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  1. Article ; Online: The Oximetric Approach to Clinical Care.

    Loomba, Rohit S

    Pediatric cardiology

    2023  Volume 44, Issue 4, Page(s) 960–961

    MeSH term(s) Humans ; Oximetry ; Oxygen
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2023-02-11
    Publishing country United States
    Document type Letter
    ZDB-ID 800857-7
    ISSN 1432-1971 ; 0172-0643
    ISSN (online) 1432-1971
    ISSN 0172-0643
    DOI 10.1007/s00246-023-03127-8
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  2. Article ; Online: When not all three-dimensional anatomic teaching resources are the same.

    Loomba, Rohit S / Anderson, Robert H

    Cardiology in the young

    2023  , Page(s) 1

    Language English
    Publishing date 2023-05-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 1078466-4
    ISSN 1467-1107 ; 1047-9511
    ISSN (online) 1467-1107
    ISSN 1047-9511
    DOI 10.1017/S1047951123001087
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  3. Article: Rates of depression, anxiety, and stress in parents of children with congenital heart disease using the Depression Anxiety Stress Scale.

    Lee, Brian K / Loomba, Rohit S

    Annals of pediatric cardiology

    2023  Volume 15, Issue 4, Page(s) 374–379

    Abstract: Context and background: The Cardiac Neurodevelopmental Outcome Collaborative has recommended using the Depression Anxiety Stress Scale (DASS) to evaluate for depression, anxiety, and stress in parents of children with congenital heart disease (CHD). ... ...

    Abstract Context and background: The Cardiac Neurodevelopmental Outcome Collaborative has recommended using the Depression Anxiety Stress Scale (DASS) to evaluate for depression, anxiety, and stress in parents of children with congenital heart disease (CHD). There has not been a longitudinal study investigating its utility in these parents.
    Aims: The aim of this study was to determine the trend of depression, anxiety, and stress in parents of patients with CHD.
    Methods: Our center uses this self-reported survey at every visit between 6 and 36 months of age. This was a single-centered, retrospective study from January 1, 2018, to June 1, 2020.
    Statistical analysis: Cox regression analysis was conducted using a composite end point of having an abnormal score in any of the three domains.
    Results: Two hundred and seventy-three mothers and 139 fathers were included in the study. For mothers, scores in each domain were elevated at 12 and 24 months. For fathers, scores in each domain were elevated at 6 months, followed by a decrease before peaking again, with depression increasing at 36 months and anxiety and stress increasing at 30 months. Increased length of stay for the index surgery was associated with an abnormal score for mothers (B = 0.02,
    Conclusions: Scores concerning for depression, anxiety, and stress peak at different points for parents. Length of stay for the index surgery and being in a relationship are important factors in the mental health of parents.
    Language English
    Publishing date 2023-01-06
    Publishing country India
    Document type Journal Article
    ZDB-ID 2430956-4
    ISSN 0974-5149 ; 0974-2069
    ISSN (online) 0974-5149
    ISSN 0974-2069
    DOI 10.4103/apc.apc_27_22
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  4. Article ; Online: Factors that mediate change in creatinine and acute kidney injury after the Norwood operation: insights from high-fidelity haemodynamic monitoring data.

    Loomba, Rohit S / Mansukhani, Sheena / Wong, Joshua

    Cardiology in the young

    2024  , Page(s) 1–8

    Abstract: Background: Acute kidney injury is a common postoperative complication of paediatric cardiac surgery associated with increased morbidity and mortality. The purpose of this study is to characterise associations between haemodynamic parameters, clinical ... ...

    Abstract Background: Acute kidney injury is a common postoperative complication of paediatric cardiac surgery associated with increased morbidity and mortality. The purpose of this study is to characterise associations between haemodynamic parameters, clinical parameters, and medical interventions, on acute kidney injury.
    Methods: Nine patients with univentricular physiology undergoing the Norwood procedure from a single-centre tertiary care paediatric cardiac ICU were included (September 2022 to March 2023). Patients were monitored with the T3 software. Data were analysed using a Fisher exact test, Mann-Whitney-
    Results: Over 27,000 datapoints were included. Acute kidney injury occurred in 2 patients (22%) during this period. Net fluid balance and renal oxygen extraction were independently associated with acute kidney injury, while commonly used metrics of pressure (systolic, diastolic, or mean arterial blood pressure) were not. The resulting acute kidney injury risk score was (4.1 × fluid balance) + (1.9 × renal oxygen extraction). The risk score was significantly higher in acute kidney injury with a score of 32.9 compared to 7.9 (
    Conclusion: Among patients with univentricular physiology undergoing the Norwood procedure, renal oxygen extraction and a higher net fluid balance are independently associated with increased risk of acute kidney injury. Renal perfusion pressure is not significantly associated with acute kidney injury.
    Language English
    Publishing date 2024-04-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 1078466-4
    ISSN 1467-1107 ; 1047-9511
    ISSN (online) 1467-1107
    ISSN 1047-9511
    DOI 10.1017/S1047951124000842
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  5. Article ; Online: Oximetry titrated care: This is the way.

