Special considerations for the stabilization and resuscitation of patients with cardiac disease in the Neonatal Intensive Care Unit
Effective resuscitation of neonates with congenital heart disease (CHD) depends on comprehensive planning, thorough understanding of physiology, vigilant monitoring, and interdisciplinary collaboration to achieve the best outcomes. Neonatal heart disease can affect cardiac structure, rhythm, or vent...
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| description | Effective resuscitation of neonates with congenital heart disease (CHD) depends on comprehensive planning, thorough understanding of physiology, vigilant monitoring, and interdisciplinary collaboration to achieve the best outcomes. Neonatal heart disease can affect cardiac structure, rhythm, or ventricular function, and may be either congenital or acquired. Critical congenital heart disease (CCHD) can result in inadequate pulmonary blood flow, impaired intracardiac mixing, airway obstruction, or insufficient cardiac output. Tailored resuscitation strategies are important as early as the delivery room, where some CHD lesions may cause immediate cardiovascular instability during the transition from fetal to postnatal circulation. Premature infants with CHD are at higher risk due to their small size and the complications associated with prematurity, affecting both CHD management and overall clinical stability. Addressing both cardiac and non-cardiac causes of decompensation requires a precise understanding of each patient's unique physiology and trajectory from delivery through postintervention intensive care. |
| doi_str_mv | 10.1016/j.semperi.2024.151989 |
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Neonatal heart disease can affect cardiac structure, rhythm, or ventricular function, and may be either congenital or acquired. Critical congenital heart disease (CCHD) can result in inadequate pulmonary blood flow, impaired intracardiac mixing, airway obstruction, or insufficient cardiac output. Tailored resuscitation strategies are important as early as the delivery room, where some CHD lesions may cause immediate cardiovascular instability during the transition from fetal to postnatal circulation. Premature infants with CHD are at higher risk due to their small size and the complications associated with prematurity, affecting both CHD management and overall clinical stability. Addressing both cardiac and non-cardiac causes of decompensation requires a precise understanding of each patient's unique physiology and trajectory from delivery through postintervention intensive care.</description><identifier>ISSN: 0146-0005</identifier><identifier>ISSN: 1558-075X</identifier><identifier>EISSN: 1558-075X</identifier><identifier>DOI: 10.1016/j.semperi.2024.151989</identifier><identifier>PMID: 39477714</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abbreviations: AHA, American Heart Association ; Ao, aorta ; APV, absent pulmonary valve ; ARC, acute respiratory compromise ; ARF, acute renal failure ; AV, atrioventricular ; AVRT, atrioventricular reentrant tachycardia ; BP, blood pressure ; CCHB, congenital complete heart block ; CCHD, critical congenital heart disease ; CHD, congenital heart disease ; CLD, chronic lung disease ; CPAP, continuous positive airway pressure ; CPR, cardiopulmonary resuscitation ; CVC, central venous catheter ; DCM, dilated cardiomyopathy ; DR, delivery room ; EAT, ectopic atrial tachycardia ; ECA, extracardiac anomalies ; ECMO, extracorporeal membrane oxygenation ; eCPR, extracorporeal cardiopulmonary resuscitation ; EKG, electrocardiogram ; HCM, hypertrophic cardiomyopathy ; Heart Defects, Congenital - complications ; Heart Defects, Congenital - physiopathology ; Heart Defects, Congenital - therapy ; HLHS, hypoplastic left heart syndrome ; HR, heart rate ; Humans ; ICU, intensive care unit ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; IV, intravenous ; IVC, inferior vena cava ; IVH, intraventricular hemorrhage ; IVS, intact ventricular septum ; LA, left atrium ; LV, left ventricle ; LVOTO, left ventricular outflow tract obstruction ; MI, myocardial infarction ; NCCM, noncompaction cardiomyopathy ; NEC, necrotizing enterocolitis ; NICU, neonatal intensive care unit ; NRP, neonatal resuscitation program ; PA, pulmonary artery ; PALS, pediatric advanced life support ; pCO2, partial pressure of carbon dioxide ; PDA, patent ductus arteriosus ; PEA, pulseless electrical activity ; PEEP, positive end-expiratory pressure ; PGE, prostaglandin E ; PLCS, Postligation cardiac syndrome ; PPV, positive pressure ventilation ; PS, pulmonary stenosis ; PVR, pulmonary vascular resistance ; Qp, pulmonary blood flow ; Qs, systemic blood flow ; RA, right atrium ; Resuscitation - methods ; RV, right ventricle ; RVOTO, right ventricular outflow tract obstruction ; SpO2, pulse oximetry measured oxygen saturation ; SSA, Sjögren's-syndrome-related antigen A ; SVC, superior vena cava ; SvO2, mixed venous oxygen saturation ; SVR, systemic vascular resistance ; SVT, supraventricular tachycardia ; TAPVR, total anomalous pulmonary venous return ; TGA, transposition of the great arteries ; TOF, tetralogy of Fallot ; VSD, ventricular septal defect ; VT, ventricular tachycardia</subject><ispartof>Seminars in perinatology, 2024-12, Vol.48 (8), p.151989, Article 151989</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1584-fa3b36ff3330f735f49a69829ef335dae5475dd344c4a1464d613cd6d3cce36d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.semperi.2024.151989$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39477714$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johnson, Beth Ann</creatorcontrib><creatorcontrib>Shepherd, Jennifer</creatorcontrib><creatorcontrib>Bhombal, Shazia</creatorcontrib><creatorcontrib>Ali, Noorjahan</creatorcontrib><creatorcontrib>Joynt, Chloe</creatorcontrib><title>Special considerations for the stabilization and resuscitation of patients with cardiac disease in the Neonatal Intensive Care Unit</title><title>Seminars in perinatology</title><addtitle>Semin Perinatol</addtitle><description>Effective resuscitation of neonates with congenital heart disease (CHD) depends on comprehensive planning, thorough understanding of physiology, vigilant monitoring, and interdisciplinary collaboration to achieve the best outcomes. Neonatal heart disease can affect cardiac structure, rhythm, or ventricular function, and may be either congenital or acquired. Critical congenital heart disease (CCHD) can result in inadequate pulmonary blood flow, impaired intracardiac mixing, airway obstruction, or insufficient cardiac output. Tailored resuscitation strategies are important as early as the delivery room, where some CHD lesions may cause immediate cardiovascular instability during the transition from fetal to postnatal circulation. Premature infants with CHD are at higher risk due to their small size and the complications associated with prematurity, affecting both CHD management and overall clinical stability. Addressing both cardiac and non-cardiac causes of decompensation requires a precise understanding of each patient's unique physiology and trajectory from delivery through postintervention intensive care.</description><subject>Abbreviations: AHA, American Heart Association</subject><subject>Ao, aorta</subject><subject>APV, absent pulmonary valve</subject><subject>ARC, acute respiratory compromise</subject><subject>ARF, acute renal failure</subject><subject>AV, atrioventricular</subject><subject>AVRT, atrioventricular reentrant tachycardia</subject><subject>BP, blood pressure</subject><subject>CCHB, congenital complete heart block</subject><subject>CCHD, critical congenital heart disease</subject><subject>CHD, congenital heart disease</subject><subject>CLD, chronic lung disease</subject><subject>CPAP, continuous positive airway pressure</subject><subject>CPR, cardiopulmonary resuscitation</subject><subject>CVC, central venous catheter</subject><subject>DCM, dilated