Young patients with fulminant myocarditis should be rapidly transferred to a clinic with a mechanical circulatory support program to offer this life-saving option.The three implanted devices have been described extensively.The Medos-system (Medos, Stolberg, Germany) has similar characteristics as the Thoratec device. The majority of patients receives care in an intensive care unit at presentation and is treated with intravenous inotropes . The Thoratec is an ideal system for midterm support, which is usually necessary in fulminant myocarditis for bridge to recovery or for bridge to transplantation.The Novacor LVAD system, with its large ventricle implanted in an abdominal pocket, usually is not suitable for pediatric or adolescent patients. Proportions were compared using χA total of 540 patient encounters were identified for 528 patients. Message:
Correspondence to Darren Klugman, MD, MMS, Division of Critical Care Medicine and Cardiology, Children’s National Medical Center, 111 Michigan Ave, NW, Washington, DC 20010. Data is temporarily unavailable. The institutional review board at the Children’s National Medical Center reviewed and approved this study.Data for this study were obtained from PHIS, an administrative database that contains inpatient, emergency department, ambulatory surgery, and observation data from 42 nonprofit, tertiary care pediatric hospitals in the United States. Aggressive management consisting of inotropic support with catecholamines, afterload reduction, phosphodiesterase inhibitors, and diuretic treatment resulted in insufficient circulatory response in all seven patients. Data are deidentified at the time of data submission, and data are subjected to several reliability and validity checks before being included in the database.Pediatric acute myocarditis has a heterogeneous clinical presentation, and its accurate diagnosis is difficult.There is lack of sufficient evidence-based diagnostic and treatment guidelines for management of pediatric acute myocarditis.There is significant regional variability and temporal changes in treatments used for pediatric myocarditis during the past 5 years in the United States.Myocarditis continues to have significant morbidity and mortality, with a large percentage of patients requiring mechanical cardiovascular support.The participating hospitals submit discharge-level data on a quarterly basis from their internal data systems, using a standardized discharge abstract. Recent reports have linked human herpesvirus 6 (HHV-6) infection, typically a benign infection in childhood, with myocarditis. The medical record numbers, billing numbers, physician identifications, and zip codes are encrypted to protect the identity of the patients and assure compliance with federal regulations. This article has been saved into your User Account, in the Favorites area, under the new folder
6. One 7-year-old girl (Medos-BVAD) died after a support time of 11 days because of irreversible multiorgan failure. One 15-year-old girl remains on support and the decision to wean or not has not been made.An interesting aspect during the weaning procedure seems to be the course of atrial and brain natriuretic peptides as markers of heart insufficiency. As good markers, atrial and brain natriuretic peptides were found which reached normal values after recovery of myocardial function. may email you for journal alerts and information, but is committed
N. Reiss, Clinic for Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westphalia, Ruhr-University of Bochum, Georgstrasse.
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