Anomalous origin of circumflex coronary artery from right pulmonary artery in a hypoplastic left heart syndrome child.

We describe the case of a newborn with hypoplastic left heart syndrome (HLHS) and aberrant origin of the circumflex coronary artery from the right pulmonary artery. The patient underwent a modified Norwood procedure with direct reimplantation of the circumflex coronary artery to the neo-aorta, but died on the 5(th) postoperative day because of myocardial failure. Detailed assessment of coronary arteries as part of the routine echocardiographic evaluation of HLHS and intraoperative inspection of them is crucial.

[Influence of Pringle maneuver used in children during hepatic tumors resections on fluid resuscitation and intraoperative blood loss]. / Wplyw manewru Pringle'a zastosowanego u dzieci podczas resekcji guzów watroby na terapie plynowa i sródoperacyjna utrate krwi.

UNLABELLED: Partial vascular exclusion (Pringle maneuver) is one of the methods diminishing risk of massive intraoperative blood loss. Effects of Pringle maneuver were deeply explored in adults due to big series of operated patients but experiences with Pringle maneuver in children are very limited. The aim of the study was to estimate usefulness of Pringle maneuver in the limitation of intraoperative blood loss and the amount of intraoperative fluid therapy necessary during liver resections in children. MATERIAL AND METHODS: The group of 70 children operated because of liver tumors during the period of 20 years were studied. Patients were divided into 2 subgroups. Group I consisted of 35 patients without Pringle maneuver during liver resection. Group II was consisted of 35 children operated with Pringle maneuver. In all patients intraoperative diuresis and hemodynamic parameters of blood circulation were monitored and the blood loss and fluid therapy were assessed. RESULTS: In group I operated on without Pringle maneuver statistically significant higher amount of blood transfusions were indicated and in group II statistically significant higher amount of colloids were indicated. CONCLUSIONS: The results achieved documented that introduction of Pringle maneuver during liver resection in children allow to achieve statistically significant limitation of blood loss during operation but hemodynamic disorders during partial vascular exclusion (Pringle maneuver) requires transfusion of higher amounts of volume colloid fluids.

[Weaning newborns from noninvasive ventilation]. / Zasady uwalniania noworodków z wentylacji neinwazyjnej.

The purpose of the study was to propose the recommendations for weaning infants from nasal continuous positive airway pressure (nCPAP) and nasal intermittent positive pressure ventilation (NIPPV). Despite the fact that both methods are commonly used for respiratory insufficiency in infants, detailed recommendations for weaning have not been described so far. The proposed recommendations are based on previously described data and a wide survey conducted among Polish neonatologists and intensive therapy paediatricians.

[Guidelines for the use of special purposes central vein catheters (Broviac, Hickman and Gronshong): proposals for recommendations]. / Zalecenia dotyczace stosowania i obslugi ceników tunelizowanych z mankietem (typu Broviac, Hickman i Groshong) u noworodków i niemowlat - propozycje.

On the basis of literature search and own experiences as well as the current opinions of the Polish National Survey in Paediatric and Neonatal Intensive Care for indications and use of tunnelized catheters with a cuff, the authors present the guidelines for special purpose central vein catheters in the newborn and infants.