cardiomyopathy</subject><subject>DR, delivery room</subject><subject>EAT, ectopic atrial tachycardia</subject><subject>ECA, extracardiac anomalies</subject><subject>ECMO, extracorporeal membrane oxygenation</subject><subject>eCPR, extracorporeal cardiopulmonary resuscitation</subject><subject>EKG, electrocardiogram</subject><subject>HCM, hypertrophic cardiomyopathy</subject><subject>Heart Defects, Congenital - complications</subject><subject>Heart Defects, Congenital - physiopathology</subject><subject>Heart Defects, Congenital - therapy</subject><subject>HLHS, hypoplastic left heart syndrome</subject><subject>HR, heart rate</subject><subject>Humans</subject><subject>ICU, intensive care unit</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Intensive Care Units, Neonatal</subject><subject>IV, intravenous</subject><subject>IVC, inferior vena cava</subject><subject>IVH, intraventricular hemorrhage</subject><subject>IVS, intact ventricular septum</subject><subject>LA, left atrium</subject><subject>LV, left ventricle</subject><subject>LVOTO, left ventricular outflow tract obstruction</subject><subject>MI, myocardial infarction</subject><subject>NCCM, noncompaction cardiomyopathy</subject><subject>NEC, necrotizing enterocolitis</subject><subject>NICU, neonatal intensive care unit</subject><subject>NRP, neonatal resuscitation program</subject><subject>PA, pulmonary artery</subject><subject>PALS, pediatric advanced life support</subject><subject>pCO2, partial pressure of carbon dioxide</subject><subject>PDA, patent ductus arteriosus</subject><subject>PEA, pulseless electrical activity</subject><subject>PEEP, positive end-expiratory pressure</subject><subject>PGE, prostaglandin E</subject><subject>PLCS, Postligation cardiac syndrome</subject><subject>PPV, positive pressure ventilation</subject><subject>PS, pulmonary stenosis</subject><subject>PVR, pulmonary vascular resistance</subject><subject>Qp, pulmonary blood flow</subject><subject>Qs, systemic blood flow</subject><subject>RA, right atrium</subject><subject>Resuscitation - methods</subject><subject>RV, right ventricle</subject><subject>RVOTO, right ventricular outflow tract obstruction</subject><subject>SpO2, pulse oximetry measured oxygen saturation</subject><subject>SSA, Sjögren's-syndrome-related antigen A</subject><subject>SVC, superior vena cava</subject><subject>SvO2, mixed venous oxygen saturation</subject><subject>SVR, systemic vascular resistance</subject><subject>SVT, supraventricular tachycardia</subject><subject>TAPVR, total anomalous pulmonary venous return</subject><subject>TGA, transposition of the great arteries</subject><subject>TOF, tetralogy of Fallot</subject><subject>VSD, ventricular septal defect</subject><subject>VT, ventricular tachycardia</subject><issn>0146-0005</issn><issn>1558-075X</issn><issn>1558-075X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEFPGzEQha2KqgTanwDykcsGe23vZk8IRbRFQu2hjdSb5dhjZaKNd7EdEL32j9ewgSunGT29maf3EXLG2Zwz3lxu5wl2I0Sc16yWc654t-g-kBlXalGxVv05IjPGZVMxxtQxOUlpy5iQHWefyLHoZNu2XM7Iv18jWDQ9tUNI6CCajGWjfog0b4CmbNbY498XmZrgaIS0TxbzpAyejmWDkBN9xLyh1kSHxlKHCUwCiuHlzw8Ygskl5zZkKEkPQJcmAl0FzJ_JR2_6BF8O85Ssvt78Xn6v7n5-u11e31WWq4WsvBFr0XgvhGC-FcrLzjTdou6gSMoZULJVzgkprTSluXQNF9Y1TlgLooxTcjH9HeNwv4eU9Q6Thb43AYZ90oLXdSN507FiVZPVxiGlCF6PEXcmPmnO9DN_vdUH_vqZv574l7vzQ8R-vQP3dvUKvBiuJgOUog8IUReWECw4jGCzdgO-E_Ef45GcEQ</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Johnson, Beth Ann</creator><creator>Shepherd, Jennifer</creator><creator>Bhombal, Shazia</creator><creator>Ali, Noorjahan</creator><creator>Joynt, Chloe</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202412</creationdate><title>Special considerations for the stabilization and resuscitation of patients with cardiac disease in the Neonatal Intensive Care Unit</title><author>Johnson, Beth Ann ; Shepherd, Jennifer ; Bhombal, Shazia ; Ali, Noorjahan ; Joynt, Chloe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1584-fa3b36ff3330f735f49a69829ef335dae5475dd344c4a1464d613cd6d3cce36d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abbreviations: AHA, American Heart Association</topic><topic>Ao, aorta</topic><topic>APV, absent pulmonary valve</topic><topic>ARC, acute respiratory compromise</topic><topic>ARF, acute renal failure</topic><topic>AV, atrioventricular</topic><topic>AVRT, atrioventricular reentrant tachycardia</topic><topic>BP, blood pressure</topic><topic>CCHB, congenital complete heart block</topic><topic>CCHD, critical congenital heart disease</topic><topic>CHD, congenital heart disease</topic><topic>CLD, chronic lung disease</topic><topic>CPAP, continuous positive airway pressure</topic><topic>CPR, cardiopulmonary resuscitation</topic><topic>CVC, central venous catheter</topic><topic>DCM, dilated cardiomyopathy</topic><topic>DR, delivery room</topic><topic>EAT, ectopic atrial tachycardia</topic><topic>ECA, extracardiac anomalies</topic><topic>ECMO, extracorporeal membrane oxygenation</topic><topic>eCPR, extracorporeal cardiopulmonary resuscitation</topic><topic>EKG, electrocardiogram</topic><topic>HCM, hypertrophic cardiomyopathy</topic><topic>Heart Defects, Congenital - complications</topic><topic>Heart Defects, Congenital - physiopathology</topic><topic>Heart Defects, Congenital - therapy</topic><topic>HLHS, hypoplastic left heart syndrome</topic><topic>HR, heart rate</topic><topic>Humans</topic><topic>ICU, intensive care unit</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Intensive Care Units, Neonatal</topic><topic>IV, intravenous</topic><topic>IVC, inferior vena cava</topic><topic>IVH, intraventricular hemorrhage</topic><topic>IVS, intact ventricular septum</topic><topic>LA, left atrium</topic><topic>LV, left ventricle</topic><topic>LVOTO, left ventricular outflow tract obstruction</topic><topic>MI, myocardial infarction</topic><topic>NCCM, noncompaction cardiomyopathy</topic><topic>NEC, necrotizing enterocolitis</topic><topic>NICU, neonatal intensive care unit</topic><topic>NRP, neonatal resuscitation program</topic><topic>PA, pulmonary artery</topic><topic>PALS, pediatric advanced life support</topic><topic>pCO2, partial pressure of carbon dioxide</topic><topic>PDA, patent ductus arteriosus</topic><topic>PEA, pulseless electrical activity</topic><topic>PEEP, positive end-expiratory pressure</topic><topic>PGE, prostaglandin E</topic><topic>PLCS, Postligation cardiac syndrome</topic><topic>PPV, positive pressure ventilation</topic><topic>PS, pulmonary stenosis</topic><topic>PVR, pulmonary vascular resistance</topic><topic>Qp, pulmonary blood flow</topic><topic>Qs, systemic blood flow</topic><topic>RA, right atrium</topic><topic>Resuscitation - methods</topic><topic>RV, right ventricle</topic><topic>RVOTO, right ventricular outflow tract obstruction</topic><topic>SpO2, pulse oximetry measured oxygen saturation</topic><topic>SSA, Sjögren's-syndrome-related antigen A</topic><topic>SVC, superior vena cava</topic><topic>SvO2, mixed venous oxygen saturation</topic><topic>SVR, systemic vascular resistance</topic><topic>SVT, supraventricular tachycardia</topic><topic>TAPVR, total anomalous pulmonary venous return</topic><topic>TGA, transposition of the great arteries</topic><topic>TOF, tetralogy of Fallot</topic><topic>VSD, ventricular septal defect</topic><topic>VT, ventricular tachycardia</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johnson, Beth Ann</creatorcontrib><creatorcontrib>Shepherd, Jennifer</creatorcontrib><creatorcontrib>Bhombal, Shazia</creatorcontrib><creatorcontrib>Ali, Noorjahan</creatorcontrib><creatorcontrib>Joynt, Chloe</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Seminars in perinatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Johnson, Beth Ann</au><au>Shepherd, Jennifer</au><au>Bhombal, Shazia</au><au>Ali, Noorjahan</au><au>Joynt, Chloe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Special considerations for the stabilization and resuscitation of patients with cardiac disease in the Neonatal Intensive Care Unit</atitle><jtitle>Seminars in perinatology</jtitle><addtitle>Semin