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您的检索式：作者名="Morgan Recher"
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| 1 | Assessment of left-ventricular diastolic function in pediatric intensive-care patients:a review of parameters and indications compared with those for adults显示文摘Background The incidence of diastolic heart failure has increased over time.The evaluation of left-ventricular diastolic func-tion is complex,ongoing,and remains poorly performed in pediatric intensive-care patients.This study aimed to review the literature and to provide an update on the evaluation of left-ventricular diastolic function in adults and children in intensive care.Data sources We searched data from PubMed/Medline.Thirty-two studies were included.Four pragmatic questions were identified:(1)What is the physiopathology of diastolic dysfunction?(2)Which tools are required to evaluate diastolic func-tion?(3)What are the echocardiographic criteria needed to evaluate diastolic function?(4)When should diastolic function be evaluated in pediatric intensive care?Results Early diastole allows characterization of relaxation,whereas compliance assessments and filling pressures are evalu-ated during late diastole.The evolution of diastolic function differs between adults and children.Unlike in adults,decreased compliance occurs at the same time as delayed relaxation in children.Diastolic function can be evaluated by Doppler echo-cardiography.The echocardiographic criteria for ventricular relaxation include the E wave,E/A wave ratio,and isovolumic relaxation time.Ventricular compliance can be assessed by the E/e'wave ratio,atrial volume,and Ap wave duration during pulmonary vein flow.In adult intensive-care patients,the E/e'ratio can be used as an index of tolerance for volume expan-sion in septic patients and to adjust the inotropic support.Conclusion Clinical studies would allow some of these parameters to be validated for use in children in intensive care. | Morgan Recher Astrid Botte Jerome Soquet Jean-Benoit Baudelet François Godart Stephane Leteurtre | 2021 | World Journal of Pediatrics2021，17，1： | 2 |
| 2 | Impact of time to diagnosis on the occurrence of cardiogenic shock in MIS‑C post‑COVID-19 infection显示文摘Background In multisystem inflammatory syndrome in children(MIS-C),diagnostic delay could be associated with severity.This study aims to measure the time to diagnosis in MIS-C,assess its impact on the occurrence of cardiogenic shock,and specify its determinants.Methods A single-center prospective cohort observational study was conducted between May 2020 and July 2022 at a tertiary care hospital.Children meeting the World Health Organization MIS-C criteria were included.A long time to diagnosis was defined as six days or more.Data on time to diagnosis were collected by two independent physicians.The primary outcome was the occurrence of cardiogenic shock.Logistic regression and receiver operating characteristic curve analysis were used for outcomes,and a Cox proportional hazards model was used for determinants.Results Totally 60 children were assessed for inclusion,and 31 were finally analyzed[52%males,median age 8.8(5.7-10.7)years].The median time to diagnosis was 5.3(4.2-6.2)days.In univariable analysis,age above the median,time to diagnosis,high C-reactive protein,and high N-terminal pro-B-type natriuretic peptide(NT-proBNP)were associated with cardiogenic shock[odds ratio(OR)6.13(1.02-36.9),2.79(1.15-6.74),2.08(1.05-4.12),and 1.70(1.04-2.78),respectively].In multivariable analysis,time to diagnosis≥6 days was associated with cardiogenic shock[adjusted OR(aOR)21.2(1.98-227)].Time to diagnosis≥6 days had a sensitivity of 89% and a specificity of 77% in predicting cardiogenic shock;the addition of age>8 years and NT-proBNP at diagnosis≥11,254 ng/L increased the specificity to 91%.Independent determinants of short time to diagnosis were age<8.8 years[aHR 0.34(0.13-0.88)],short distance to tertiary care hospital[aHR 0.27(0.08-0.92)],and the late period of the COVID-19 pandemic[aHR 2.48(1.05-5.85)].Conclusions Time to diagnosis≥6 days was independently associated with cardiogenic shock in MIS-C.Early diagnosis and treatment are crucial to avoid the use of inotropes and limit morbidity,especially in older children. | Said Bichali Mathilde Bonnet Marie‑Emilie Lampin Jean‑Benoit Baudelet Heloise Reumaux Olivia Domanski Thameur Rakza Alexandre Delarue Morgan Recher Jerome Soquet Francois Dubos Stephane Leteurtre Ali Houeijeh Francois Godart | 2023 | World Journal of Pediatrics2023，19，6： | 0 |
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