ABSTRACT
An 11-year-old girl experienced an episode of near-drowning. She was immediately rescued and was defibrillated. Transthoracic echocardiography and coronary computed tomographic angiography confirmed the diagnosis of anomalous left coronary artery from the pulmonary artery (ALCAPA). We report a rare description of this congenital coronary anomaly in a child, revealed after exercise-induced sudden cardiac arrest while swimming.
Subject(s)
Bland White Garland Syndrome/diagnostic imaging , Computed Tomography Angiography , Coronary Angiography , Echocardiography , Heart Arrest/etiology , Near Drowning/etiology , Bland White Garland Syndrome/complications , Child , Coronary Vessels/diagnostic imaging , Female , Humans , Pulmonary Artery/abnormalities , Pulmonary Artery/diagnostic imaging , SwimmingABSTRACT
Shock after protamine infusion are rare. We report here the case of a 6-day-old boy having presented severe and recurring hypotensions after protamine infusions during cardiac surgery under cardio pulmonary bypass. The physiopathology of these reactions is complex and, in the presented case, involved mechanism may not be anaphylactic.
Subject(s)
Cardiopulmonary Bypass , Heparin Antagonists/adverse effects , Protamines/adverse effects , Shock/chemically induced , Fatal Outcome , Heparin Antagonists/administration & dosage , Histamine/blood , Humans , Hypotension/chemically induced , Hypotension/physiopathology , Hypotension/therapy , Infant, Newborn , Male , Prenatal Diagnosis , Protamines/administration & dosage , Shock/physiopathology , Transposition of Great Vessels/surgeryABSTRACT
OBJECTIVE: To assesses the results of our education program relative to anticoagulation therapy and self-monitoring of INR. MATERIALS AND METHODS: All children treated with oral anticoagulation therapy and followed using INR self-monitoring in Tours and Nantes, France, were included. A questionnaire on the treatment and its management was sent to the patients and their family. We analyzed the quality of anticoagulation using the proportion of INR within the target range. RESULTS: Thirty-three children were included, with a mean age of 10.9years. Thirty-one questionnaires could be analyzed. Insufficient knowledge on the treatment objective and risks, the INR target range, and the interpretation of the INR was observed. We found 65.8% of INRs within the target range. The proportion of INRs within the target range was better with the INR self-testing than with the laboratory test (69.7% vs. 49.1%, P=0.003). There was no major complication observed during the study period. A moderate correlation (K=0.57) was noted between the INRs measured with the point-of-care monitor and the laboratory test on the same day. CONCLUSION: However, home-monitoring of oral anticoagulation therapy increases the quality of anticoagulation. Both education and the training program need improvement in order to provide patients and their families with better knowledge on anticoagulation therapy.
Subject(s)
Anticoagulants/therapeutic use , International Normalized Ratio/instrumentation , Patient Education as Topic , Point-of-Care Systems , Self Care/instrumentation , Administration, Oral , Adolescent , Child , Child, Preschool , Female , France , Humans , Male , Program Evaluation , Surveys and QuestionnairesABSTRACT
Perinatal asphyxia is a common emergency for both obstetricians and pediatricians. A prospective study was conducted in 14 maternity hospitals (type II centres) in the Paris suburbs in order to assess pediatric activity and neonatal morbidity associated with supposed perinatal asphyxia in term newborns. Pediatricians were called in at birth very frequently: 1/20 deliveries. Intubation and/or resuscitation procedures were needed in 20% of cases and 20% of infants were referred to a neonatal unit for birth asphyxia or associated pathology. Moderate encephalopathy was observed in 1.5% of all term newborns who needed medical intervention for supposed birth asphyxia.
