approaching accepted standards in developed countries.MethodsOur report provides a stepwise approach to developing highly successful self-sustainable, replicable, and scalable humanitarian congenital cardiac surgical programs, and provides data to allow insight into the efficacy of our model.ResultsThis program model has evolved over 25 years, during which it has been replicated several times and scaled throughout a vast and populous country. Since 1989, Russia has undergone considerable social, political, and economic changes. Our program model proved successful throughout this time despite dynamic social, political, and medical landscapes.ConclusionsThe positive results of our program model indicate that these methodologies may be helpful to others attempting to address the worldwide shortage of cardiovascular care and particularly the complex interventions required in the management of congenital cardiovascular disease.

Published
2014

11. Reduced Intracranial Hemorrhage with Anticoagulation Guideline Implementation

Author

Duffy, Vicky, Schneider, Brian, Deitemyer, Matt, Walczak, Ashley, and Simsic, Janet M.

Subjects
Original Article
Abstract

Hemorrhagic and thrombotic complications, including intracranial hemorrhage, embolic stroke, surgical bleeding, and circuit thrombosis, are common during extracorporeal membrane oxygenation (ECMO), occurring in up to 50% of patients. These complications have a significant impact on morbidity and mortality. Our objective was to implement standardized ECMO anticoagulation guidelines for the pediatric cardiothoracic intensive care unit (CTICU) to reduce the incidence of intracranial hemorrhage while on ECMO. All CTICU patients who received ECMO from January 2016 to December 2020 were retrospectively reviewed. Standardized ECMO anticoagulation guidelines were implemented in the fourth quarter of 2017. Variables and clinical outcomes before and after guideline implementation were compared. From January 2016 to December 2017, there were 22 separate ECMO runs. Eight of 22 (36%) suffered intracranial hemorrhage while on ECMO. Seven of 8 (88%) were withdrawn from ECMO secondary to bleed and expired prior to hospital discharge. From January 2018 to December 2020, there were 22 separate ECMO runs in the CTICU. Three of 22 (14%) suffered intracranial hemorrhage while on ECMO. One of 3 (33%) expired prior to hospital discharge. Implementation of standardized ECMO anticoagulation guidelines in the CTICU was successful in improving clinical outcomes as evidenced by reduction in the incidence of intracranial hemorrhage in this high-risk patient population.

Published
2022

20. Perioperative effects and safety of nesiritide following cardiac surgery in children

Author

Simsic, Janet M., Scheurer, Mark, Tobias, Joseph D., Berkenbosch, John, Schechter, William, Madera, Freddie, Weinstein, Samuel, and Michler, Robert E.

Subjects
Congenital heart disease -- Care and treatment -- Complications and side effects -- Research, Heart -- Surgery, Surgery -- Complications, Health, Care and treatment, Complications and side effects, Research, Dosage and administration
Abstract

Nesiritide (Natrecor, Scios Inc), human B-type natriuretic peptide, has hemodynamic effects that may be beneficial in pediatric patients after cardiac surgery. Experience with nesiritide and pediatrics is limited. The purpose [...]

Published
2006

21. Role of microtubules versus myosin heavy chain isoforms in contractile dysfunction of hypertrophied murine cardiocytes

Author

Ishibashi, Yuji, Takahashi, Masaru, Isomatsu, Yukihisa, Qiao, Fei, Iijima, Yoshihiro, Shiraishi, Hirokazu, Simsic, Janet M., Baicu, Catalin F., Robbins, Jeffrey, Zile, Michael R., and Cooper, George, IV

Subjects
Myosin -- Physiological aspects, Hypertrophy -- Physiological aspects, Heart failure -- Physiological aspects, Cytoskeleton -- Physiological aspects, Biological sciences
Abstract

In large mammals there is a correlation between microtubule network densification and contractile dysfunction in severe pressure-overload hypertrophy. In small mammals there is a similar correlation for the shift to [beta]-myosin heavy chain (MHC), a MHC isoform having a slower ATPase [V.sub.max.] In this study, murine left ventricular (LV) pressure overload invoked both mechanisms: microtubule network densification and [beta]-MHC expression. Cardiac [beta]-MHC was also augmented without altering tubulin levels by two load-independent means, chemical thyroidectomy and transgenesis. In hypertrophy, contractile function of the LV and its cardiocytes decreased proportionally; microtubule depolymerization restored normal cellular contraction. In hypothyroid mice having a complete shift from [alpha]-MHC to [beta]-MHC, contractile function of the LV and its cardiocytes also decreased, but microtubule depolymerization had no effect on cellular contraction. In transgenic mice having a cardiac [beta]-MHC increase similar to that in hypertrophy, contractile function of the LV and its cardiocytes was normal, and microtubule depolymerization had no effect. Thus, although both mechanisms may cause contractile dysfunction, for the extent of MHC isoform switching seen even in severe murine LV pressure-overload hypertrophy, microtubule network densification appears to have the more important role. left ventricle; heart failure; cytoskeleton; contractile proteins; sarcomeres

Published
2003

42. Reducing variation in feeding newborns with congenital heart disease

Author

Simsic, Janet M., Carpenito, Kirby‐Rose, Kirchner, Kristin, Peters, Stephanie, Miller‐Tate, Holly, Joy, Brian, and Galantowicz, Mark

Abstract

Enteral feeding is associated with decreased infection rates, decreased mechanical ventilation, decreased hospital length of stay, and improved wound healing. Enteral feeding difficulties are common in congenital heart disease. Our objective was to develop experience‐based newborn feeding guidelines for the initiation and advancement of enteral feeding in the cardiothoracic intensive care unit. This is a retrospective analysis of a quality improvement project. This quality improvement project was performed in a cardiothoracic intensive care unit. Newborns admitted to the cardiothoracic intensive care unit for cardiac surgery from January 2011 to May 2015 were retrospectively reviewed. Newborn feeding guidelines for the initiation and advancement of enteral feeding were implemented in January 2012. Guideline compliance and clinical variables before and after guideline implementation were reviewed. Compliance with the guidelines increased from 83% in 2012 to 100% in the first two quarters of 2015. Preguidelines (January 2011–December 2011): 45 newborns underwent cardiac surgery; 8 deaths prior to discharge; 1 patient discharged from NICU, therefore, N= 36. Postguidelines (January 2012–May 2015): 131 newborns with 12 deaths, 12 admitted from home, 8 in the NICU, 3 on the floor preop, and 3 back transferred, therefore, N= 93. No difference in feeding preop (post 75% vs pre 69%; P= .5) or full po feeds at discharge (post 78% vs pre 89%; P= .2). Mesenteric ischemia was not statistically different postguidelines (post 6% vs pre 14%; P= .14). Length of hospital stay decreased postguidelines (post 27 + 17 d vs pre 34 + 42 d; P< .001). Implementation of experience‐based newborn feeding guidelines for initiation and advancement of enteral feeding in the cardiothoracic intensive care unit was successful in reducing practice variation supported by increasing guideline compliance. Percentage of patient's full oral feeding at discharge did not change. Length of hospital stay was reduced although cannot be fully attributed to feeding guideline implementation.

Published
2017
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