Perinatol</addtitle><date>2024-12</date><risdate>2024</risdate><volume>48</volume><issue>8</issue><spage>151989</spage><pages>151989-</pages><artnum>151989</artnum><issn>0146-0005</issn><issn>1558-075X</issn><eissn>1558-075X</eissn><abstract>Effective resuscitation of neonates with congenital heart disease (CHD) depends on comprehensive planning, thorough understanding of physiology, vigilant monitoring, and interdisciplinary collaboration to achieve the best outcomes. Neonatal heart disease can affect cardiac structure, rhythm, or ventricular function, and may be either congenital or acquired. Critical congenital heart disease (CCHD) can result in inadequate pulmonary blood flow, impaired intracardiac mixing, airway obstruction, or insufficient cardiac output. Tailored resuscitation strategies are important as early as the delivery room, where some CHD lesions may cause immediate cardiovascular instability during the transition from fetal to postnatal circulation. Premature infants with CHD are at higher risk due to their small size and the complications associated with prematurity, affecting both CHD management and overall clinical stability. Addressing both cardiac and non-cardiac causes of decompensation requires a precise understanding of each patient's unique physiology and trajectory from delivery through postintervention intensive care.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39477714</pmid><doi>10.1016/j.semperi.2024.151989</doi></addata></record> |
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| subjects | Abbreviations: AHA, American Heart Association Ao, aorta APV, absent pulmonary valve ARC, acute respiratory compromise ARF, acute renal failure AV, atrioventricular AVRT, atrioventricular reentrant tachycardia BP, blood pressure CCHB, congenital complete heart block CCHD, critical congenital heart disease CHD, congenital heart disease CLD, chronic lung disease CPAP, continuous positive airway pressure CPR, cardiopulmonary resuscitation CVC, central venous catheter DCM, dilated cardiomyopathy DR, delivery room EAT, ectopic atrial tachycardia ECA, extracardiac anomalies ECMO, extracorporeal membrane oxygenation eCPR, extracorporeal cardiopulmonary resuscitation EKG, electrocardiogram HCM, hypertrophic cardiomyopathy Heart Defects, Congenital - complications Heart Defects, Congenital - physiopathology Heart Defects, Congenital - therapy HLHS, hypoplastic left heart syndrome HR, heart rate Humans ICU, intensive care unit Infant, Newborn Infant, Premature Intensive Care Units, Neonatal IV, intravenous IVC, inferior vena cava IVH, intraventricular hemorrhage IVS, intact ventricular septum LA, left atrium LV, left ventricle LVOTO, left ventricular outflow tract obstruction MI, myocardial infarction NCCM, noncompaction cardiomyopathy NEC, necrotizing enterocolitis NICU, neonatal intensive care unit NRP, neonatal resuscitation program PA, pulmonary artery PALS, pediatric advanced life support pCO2, partial pressure of carbon dioxide PDA, patent ductus arteriosus PEA, pulseless electrical activity PEEP, positive end-expiratory pressure PGE, prostaglandin E PLCS, Postligation cardiac syndrome PPV, positive pressure ventilation PS, pulmonary stenosis PVR, pulmonary vascular resistance Qp, pulmonary blood flow Qs, systemic blood flow RA, right atrium Resuscitation - methods RV, right ventricle RVOTO, right ventricular outflow tract obstruction SpO2, pulse oximetry measured oxygen saturation SSA, Sjögren's-syndrome-related antigen A SVC, superior vena cava SvO2, mixed venous oxygen saturation SVR, systemic vascular resistance SVT, supraventricular tachycardia TAPVR, total anomalous pulmonary venous return TGA, transposition of the great arteries TOF, tetralogy of Fallot VSD, ventricular septal defect VT, ventricular tachycardia |
| title | Special considerations for the stabilization and resuscitation of patients with cardiac disease in the Neonatal Intensive Care Unit |
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