World J Pediatr Congenit Heart Surg. 2022 Sep;13(5):588-592. doi: 10.1177/21501351221099935.ABSTRACTThe Giessen hybrid strategy is used for initial palliation of HLHS and variants when the intent is to pursue further staged palliative reconstruction toward Fontan circulation. It is also used for initial palliation of HLHC and other anomalies with potential for eventual biventricular repair. From June 1998 – October 2021, 197 patients with HLHS and related variants underwent hybrid stage 1. Follow-up is complete (median 8.3 [range 0-23.3] years). Operative mortality for hybrid stage I was 3.6% (7/197); reduced to 2.8% since 2010 (4/141). Interstage mortality was 4.1% (8/197). Operative mortality…
Origen: Hypoplastic Left Heart Syndrome Palliation: Technical Aspects and Common Pitfalls of the Hybrid Approach – PubMed

World J Pediatr Congenit Heart Surg. 2022 Sep;13(5):593-599. doi: 10.1177/21501351221111390.ABSTRACTDespite overall improvements in outcomes for patients with hypoplastic left heart syndrome, there remain anatomic features that can place these patients at higher risk throughout their treatment course. These include severe preoperative obstruction to pulmonary venous return, restrictive atrial septum, coronary fistulae, severe tricuspid regurgitation, smaller ascending aorta diameter (especially if <2 mm), and poor ventricular function. The risk of traditional staged palliation has led to the development of alternative strategies for such patients. To further improve the outcomes, we must continue to diligently examine and study anatomic details in HLHS…
Origen: High-Risk Anatomic Subsets in Hypoplastic Left Heart Syndrome – PubMed

J Neurosci Nurs. 2022 Oct 1;54(5):199-200. doi: 10.1097/JNN.0000000000000659. Epub 2022 Jun 21.NO ABSTRACTPMID:36053088 | DOI:10.1097/JNN.0000000000000659
Origen: Preparing a Pediatric Palliative Care Program for Sustainable Support: A Practice Reflection – PubMed

World J Pediatr Congenit Heart Surg. 2022 Sep;13(5):609-614. doi: 10.1177/21501351221103511.ABSTRACTHypoplastic left heart syndrome (HLHS) is possibly the most challenging congenital heart defect to confront in any setting. The highly specialized infrastructure and resources needed to treat HLHS is not available in many low-resource settings. However, low-resource settings must not be assumed to be synonymous with low- and middle-income countries as national income is not necessarily indicative of a country’s prioritization of healthcare resources. Besides, a low-resource setting may be institution-specific as well as country-specific. We have stratified institutional capabilities for addressing the requirements of treatment for HLHS into five levels…
Origen: Management of Hypoplastic Left Heart Syndrome in Low-Resource Settings and the Ethics of Decision-Making – PubMed

Syst Rev. 2022 Sep 2;11(1):186. doi: 10.1186/s13643-022-02054-8.ABSTRACTBACKGROUND: Heterogeneity amongst palliative care interventions in the intensive care unit (ICU) and their outcomes has meant that, even when found to be effective, translation of evidence into practice is hindered. Previous evidence reviews have suggested that the field of ICU-based palliative care would benefit from well-designed, targeted interventions, with explicit knowledge translation research demonstrating valid implementation strategies. Reviewing effectiveness studies alongside process evaluations for these interventions will give insight into the implementation barriers or constraints identified, and the implementation strategies adopted.METHODS: A systematic review to identify and synthesise knowledge on how models of…
Origen: Implementation lessons learnt when trialling palliative care interventions in the intensive care unit: relationships between determinants, implementation strategies, and models of delivery-a systematic review protocol – PubMed