Jan 2nd, 2024

In the field of pediatrics, several notable studies and guidelines have been developed, contributing significantly to the understanding and management of various pediatric conditions.

The 2023 guidelines issued by the American Heart Association and American Academy of Pediatrics provide an updated overview on neonatal resuscitation, with a focus on umbilical cord management and devices used for positive-pressure ventilation during newborn resuscitation (1). This update is a crucial step in enhancing neonatal care practices.

A single-center retrospective study investigated the clinical profile, genetic basis, and survival of childhood cardiomyopathy. In this study, 317 children with cardiomyopathy were observed, and it was found that five-year survival rates varied across different types of cardiomyopathy, with restrictive cardiomyopathy (RCM) having the lowest survival rate. Ten-year survival rates followed a similar trend. The study highlighted the high mortality associated with RCM and identified New York Heart Association/Ross class III or IV and gene mutations as mortality predictors (2).

In the context of congenital heart disease management, a data analysis study on in-patient echocardiography utilization post repair of congenital heart disease revealed significant findings. The study, which included 37,238 surgical encounters, noted increased echocardiogram use with higher surgical complexity and considerable variability across centers. This indicates that surgical complexity is a key factor influencing echocardiography use, providing benchmarks for clinical practice (3).

A prospective population-based cohort study explored the nutritional impact on blood pressure in preterm children. The study focused on very preterm children, comparing those with high amino acid intake (>3.5 g/kg/day) to those with lower intake. Out of 1,102 children (717 exposed, 385 non-exposed), it was found that high amino acid intake was associated with an increased risk of systolic hypertension, highlighting a potential link between early nutrition and long-term cardiovascular outcomes in preterm infants (4).

In postoperative care, a retrospective cohort study examined predictors of early peritoneal dialysis initiation in newborns and infants post-cardiac surgery. This study, involving 57 patients, identified that higher pre-operative serum creatinine and longer cardiopulmonary bypass time were associated with early initiation of peritoneal dialysis. These findings aid in risk stratification for early peritoneal dialysis in this patient group (5).

Lastly, a case-control study focused on sociodemographic factors in pediatric cardiac arrest. It involved pediatric patients with out-of-hospital cardiac arrest (POHCA) in Ontario, Canada, comparing 1826 cases with 7254 matched controls based on age, sex, and comorbidities. The study underscored the association of sociodemographic factors with POHCA risk, emphasizing the importance of addressing disparities in pediatric cardiac arrest risks (6).

Each of these studies contributes to the broader understanding of pediatric care, offering insights into effective treatment and management strategies for various pediatric conditions.

1. Yamada NK, Szyld E, Strand ML, Finan E, Illuzzi JL, Kamath-Rayne BD, et al. 2023 American Heart Association and American Academy of Pediatrics Focused Update on Neonatal Resuscitation: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2024;149(1):e157-e66.

2. Yuan W, Jia Z, Li J, Liu L, Tian J, Huang X, et al. The clinical profile, genetic basis and survival of childhood cardiomyopathy: a single-center retrospective study. Eur J Pediatr. 2024.

3. Skaff AM, Valikodath NG, Godown J, Parra DA. "In-patient echocardiography utilization post repair of congenital heart disease. Analysis of data from the Pediatric Health Information System from 2010 to 2019". Cardiol Young. 2024:1-6.

4. Rozé JC, Bacchetta J, Lapillonne A, Boudred F, Picaud JC, Marchand-Martin L, et al. High Amino Acid Intake in Early Life Is Associated With Systolic but Not Diastolic Arterial Hypertension at 5 Years of Age in Children Born Very Preterm. J Am Heart Assoc. 2024;13(1):e032804.

5. Rivera-Figueroa E, Ansari M, Mallory ET, Garg P, Onder AM. Predictors of early peritoneal dialysis initiation in newborns and young infants following cardiac surgery. Cardiol Young. 2024:1-8.

6. Idrees S, Anderson KK, Choi YH, Tijssen JA. Sociodemographic Factors and the Risk of Pediatric Out-of-Hospital Cardiac Arrest in Ontario, Canada: A Province-Wide Case-Control Study. J Am Heart Assoc. 2024;13(1):e032718.