Can Airway Abnormalities be the Elephant in the Room in Children with Congenital Heart Disease?
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ABSTRACT:
SUBMITTER: Parameswaran N
PROVIDER: S-EPMC7358868 | biostudies-literature | 2020 May
REPOSITORIES: biostudies-literature
Publications
Can Airway Abnormalities be the Elephant in the Room in Children with Congenital Heart Disease?
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine 20200501 5
<b>How to cite this article</b>: Parameswaran N. Can Airway Abnormalities be the Elephant in the Room in Children with Congenital Heart Disease? Indian J Crit Care Med 2020;24(5):289-290. ...[more]
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Project description:In the past 2 decades, it has become evident that individuals born with congenital heart disease (CHD) are at risk of developing life-long neurological deficits. Multifactorial risk factors contributing to neurodevelopmental abnormalities associated with CHD have been identified; however, the underlying causes remain largely unknown, and efforts to address this issue have only recently begun. There has been a dramatic shift in focus from newly acquired brain injuries associated with corrective and palliative heart surgery to antenatal and preoperative factors governing altered brain maturation in CHD. In this review, we describe key time windows of development during which the immature brain is vulnerable to injury. Special emphasis is placed on the dynamic nature of cellular events and how CHD may adversely impact the cellular units and networks necessary for proper cognitive and motor function. In addition, we describe current gaps in knowledge and offer perspectives about what can be done to improve our understanding of neurological deficits in CHD. Ultimately, a multidisciplinary approach will be essential to prevent or improve adverse neurodevelopmental outcomes in individuals surviving CHD.
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Project description:PurposeThe low salivary pH and buffering capacity are caused by using heart failure medications. For this reason oral health should be supported in cardiac patients, it is necessary that they attend dental clinics for regular follow up. The aim of this study is to evaluate the relationship between the salivary oxidative stress markers and salivary pH, salivary buffering capacity, salivary flow rate and dental caries of children with congenital heart disease (CHD).Materials and methodsThis cross sectional study was carried out with 42 CHD and 42 healthy children. The participants' gender, age, general health and medications, and caries scores (dfs/ DMFS) were written down, then their unstimulated saliva samples were collected. These specimens were evaluated in terms of the salivary secretion rate, salivary buffering capacity, pH, protein levels, superoxide dismutase (SOD), ferric reducing antioxidant power (FRAP), the thiobarbituric acid reactive substances (TBARS), protein carbonyl, protein thiols, total sialic acid.ResultsBoth groups showed caries at similar levels. The salivary pH and buffering capacity were significantly less in the children with CHD than in the controls. The levels of TBARS and protein carbonyl were significantly higher in the children with CHD than in the controls. There was not any significant difference relating to the mean salivary secretion rate, protein levels, SOD, FRAP, protein thiols and total sialic acid.ConclusionThe elevated TBARS and protein carbonyl levels in the patients with CHD were observed as an indicator of the free radical damage leading to oxidative stress.
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