    Loomba, Rohit S / Flores, Saul

    Paediatric anaesthesia

    2021  Volume 32, Issue 3, Page(s) 485

    MeSH term(s) Humans ; Oximetry
    Language English
    Publishing date 2021-12-05
    Publishing country France
    Document type Letter ; Comment
    ZDB-ID 1086049-6
    ISSN 1460-9592 ; 1155-5645
    ISSN (online) 1460-9592
    ISSN 1155-5645
    DOI 10.1111/pan.14350
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  6. Article ; Online: Hocus POCUS! Parental Quantification of Left-Ventricular Ejection Fraction Using Point of Care Ultrasound: Fiction or Reality?

    Jaji, Amina / Loomba, Rohit S

    Pediatric cardiology

    2022  

    Abstract: Point of care ultrasound has become increasingly utilized in pediatric settings. The assessment of cardiac function is one such implementation of this. This study aimed to determine the feasibility of parents in acquiring images to assess function using ... ...

    Abstract Point of care ultrasound has become increasingly utilized in pediatric settings. The assessment of cardiac function is one such implementation of this. This study aimed to determine the feasibility of parents in acquiring images to assess function using a handheld ultrasound probe and the correlation of fractional shortening measurements by handheld ultrasound with hospital acquired echocardiography. This was a single-center prospective study of parents of pediatric patients admitted to the hospital. Parents underwent a 25-min education session on how to use the handheld ultrasound probe and then were asked to acquire a parasternal short-axis and apical four-chamber image on their own. Acquired images were reviewed by two physicians to determine adequacy of images to assess systolic cardiac function subjectively and objectively. Fractional shortening was measured using parent-acquired images and then compared to recent hospital acquired fractional shortening. A total of 25 parents of 21 patients enrolled and completed the study. Of the enrolled parents, 96% of both parasternal short-axis and apical four-chamber images acquired were deemed appropriate for subjective assessment of systolic function. Inter-reader variability of fractional shortening was moderate between two readers. Correlation of fractional shortening measured from parent-acquired images versus hospital acquired images was moderate. Parents were able to successfully obtain a parasternal short-axis and apical four-chamber image adequate to assess function and quantify fractional shortening after a 25-min education session. This pilot data demonstrate that further exploration of parent-performed point of care cardiac assessment may be warranted.
    Language English
    Publishing date 2022-12-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800857-7
    ISSN 1432-1971 ; 0172-0643
    ISSN (online) 1432-1971
    ISSN 0172-0643
    DOI 10.1007/s00246-022-03090-w
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  7. Article ; Online: Reply: Emerging role of statin therapy in the prevention and management of cirrhosis, portal hypertension, and HCC.

    Sharpton, Suzanne / Loomba, Rohit

    Hepatology (Baltimore, Md.)

    2024  

    Language English
    Publishing date 2024-03-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604603-4
    ISSN 1527-3350 ; 0270-9139
    ISSN (online) 1527-3350
    ISSN 0270-9139
    DOI 10.1097/HEP.0000000000000848
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  8. Article ; Online: Haemodynamic and clinical variables after surgical systemic to pulmonary artery shunt placement versus arterial ductal stenting.

    Sheth, Saloni P / Loomba, Rohit S

    Cardiology in the young

    2022  Volume 33, Issue 10, Page(s) 2060–2065

    Abstract: Background: Transcatheter stenting of the arterial duct is an alternative to surgical systemic to pulmonary artery shunt in neonates with parallel circulation. The current study compares haemodynamic and laboratory values in these patients for the first ...

