Showing papers by "Ravi R. Thiagarajan published in 2009"
TL;DR: Survival among this cohort of adults with severe respiratory failure supported with ECMO was 50%.
Abstract: Objective
To evaluate clinical and treatment factors for patients recorded in the Extracorporeal Life Support Organization (ELSO) registry and survival of adult extracorporeal membrane oxygenation (ECMO) respiratory failure patients.
404 citations
TL;DR: Looking list mortality since the pediatric heart allocation system was revised in 1999 is examined to determine whether the revised allocation system is prioritizing patients optimally and to identify specific high-risk populations that may benefit from emerging pediatric cardiac assist devices.
Abstract: Background— Children listed for heart transplantation face the highest waiting list mortality in solid-organ transplantation medicine. We examined waiting list mortality since the pediatric heart allocation system was revised in 1999 to determine whether the revised allocation system is prioritizing patients optimally and to identify specific high-risk populations that may benefit from emerging pediatric cardiac assist devices. Methods and Results— We conducted a multicenter cohort study using the US Scientific Registry of Transplant Recipients. All children <18 years of age who were listed for a heart transplant between 1999 and 2006 were included. Among 3098 children, the median age was 2 years (interquartile range 0.3 to 12 years), and median weight was 12.3 kg (interquartile range 5 to 38 kg); 1294 (42%) were nonwhite; and 1874 (60%) were listed as status 1A (of whom 30% were ventilated and 18% were on extracorporeal membrane oxygenation). Overall, 533 (17%) died, 1943 (63%) received transplants, and ...
333 citations
TL;DR: The use of E-CPR was associated with survival in 27% of adults with cardiac arrest facing imminent mortality, and the need for renal replacement therapy during ECMO increased odds of mortality.
247 citations
Journal Article•
TL;DR: ECPR may promote survival in children with cardiac disease experiencing cardiac arrest unresponsive to conventional CPR with favorable early neurological outcomes, and CPR duration was not associated with mortality, whereas patients with metabolic acidosis and noncardiac structural or chromosome anomalies had higher mortality.
168 citations
TL;DR: Children with cardiac disease, less severe metabolic acidosis before ECMO, and an uncomplicated ECMO course have decreased odds of sustaining neurologic injury, according to a multivariable logistic regression model.
Abstract: Objectives:Extracorporeal membrane oxygenation (ECMO) to aid failed cardiopulmonary resuscitation (CPR) in children is associated with a high incidence of neurologic injury. We sought to identify risk factors for acute neurologic injury in children undergoing ECMO to aid CPR (E-CPR).Design:Retrospec
160 citations
TL;DR: The use of an enteral feeding algorithm is a safe and effective means of initiating and advancing enteral nutrition in infants with hypoplastic left heart syndrome following stage I palliation.
Abstract: Background:Infants with hypoplastic left heart syndrome (HLHS) experience a high incidence of growth failure in the postoperative period following stage I palliation. Because of an increased risk of necrotizing enterocolitis in this population, clinicians may be reluctant to initiate early enteral f
138 citations
TL;DR: Wait-list mortality is associated with weight <3 kg, level of invasive support and CHD, but not listing status, which captures medical urgency poorly, and measures to expand infant organ donation, especially among neonates, are urgently needed.
Abstract: Background Infants awaiting heart transplantation (HT) face the highest wait-list mortality among all children and adults listed for HT in the USA. We sought to determine the risk of death for infants Methods We analyzed outcomes for all infants listed for HT in the USA from January 1999 to July 2006, using data reported to the U.S. Scientific Registry of Transplant Recipients. Results Of the 1,133 listed infants, 61% were Conclusions One in four infants listed for HT in the USA die before a donor heart can be identified. Wait-list mortality is associated with weight
94 citations
TL;DR: Elective Ladd procedures are well tolerated by HS patients and in light of improved survival beyond infanthood, HS patients with asymptomatic malrotation should be offered a prophylactic Ladd procedure.
51 citations
TL;DR: Extracorporeal membrane oxygenation, used as a bridge to surgery, represents a useful modality to rescue patients with failing circulation and unrepaired complex heart defects.
39 citations
TL;DR: It is concluded that minority children listed for HT have significantly higher wait‐list mortality compared to white children, and Socioeconomic variables appear to explain a small fraction of this increased risk.
24 citations