    Abstract Background: Transcatheter stenting of the arterial duct is an alternative to surgical systemic to pulmonary artery shunt in neonates with parallel circulation. The current study compares haemodynamic and laboratory values in these patients for the first 48 hours after either intervention.
    Methods: Neonates with ductal dependent pulmonary blood flow who underwent surgical shunt placement or catheter-based arterial ductal stent placement between January 2013 and January 2022 were identified. Haemodynamic variables included heart rate, blood pressure, near infrared spectroscopy, central venous pressure, vasoactive inotropic score, and arterial saturation. Laboratory variables collected included blood urea nitrogen, serum creatinine, and serum lactate. Variables were collected at baseline, upon post-procedural admission, 6 hours after admission, 12 hours after admission, and 48 hours after admission. Secondary outcomes included post-procedural mechanical ventilation duration, post-procedural hospital length of stay, need for reintervention, need for extracorporeal membrane oxygenation, cardiac arrest, and inpatient mortality.
    Results: Of the 52 patients included, 38 (73%) underwent shunt placement while 14 (27%) underwent a stent placement. Heart rates, renal oxygen extraction ratio, and cerebral oxygen extraction ratio were significantly lower in the stent group (p = <0.01, 0.01, and < 0.01, respectively).Haemoglobin and vasoactive inotropic scores were significantly lower in the stent group (p = <0.01, <0.01, respectively). The stent group had increased risk for cardiac arrest (p = 0.04).
    Conclusion: Patients who undergo arterial ductal stent placement have lower heart rates, haemoglobin, renal oxygen extraction ratio, cerebral oxygen extraction ratio, and vasoactive inotropic score in the first 48 hours post-procedure compared to patients with shunt placement.
    MeSH term(s) Infant, Newborn ; Humans ; Infant ; Pulmonary Artery/surgery ; Blalock-Taussig Procedure/adverse effects ; Treatment Outcome ; Stents ; Hemodynamics ; Retrospective Studies ; Oxygen ; Heart Arrest/etiology ; Hemoglobins ; Pulmonary Circulation ; Heart Defects, Congenital
    Chemical Substances Oxygen (S88TT14065) ; Hemoglobins
    Language English
    Publishing date 2022-12-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 1078466-4
    ISSN 1467-1107 ; 1047-9511
    ISSN (online) 1467-1107
    ISSN 1047-9511
    DOI 10.1017/S104795112200395X
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  9. Article ; Online: Reduced length of stay after implementation of a clinical pathway following repair of ventricular septal defect.

    Ogdon, Tracey L / Loomba, Rohit S / Penk, Jamie S

    Cardiology in the young

    2023  Volume 34, Issue 1, Page(s) 101–104

    Abstract: Background: There is variation in care and hospital length of stay following surgical repair of ventricular septal defects. The use of clinical pathways in a variety of paediatric care settings has been shown to reduce practice variability and overall ... ...

    Abstract Background: There is variation in care and hospital length of stay following surgical repair of ventricular septal defects. The use of clinical pathways in a variety of paediatric care settings has been shown to reduce practice variability and overall length of stay without increasing the rate of adverse events.
    Methods: A clinical pathway was created and used to guide care following surgical repair of ventricular septal defects. A retrospective review was done to compare patients two years prior and three years after the pathway was implemented.
    Results: There were 23 pre-pathway patients and 25 pathway patients. Demographic characteristics were similar between groups. Univariate analysis demonstrated a significantly shorter time to initiation of enteral intake in the pathway patients (median time to first enteral intake after cardiac ICU admission was 360 minutes in pre-pathway patients and 180 minutes in pathway patients, p < 0.01). Multivariate regression analyses demonstrated that the pathway use was independently associated with a decrease in time to first enteral intake (-203 minutes), hospital length of stay (-23.1 hours), and cardiac ICU length of stay (-20.5 hours). No adverse events were associated with the use of the pathway, including mortality, reintubation rate, acute kidney injury, increased bleeding from chest tube, or readmissions.
    Conclusions: The use of the clinical pathway improved time to initiation of enteral intake and decreased length of hospital stay. Surgery-specific pathways may decrease variability in care while also improving quality metrics.
    MeSH term(s) Child ; Humans ; Length of Stay ; Critical Pathways ; Heart Septal Defects, Ventricular/surgery ; Hospitalization ; Retrospective Studies
    Language English
    Publishing date 2023-05-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 1078466-4
    ISSN 1467-1107 ; 1047-9511
    ISSN (online) 1467-1107
    ISSN 1047-9511
    DOI 10.1017/S1047951123001245
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  10. Article: When Volume and Pressure Are Not Equal.

    Loomba, Rohit S / Flores, Saul / Bronicki, Ronald A

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2022  Volume 23, Issue 4, Page(s) 333–334

    MeSH term(s) Blood Pressure ; Humans
    Language English
    Publishing date 2022-04-07
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000002927
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